Provider Demographics
NPI:1174035885
Name:ABAS, ARCELYN VILLANUEVA (NP)
Entity Type:Individual
Prefix:MRS
First Name:ARCELYN
Middle Name:VILLANUEVA
Last Name:ABAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13633 AVION DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-3701
Mailing Address - Country:US
Mailing Address - Phone:213-509-8348
Mailing Address - Fax:
Practice Address - Street 1:13633 AVION DR
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-3701
Practice Address - Country:US
Practice Address - Phone:213-509-8348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA747434OtherREGISTERED NURSE