Provider Demographics
NPI:1144526690
Name:MOLINA, LUCRECIA S (FNP)
Entity type:Individual
Prefix:
First Name:LUCRECIA
Middle Name:S
Last Name:MOLINA
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 1:11403 MERCATELLO AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6410
Mailing Address - Country:US
Mailing Address - Phone:661-587-3622
Mailing Address - Fax:661-327-7633
Practice Address - Street 1:3737 SAN DIMAS ST STE 101
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5733
Practice Address - Country:US
Practice Address - Phone:661-327-5037
Practice Address - Fax:661-327-7633
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP20283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily