Provider Demographics
NPI:1457442089
Name:BUSELLI, ELIZABETH FLORENTINO (NP)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:FLORENTINO
Last Name:BUSELLI
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:4165 BLACKHAWK PLAZA CIR
Mailing Address - Street 2:#250
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-4904
Mailing Address - Country:US
Mailing Address - Phone:925-736-8510
Mailing Address - Fax:925-736-2491
Practice Address - Street 1:4165 BLACKHAWK PLAZA CIR
Practice Address - Street 2:#250
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4904
Practice Address - Country:US
Practice Address - Phone:925-736-8510
Practice Address - Fax:925-736-2491
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA478730363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12809OtherNURSE PRACTIONER