Provider Demographics
NPI:1376532531
Name:RONQUILLO, FLORENTINA MAGAT (APRN-BC, WHCNP, MSN)
Entity Type:Individual
Prefix:
First Name:FLORENTINA
Middle Name:MAGAT
Last Name:RONQUILLO
Suffix:
Gender:F
Credentials:APRN-BC, WHCNP, MSN
Other - Prefix:
Other - First Name:FLORENTINA
Other - Middle Name:ESTRELLA
Other - Last Name:MAGAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1910 CUSTOMER CARE WAY
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-5167
Mailing Address - Country:US
Mailing Address - Phone:209-384-6488
Mailing Address - Fax:
Practice Address - Street 1:1500 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4408
Practice Address - Country:US
Practice Address - Phone:209-574-1365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 399867 NPF 8989363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health