Provider Demographics
NPI:1275240889
Name:LOMBERA, KAITLYN SABRINA
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:SABRINA
Last Name:LOMBERA
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 1:3605 LONG BEACH BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4026
Mailing Address - Country:US
Mailing Address - Phone:310-535-1500
Mailing Address - Fax:
Practice Address - Street 1:3605 LONG BEACH BLVD STE 410
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4026
Practice Address - Country:US
Practice Address - Phone:310-535-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker