Provider Demographics
NPI:1144731134
Name:BAUZON, VERNICE MARIE AQUINO (NP)
Entity type:Individual
Prefix:
First Name:VERNICE MARIE
Middle Name:AQUINO
Last Name:BAUZON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S ANAHEIM HILLS RD
Mailing Address - Street 2:STE 206
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4759
Mailing Address - Country:US
Mailing Address - Phone:951-907-6198
Mailing Address - Fax:
Practice Address - Street 1:500 S ANAHEIM HILLS RD STE 206
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4759
Practice Address - Country:US
Practice Address - Phone:714-282-6934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily