Provider Demographics
NPI:1235276940
Name:VELIZ, AURA (RNP)
Entity Type:Individual
Prefix:
First Name:AURA
Middle Name:
Last Name:VELIZ
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N MACLAY AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-2455
Mailing Address - Country:US
Mailing Address - Phone:661-948-7376
Mailing Address - Fax:818-361-7309
Practice Address - Street 1:405 N MACLAY AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-2445
Practice Address - Country:US
Practice Address - Phone:818-361-3318
Practice Address - Fax:818-361-7309
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN524735363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP 13194OtherNP LICENSE NUMBER
CARN524735Medicaid