Provider Demographics
NPI:1538465265
Name:MATHIS-PASCUA, DAGMAR J
Entity type:Individual
Prefix:
First Name:DAGMAR
Middle Name:J
Last Name:MATHIS-PASCUA
Suffix:
Gender:
Credentials:
Other - Prefix:MRS
Other - First Name:DAGMAR
Other - Middle Name:J
Other - Last Name:MATHIS-PASCUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1900 ROYALTY DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3032
Mailing Address - Country:US
Mailing Address - Phone:909-623-6131
Mailing Address - Fax:909-865-0730
Practice Address - Street 1:2008 N GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2722
Practice Address - Country:US
Practice Address - Phone:909-623-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172V00000XOther Service ProvidersCommunity Health Worker