Provider Demographics
NPI:1376922013
Name:CALAGUI, LANI
Entity Type:Individual
Prefix:
First Name:LANI
Middle Name:
Last Name:CALAGUI
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 1:9069 NEW CLASSIC CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1220
Mailing Address - Country:US
Mailing Address - Phone:916-770-6403
Mailing Address - Fax:
Practice Address - Street 1:8510 STONEFLOWER WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4517
Practice Address - Country:US
Practice Address - Phone:916-770-6403
Practice Address - Fax:916-897-9459
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347005043310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility