Ma Lizza Laroza Mailom, Nurse Practitioner
Nurse Practitioner, Family in Brea, CA. Individual provider (NPI-1).
NPI number1942015409
StatusActive
Last updated in NPPESFeb 11, 2025
Details
- NPI
- 1942015409
- Entity type
- Individual (NPI-1)
- Name
- Ma Lizza Laroza Mailom
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 11, 2025
- Certification date
- Feb 11, 2025
- Last updated
- Feb 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 95029127 | CA | Yes |
Practice location
470 Buttonwood DrBrea, CA 92821-3522
Phone 714-388-8516
Mailing address
470 Buttonwood DrBrea, CA 92821-3522
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