Provider Demographics
NPI:1407989205
Name:NAVEA, LOURDES BRAVO (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:BRAVO
Last Name:NAVEA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7501 HOSPITAL DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5405
Mailing Address - Country:US
Mailing Address - Phone:916-681-1130
Mailing Address - Fax:916-681-1133
Practice Address - Street 1:7501 HOSPITAL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5405
Practice Address - Country:US
Practice Address - Phone:916-681-1130
Practice Address - Fax:916-681-1133
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA13060208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics