Provider Demographics
NPI:1053768705
Name:MACIAS, LILIA GUERRA (LVN)
Entity type:Individual
Prefix:
First Name:LILIA
Middle Name:GUERRA
Last Name:MACIAS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 KEENAN CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-9614
Mailing Address - Country:US
Mailing Address - Phone:805-260-6493
Mailing Address - Fax:
Practice Address - Street 1:623 KEENAN CT
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-9614
Practice Address - Country:US
Practice Address - Phone:805-260-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA274491164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse