Lifeshades of Nursing Professional Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LIFESHADES OF NURSING PROFESSIONAL CORPORATION

Practice address

2305 Historic Decatur Rd Ste 186
San Diego, CA 92106-6071

Phone

(818) 641-4250

NPI assigned

Mar 20, 2023

Last updated

Mar 20, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rayna CvetkovaNPI 1093288102

Title

Owner

Phone

(818) 641-4250

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rayna Cvetkova

  • Acute Care Nurse Practitioner
  • Studio City, CA
  • NPI 1093288102
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1235831611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 HISTORIC DECATUR RD STE 186",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 HISTORIC DECATUR RD STE 186",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066071",
            "telephone_number": "818-641-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESHADES OF NURSING PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "CVETKOVA",
        "authorized_official_first_name": "RAYNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-641-4250"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifeline Transportation LLC (LifeLine Transportation)
• Lifemark Marriage & Family Therapy Corporation (Lifemark Behavioral Health)
• Lifemark Solutions LLC
• Lifeologie San Diego
• Lifepath Therapy
• Lifespan Physiotherapy Staffing, Inc (Lifespan Physical Therapy Services)
• Lifespring Center
• Lifewest Southern California
• Eugenia Liff, FNP
• Adijat Omobolanle Ligali

• Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.