Provider Demographics
NPI:1619219730
Name:DO, CLAIRE ANDREY LEZADA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE ANDREY
Middle Name:LEZADA
Last Name:DO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 W WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90810-3116
Mailing Address - Country:US
Mailing Address - Phone:562-492-6698
Mailing Address - Fax:
Practice Address - Street 1:1339 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90810-3116
Practice Address - Country:US
Practice Address - Phone:562-492-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily