Provider Demographics
NPI:1346864600
Name:AKIA, MARIA LUISA KITONGAN
Entity Type:Individual
Prefix:
First Name:MARIA LUISA
Middle Name:KITONGAN
Last Name:AKIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA LUISA
Other - Middle Name:PALANGEO
Other - Last Name:KITONGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6796 E AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1450
Mailing Address - Country:US
Mailing Address - Phone:559-908-6450
Mailing Address - Fax:
Practice Address - Street 1:2615 E CLINTON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-2223
Practice Address - Country:US
Practice Address - Phone:559-225-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA747117163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine