Provider Demographics
NPI:1861211856
Name:PACHECO, DELMY CAROLINA (FNP)
Entity type:Individual
Prefix:MRS
First Name:DELMY
Middle Name:CAROLINA
Last Name:PACHECO
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 1:29285 FIRST GRN
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4376
Mailing Address - Country:US
Mailing Address - Phone:760-486-0654
Mailing Address - Fax:
Practice Address - Street 1:29285 FIRST GRN
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4376
Practice Address - Country:US
Practice Address - Phone:760-486-0654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95029287363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty