Provider Demographics
NPI:1609435940
Name:LUGATIMAN, DIVA CHRISTY (FNP-BC)
Entity type:Individual
Prefix:MISS
First Name:DIVA CHRISTY
Middle Name:
Last Name:LUGATIMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 S EMPIRE ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-2430
Mailing Address - Country:US
Mailing Address - Phone:714-309-3403
Mailing Address - Fax:
Practice Address - Street 1:1800 VINE ST STE 221
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-5250
Practice Address - Country:US
Practice Address - Phone:213-943-2490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA757605163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse