Provider Demographics
NPI:1043846256
Name:GITAU, LUCY
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:GITAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 OAKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-8070
Mailing Address - Country:US
Mailing Address - Phone:714-757-2959
Mailing Address - Fax:
Practice Address - Street 1:336 OAKWOOD CT
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-8070
Practice Address - Country:US
Practice Address - Phone:714-757-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA816811163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health