Liezel Adolfo

Individual provider Active NPI Nurse Practitioner · Baldwin Park, CA

NPI 1992597017 · NPPES record last updated May 22, 2025

Key facts

NPI
1992597017
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
95025104 (CA)
Practice address
13820 Earl Ave
Baldwin Park, CA 91706-4911
Phone
(626) 384-8678
NPI assigned
May 22, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
95025104CAMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95025104 CA Yes

Addresses

Primary practice location

13820 Earl Ave
Baldwin Park, CA 91706-4911

Mailing address

13820 Earl Ave
Baldwin Park, CA 91706-4911
Phone (626) 384-8678

Other providers in Baldwin Park, CA

All providers in Baldwin Park, CA · Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.