Active NPI
Illimani Lesbia Fregozo, RDH
- Dental Hygienist
- Pleasant Hill, CA
National Provider Identifier
1003117631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 25607
- Practice address
- 2100 Monument Blvd
Pleasant Hill, CA 94523-3489 - Phone
- (925) 363-1256
- NPI assigned
- Nov 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 25607 | CA | Primary |
Addresses
Primary practice location
2100 Monument Blvd
Pleasant Hill, CA 94523-3489
Mailing address
1906 Helen Rd
Pleasant Hill, CA 94523-2712
Phone (650) 773-9043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25607 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289520000000",
"number": "1003117631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1906 HELEN RD",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945232712",
"telephone_number": "650-773-9043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 MONUMENT BLVD",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945233489",
"telephone_number": "925-363-1256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREGOZO",
"first_name": "ILLIMANI",
"middle_name": "LESBIA",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-12",
"last_updated": "2010-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "25607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Hill, CA
- Francis Badu Essien PC
- Janet Ellen Frankhouser
- Michelle Frankland, M.S.N., N.P.
- Brandon Scott Frazier, MSC.
- Fred Finch Youth Center
- Fresenius Medical Care Diablo Nephrology Clinics, LLC (Fresenius Medical Care - Diablo Concord)
- Barbara T. Frey, LMFT
- Justin James Frieders, D.C.
- Lance Friis
- Carey Fritz, LMFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.