Organization
LIFESHADES OF NURSING PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYNA CVETKOVA (OWNER)
(818) 641-4250
Entity
Organization
Contact information
Practice address
2305 HISTORIC DECATUR RD STE 186, SAN DIEGO, CA 92106-6071
(818) 641-4250
Mailing address
2305 HISTORIC DECATUR RD STE 186, SAN DIEGO, CA 92106-6071
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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