Provider Demographics
NPI:1194351015
Name:ROSALUNA, LAWRENCE (RN)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:ROSALUNA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5645 HARVEST RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5404
Mailing Address - Country:US
Mailing Address - Phone:916-765-2542
Mailing Address - Fax:
Practice Address - Street 1:5645 HARVEST RD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5404
Practice Address - Country:US
Practice Address - Phone:916-765-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95214654163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse