Provider Demographics
NPI:1528402880
Name:POMPILIO, ERSILIA (PNP)
Entity Type:Individual
Prefix:
First Name:ERSILIA
Middle Name:
Last Name:POMPILIO
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 N SAN FERNANDO BLVD APT 43
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4128
Mailing Address - Country:US
Mailing Address - Phone:949-702-4140
Mailing Address - Fax:
Practice Address - Street 1:1620 N SAN FERNANDO BLVD APT 43
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4128
Practice Address - Country:US
Practice Address - Phone:949-702-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530316163W00000X
CA16066163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse