Provider Demographics
NPI:1518683390
Name:LAMBA, DYMPHNYA SHIYAYO (LICENSED CARE HOME)
Entity Type:Individual
Prefix:MRS
First Name:DYMPHNYA
Middle Name:SHIYAYO
Last Name:LAMBA
Suffix:
Gender:F
Credentials:LICENSED CARE HOME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9532 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-1402
Mailing Address - Country:US
Mailing Address - Phone:520-546-1134
Mailing Address - Fax:
Practice Address - Street 1:9532 E 42ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1402
Practice Address - Country:US
Practice Address - Phone:520-546-1134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9606H3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider