Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 432283 | CA |
NPI | 1598731788 |
---|---|
Provider Name | Dolores Aguilar |
First Address | San Jose, CA 95128-2604 |
Second Address | San Jose, CA 95128-2604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 10/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q29351 | (02) | CA |
RN432283 | (05) | CA |