Provider Demographics
NPI:1700551231
Name:VILLALUZ, ERICA LEANNE KABIGTING (RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LEANNE KABIGTING
Last Name:VILLALUZ
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:LEANNE
Other - Last Name:KABIGTING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 1ST ST APT C115
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6626
Mailing Address - Country:US
Mailing Address - Phone:714-350-7849
Mailing Address - Fax:
Practice Address - Street 1:8850 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-3562
Practice Address - Country:US
Practice Address - Phone:714-827-7321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily