Provider Demographics
NPI:1861258782
Name:ALBISO, CASSANDRA JEAN (MSN, CNM, WHNP, RN)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JEAN
Last Name:ALBISO
Suffix:
Gender:F
Credentials:MSN, CNM, WHNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W STEWART DR STE 307
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3838
Mailing Address - Country:US
Mailing Address - Phone:714-633-0886
Mailing Address - Fax:
Practice Address - Street 1:1310 W STEWART DR STE 307
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3838
Practice Address - Country:US
Practice Address - Phone:714-633-0886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027436363LW0102X
CA236412176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health