Provider Demographics
NPI:1508033986
Name:FLORENDO, FREDERICK ROBERT AGUINALDO
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:ROBERT AGUINALDO
Last Name:FLORENDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ERICK
Other - Middle Name:ROBERT AGUINALDO
Other - Last Name:FLORENDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:505 SANTA CLARA ST
Mailing Address - Street 2:3RD FL
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5922
Mailing Address - Country:US
Mailing Address - Phone:707-648-5230
Mailing Address - Fax:707-648-5212
Practice Address - Street 1:505 SANTA CLARA ST
Practice Address - Street 2:3RD FL
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5922
Practice Address - Country:US
Practice Address - Phone:707-648-5230
Practice Address - Fax:707-648-5212
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator