Provider Demographics
NPI:1609359892
Name:RAZGUNAS, VICTORIA SILIBAZISO (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:SILIBAZISO
Last Name:RAZGUNAS
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:WEIMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95736-0486
Mailing Address - Country:US
Mailing Address - Phone:530-637-4025
Mailing Address - Fax:
Practice Address - Street 1:14780 W MOUNTAIN VIEW BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7280
Practice Address - Country:US
Practice Address - Phone:623-374-7774
Practice Address - Fax:855-420-6361
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95009987OtherFNP-BC