Milissa Ann Defazio, RN

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

95043893 Issued in CA

Practice address

1238 Beaver Way
La Verne, CA 91750-2520

Phone

(626) 227-3172

NPI assigned

Nov 1, 2024

Last updated

Nov 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Milissa Ann Duggan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1477376283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 BEAVER WAY",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502520",
            "telephone_number": "626-227-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 BEAVER WAY",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502520",
            "telephone_number": "626-227-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "MILISSA",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95043893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILISSA",
            "last_name": "DUGGAN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Priscilla Davis, CMT
• Janette De la Sota
• Isabel De la Torre
• Erica Catherine De Leon
• Michael Deanda, MD
• Sarah Danielle Degbeh
• Joanna Delarosa
• Adolph Thomas Delgado, MFTI
• Demian Choi DDS, Inc (Prizm Dental)
• Dental Care of la Verne

• Critical Care Medicine Registered Nurse in La Verne, CA
• Providers in La Verne, CA by specialty
• Critical Care Medicine Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.