Provider Demographics
NPI:1598956815
Name:TAGUINOD, GENEVIEVE (NP)
Entity Type:Individual
Prefix:MS
First Name:GENEVIEVE
Middle Name:
Last Name:TAGUINOD
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 1:2151 N HARBOR BLVD STE 3200
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3826
Mailing Address - Country:US
Mailing Address - Phone:714-446-5600
Mailing Address - Fax:714-446-5800
Practice Address - Street 1:2151 N HARBOR BLVD STE 3200
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3826
Practice Address - Country:US
Practice Address - Phone:714-446-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP16941363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner