Provider Demographics
NPI:1588829956
Name:ZEPEDA, CONSUELO (NP)
Entity Type:Individual
Prefix:
First Name:CONSUELO
Middle Name:
Last Name:ZEPEDA
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 1:14350 WHITTIER BLVD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2138
Mailing Address - Country:US
Mailing Address - Phone:562-945-3050
Mailing Address - Fax:562-698-5120
Practice Address - Street 1:14350 WHITTIER BLVD
Practice Address - Street 2:SUITE 325
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2138
Practice Address - Country:US
Practice Address - Phone:562-945-3050
Practice Address - Fax:562-698-5120
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA12334363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology