Provider Demographics
NPI:1346777695
Name:ANTIGUA, FRANCIS DANTE (NP)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:DANTE
Last Name:ANTIGUA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N COLLEGE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4614
Mailing Address - Country:US
Mailing Address - Phone:805-925-9581
Mailing Address - Fax:805-925-5625
Practice Address - Street 1:201 N COLLEGE DR STE 101
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4614
Practice Address - Country:US
Practice Address - Phone:805-925-9581
Practice Address - Fax:805-925-5625
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005411363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health