Provider Demographics
NPI:1497210512
Name:MARASIGAN, MARIA ANGELICA GABRIEL (FNP)
Entity Type:Individual
Prefix:
First Name:MARIA ANGELICA
Middle Name:GABRIEL
Last Name:MARASIGAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23429 VIA GAYO
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3047
Mailing Address - Country:US
Mailing Address - Phone:661-481-9610
Mailing Address - Fax:
Practice Address - Street 1:1680 S GARFIELD AVE STE 204
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5413
Practice Address - Country:US
Practice Address - Phone:818-839-5200
Practice Address - Fax:818-839-5200
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-02
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95010929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty