Provider Demographics
NPI:1861274094
Name:OLLADA ALIPIO, MICHELLE PATRICIA (RN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:PATRICIA
Last Name:OLLADA ALIPIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EASTMONT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3345
Mailing Address - Country:US
Mailing Address - Phone:949-478-5598
Mailing Address - Fax:
Practice Address - Street 1:1347 SUN DIAL DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1723
Practice Address - Country:US
Practice Address - Phone:949-478-5598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA689973163WS0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool