Provider Demographics
NPI:1164880100
Name:TOLENTINO, MEGHAN CATHLEEN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:CATHLEEN
Last Name:TOLENTINO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:CATHLEEN
Other - Last Name:GILDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:947 N HART ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6220
Mailing Address - Country:US
Mailing Address - Phone:562-243-8398
Mailing Address - Fax:
Practice Address - Street 1:947 N HART ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-6220
Practice Address - Country:US
Practice Address - Phone:562-243-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA721285163W00000X
CA95003712363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse