Provider Demographics
NPI:1083865042
Name:ABEJAR, EILEEN CARIDAD (PNP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:CARIDAD
Last Name:ABEJAR
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SOUTH MAIN STREET, PULMONARY / RSV CLINIC
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF ORANGE COUNTY
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-532-8709
Mailing Address - Fax:714-289-4072
Practice Address - Street 1:455 S MAIN ST
Practice Address - Street 2:PULMONARY/RSV CLINIC
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3835
Practice Address - Country:US
Practice Address - Phone:714-532-8709
Practice Address - Fax:714-289-4072
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA362991163W00000X
CA17310363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse