Provider Demographics
NPI:1275707085
Name:CONSTANTINO, MA.VICTORIA OMAS (RN)
Entity Type:Individual
Prefix:MS
First Name:MA.VICTORIA
Middle Name:OMAS
Last Name:CONSTANTINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8546 ALISSA WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4528
Mailing Address - Country:US
Mailing Address - Phone:916-541-8190
Mailing Address - Fax:
Practice Address - Street 1:8546 ALISSA WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4528
Practice Address - Country:US
Practice Address - Phone:916-541-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532632163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse