Provider Demographics
NPI:1508583378
Name:AGUAYO, CHRISTINE MILAGROS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MILAGROS
Last Name:AGUAYO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MILAGROS
Other - Last Name:MENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:811 W DURNESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-4930
Mailing Address - Country:US
Mailing Address - Phone:626-617-4084
Mailing Address - Fax:
Practice Address - Street 1:811 W DURNESS ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-4930
Practice Address - Country:US
Practice Address - Phone:626-617-4084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily