Provider Demographics
NPI:1053097816
Name:VELASCO, LUZ PILIPINAS TORRES
Entity type:Individual
Prefix:
First Name:LUZ PILIPINAS
Middle Name:TORRES
Last Name:VELASCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 BELLERIVE DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5712
Mailing Address - Country:US
Mailing Address - Phone:760-715-0529
Mailing Address - Fax:
Practice Address - Street 1:138 BELLERIVE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5712
Practice Address - Country:US
Practice Address - Phone:760-715-0529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374601445376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator