Provider Demographics
NPI:1679399901
Name:ESPINOZA, LEA ANN SIBUG (FNP-C)
Entity type:Individual
Prefix:
First Name:LEA ANN
Middle Name:SIBUG
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5494
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91117-0494
Mailing Address - Country:US
Mailing Address - Phone:661-886-3058
Mailing Address - Fax:
Practice Address - Street 1:11938 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2306
Practice Address - Country:US
Practice Address - Phone:562-923-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily