Individual
MS. SOPHIA MARIE LUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 843-5111
Mailing address
1267 STONER AVE APT 102, LOS ANGELES, CA 90025-1679
(805) 551-4994
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95031078
CA
363LG0600X
Gerontology Nurse Practitioner
95031078
CA
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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