Provider Demographics
NPI:1306536685
Name:LLBC MEDICAL SOLUTIONS INC.
Entity type:Organization
Organization Name:LLBC MEDICAL SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURICE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAYCRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:909-275-4798
Mailing Address - Street 1:3281 E GUASTI RD STE 700
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7643
Mailing Address - Country:US
Mailing Address - Phone:909-275-4798
Mailing Address - Fax:909-275-3940
Practice Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1356
Practice Address - Country:US
Practice Address - Phone:909-275-4798
Practice Address - Fax:909-667-8150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty