Provider Demographics
NPI:1508590324
Name:RESURRECCION, LIGAYA MACAYAON (FNP)
Entity Type:Individual
Prefix:
First Name:LIGAYA
Middle Name:MACAYAON
Last Name:RESURRECCION
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LIGAYA
Other - Middle Name:LIBANAN
Other - Last Name:MACAYAON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4036 GRAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5487
Mailing Address - Country:US
Mailing Address - Phone:909-465-5000
Mailing Address - Fax:
Practice Address - Street 1:4036 GRAND AVE STE A
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5487
Practice Address - Country:US
Practice Address - Phone:909-465-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021396363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily