| Daisy Briseno, FNP | |
|
2415 W Vine St, Suite 106, Lodi, CA 95242-3731 | |
| (209) 333-3066 | |
| (209) 333-3065 |
| Full Name | Daisy Briseno |
|---|---|
| Gender | Female |
| Speciality | Registered Nurse |
| Location | 2415 W Vine St, Lodi, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891151023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 810710 (California) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 95003972 (California) | Secondary |
| Entity Name | Team Physicians Of California Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447288345 PECOS PAC ID: 8224945084 Enrollment ID: O20040920000880 |
| Entity Name | Lodi Memorial Hospital Association Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861649352 PECOS PAC ID: 7618880717 Enrollment ID: O20050517000577 |
| Entity Name | Clinic Services Of California Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578958450 PECOS PAC ID: 7810209715 Enrollment ID: O20150707001394 |
| Mailing Address | Practice Location Address |
|---|---|
| Daisy Briseno, FNP Po Box 241011, Lodi, CA 95241-9511 Ph: (209) 339-7435 | Daisy Briseno, FNP 2415 W Vine St, Suite 106, Lodi, CA 95242-3731 Ph: (209) 333-3066 |
Nathaniel Rabang Rafanan, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1912 Lakeshore Dr, Lodi, CA 95242 Phone: 209-612-6373 | |
Milly A Pekke, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1981 Yorktown Dr, Lodi, CA 95242 Phone: 530-554-3146 | |
Helen Pascua, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 975 S Fairmont Ave, Lodi, CA 95240 Phone: 209-339-7537 | |
Tammy D Moijueh, NP Registered Nurse Medicare: Medicare Enrolled Practice Location: 2401 W Turner Rd Ste 450, Lodi, CA 95242 Phone: 925-690-7031 | |
Rafaqat Sultana Mian, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 12744 N Jack Tone Rd, Lodi, CA 95240 Phone: 550-681-0418 | |
Laurel Anne Synowicki, RN, IBCLC Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 975 S Fairmont Ave, Lodi, CA 95240 Phone: 209-339-7873 Fax: 209-334-1908 | |
Karen E Sorensen, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1046 Laurel Ave, Lodi, CA 95242 Phone: 209-369-3994 |