Provider Demographics
NPI:1902239668
Name:ACEVEDO, ANGELICA MARIA (FNP)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:MARIA
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:PARLIER
Mailing Address - State:CA
Mailing Address - Zip Code:93648-0790
Mailing Address - Country:US
Mailing Address - Phone:559-646-3561
Mailing Address - Fax:559-646-3642
Practice Address - Street 1:650 S ZEDIKER AVE
Practice Address - Street 2:BUILDING 2
Practice Address - City:PARLIER
Practice Address - State:CA
Practice Address - Zip Code:93648-2666
Practice Address - Country:US
Practice Address - Phone:559-646-3561
Practice Address - Fax:559-646-3642
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22171363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care