Provider Demographics
NPI:1477141711
Name:MALANA, RIZA LAJARA (MSN, FNP- BC, FNP- C)
Entity Type:Individual
Prefix:
First Name:RIZA
Middle Name:LAJARA
Last Name:MALANA
Suffix:
Gender:F
Credentials:MSN, FNP- BC, FNP- C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 CALLE TECATE
Mailing Address - Street 2:SUITE # 115
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5285
Mailing Address - Country:US
Mailing Address - Phone:805-485-2400
Mailing Address - Fax:805-233-3025
Practice Address - Street 1:2438 N PONDEROSA DR STE C101
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-2465
Practice Address - Country:US
Practice Address - Phone:805-383-9727
Practice Address - Fax:805-764-0176
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016284363LP2300X
CANP95016284363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily