Provider Demographics
NPI:1902632144
Name:COBAS LAMBERT, KATIUSKA
Entity type:Individual
Prefix:
First Name:KATIUSKA
Middle Name:
Last Name:COBAS LAMBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11235 N 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4146
Mailing Address - Country:US
Mailing Address - Phone:602-783-7888
Mailing Address - Fax:
Practice Address - Street 1:7025 N SCOTTSDALE RD STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-3675
Practice Address - Country:US
Practice Address - Phone:602-385-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ255765207Q00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine