Provider Demographics
NPI: | 1043684095 |
---|---|
Name: | AQUINO, MA CINDY DE LOS SANTOS (LVN) |
Entity type: | Individual |
Prefix: | |
First Name: | MA CINDY |
Middle Name: | DE LOS SANTOS |
Last Name: | AQUINO |
Suffix: | |
Gender: | F |
Credentials: | LVN |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 18225 HALE AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | MORGAN HILL |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95037-3547 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 408-465-8280 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 215 HUERTA AVE |
Practice Address - Street 2: | |
Practice Address - City: | GREENFIELD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93927-5762 |
Practice Address - Country: | US |
Practice Address - Phone: | 831-674-2180 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2015-11-13 |
Last Update Date: | 2025-04-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
171M00000X, 172V00000X | ||
CA | 291024 | 373H00000X, 164X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 164X00000X | Nursing Service Providers | Licensed Vocational Nurse | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
No | 172V00000X | Other Service Providers | Community Health Worker | |
No | 373H00000X | Nursing Service Related Providers | Day Training/Habilitation Specialist |