Provider Demographics
NPI:1437406667
Name:TACHIQUIN, MARIA GUADALUPE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:GUADALUPE
Last Name:TACHIQUIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:116 S PALISADE DR
Mailing Address - Street 2:104
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-8904
Mailing Address - Country:US
Mailing Address - Phone:805-739-8613
Mailing Address - Fax:805-739-8732
Practice Address - Street 1:116 S PALISADE DR
Practice Address - Street 2:104
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-8904
Practice Address - Country:US
Practice Address - Phone:805-739-8613
Practice Address - Fax:805-739-8732
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN377511163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory