Provider Demographics
NPI:1053470989
Name:LAZE, ADRIANA (RN)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:LAZE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 ARMLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-1905
Mailing Address - Country:US
Mailing Address - Phone:562-696-1593
Mailing Address - Fax:
Practice Address - Street 1:301 W BASTANCHURY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3419
Practice Address - Country:US
Practice Address - Phone:714-879-9936
Practice Address - Fax:714-879-3035
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA606774163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse