Provider Demographics
NPI:1811686991
Name:LIGHT CARE NURSING CORPORATION
Entity type:Organization
Organization Name:LIGHT CARE NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:CHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGULANNA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:951-441-9846
Mailing Address - Street 1:4944 E CLINTON WAY STE 107
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1527
Mailing Address - Country:US
Mailing Address - Phone:951-801-2819
Mailing Address - Fax:951-269-4064
Practice Address - Street 1:4944 E CLINTON WAY STE 107
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1527
Practice Address - Country:US
Practice Address - Phone:951-801-2819
Practice Address - Fax:951-269-4064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty