Provider Demographics
NPI:1073190443
Name:GARCIANO, MARIA ANGELA (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANGELA
Last Name:GARCIANO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:GARCIANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-BC
Mailing Address - Street 1:1703 TERMINO AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2126
Mailing Address - Country:US
Mailing Address - Phone:714-928-4480
Mailing Address - Fax:
Practice Address - Street 1:1703 TERMINO AVE STE 108
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2126
Practice Address - Country:US
Practice Address - Phone:714-928-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016950363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily