Provider Demographics
NPI:1497343578
Name:BULAGAO, MA. KATRINA SOLAMILLO (RN)
Entity Type:Individual
Prefix:
First Name:MA. KATRINA
Middle Name:SOLAMILLO
Last Name:BULAGAO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-5907
Mailing Address - Country:US
Mailing Address - Phone:626-905-1894
Mailing Address - Fax:
Practice Address - Street 1:849 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-5907
Practice Address - Country:US
Practice Address - Phone:626-905-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA163WH0200X163WC1500X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health