Basic Information
| Provider Information | |||||||||
| NPI: | 1477141711 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALANA | ||||||||
| FirstName: | RIZA | ||||||||
| MiddleName: | LAJARA | ||||||||
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| Credential: | MSN, FNP- BC, FNP- C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 CALLE TECATE | ||||||||
| Address2: | SUITE # 115 | ||||||||
| City: | CAMARILLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930125285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054852400 | ||||||||
| FaxNumber: | 8052333025 | ||||||||
| Practice Location | |||||||||
| Address1: | 2438 N PONDEROSA DR STE C101 | ||||||||
| Address2: | |||||||||
| City: | CAMARILLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930102465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053839727 | ||||||||
| FaxNumber: | 8057640176 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2021 | ||||||||
| LastUpdateDate: | 07/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 95016284 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 363LF0000X | NP95016284 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.