Provider Demographics
NPI:1285656165
Name:TAPIA, MIRIAM LAURA (RN, PHN, NP-C, MSN)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:LAURA
Last Name:TAPIA
Suffix:
Gender:F
Credentials:RN, PHN, NP-C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Mailing Address - Street 1:7777 SOUTH FREEDOM RD
Mailing Address - Street 2:
Mailing Address - City:FRENCH CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95231
Mailing Address - Country:US
Mailing Address - Phone:209-946-3400
Mailing Address - Fax:209-946-3459
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:209-946-3400
Practice Address - Fax:209-946-3459
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA503570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily