Provider Demographics
NPI:1548437932
Name:VITOCRUZ, MA. MERCEDES MANALASTAS (BS, RN,WHNP)
Entity type:Individual
Prefix:
First Name:MA. MERCEDES
Middle Name:MANALASTAS
Last Name:VITOCRUZ
Suffix:
Gender:F
Credentials:BS, RN,WHNP
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Mailing Address - Street 1:23318 MARIGOLD AVE UNIT Q-203
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2769
Mailing Address - Country:US
Mailing Address - Phone:310-222-1289
Mailing Address - Fax:310-222-8822
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA17045363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology