Provider Demographics
NPI:1346752920
Name:GIAFFOGLIONE, ANTONIA (SCHOOL NURSE CREDEN)
Entity Type:Individual
Prefix:MRS
First Name:ANTONIA
Middle Name:
Last Name:GIAFFOGLIONE
Suffix:
Gender:F
Credentials:SCHOOL NURSE CREDEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SAN ANGELO AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91746-1842
Mailing Address - Country:US
Mailing Address - Phone:626-483-3293
Mailing Address - Fax:
Practice Address - Street 1:2410 BROADWAY
Practice Address - Street 2:
Practice Address - City:WALNUT PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6342
Practice Address - Country:US
Practice Address - Phone:323-923-0383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255730163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool