Provider Demographics
NPI:1053738252
Name:SALAZAR, LILIBETH (NP)
Entity type:Individual
Prefix:
First Name:LILIBETH
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11526 213TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-2012
Mailing Address - Country:US
Mailing Address - Phone:562-760-7744
Mailing Address - Fax:
Practice Address - Street 1:3300 E SOUTH ST STE 206
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90805-4590
Practice Address - Country:US
Practice Address - Phone:562-232-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily