Individual provider Active NPI

Lorraine Gay Dizon Liwag

  • Family Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1760112916
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020655 Issued in CA
Practice address
1717 Scott Rd Apt H
Burbank, CA 91504-3875
Phone
(818) 966-7260
NPI assigned
Jun 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95020655 CA Primary

Addresses

Primary practice location

1717 Scott Rd Apt H
Burbank, CA 91504-3875

Mailing address

1717 Scott Rd Apt H
Burbank, CA 91504-3875
Phone (818) 966-7260

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

LicenseStateTypeSpecialty
95020655CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1760112916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SCOTT RD APT H",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915043875",
            "telephone_number": "818-966-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SCOTT RD APT H",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915043875",
            "telephone_number": "818-966-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIWAG",
        "first_name": "LORRAINE GAY",
        "middle_name": "DIZON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.