Provider Demographics
NPI:1578187571
Name:STOYKOVICH, ARACELI AMANO (NP)
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:AMANO
Last Name:STOYKOVICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5040
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-0040
Mailing Address - Country:US
Mailing Address - Phone:530-712-2171
Mailing Address - Fax:530-712-2149
Practice Address - Street 1:2450 ORO DAM BLVD E
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6052
Practice Address - Country:US
Practice Address - Phone:530-712-2171
Practice Address - Fax:530-712-2149
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95082806163W00000X
CA95016269363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse