Provider Demographics
NPI:1629492897
Name:TOLENTINO, MARIA LUZ (FNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LUZ
Last Name:TOLENTINO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 PARADISE WAY
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3071
Mailing Address - Country:US
Mailing Address - Phone:209-756-7079
Mailing Address - Fax:
Practice Address - Street 1:771 PARADISE WAY
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3071
Practice Address - Country:US
Practice Address - Phone:209-756-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily