Provider Demographics
NPI:1629648746
Name:BUENAFLOR-SALES, MARIA PERLA LEGASPI (AGPCNP)
Entity Type:Individual
Prefix:
First Name:MARIA PERLA
Middle Name:LEGASPI
Last Name:BUENAFLOR-SALES
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SAND CREEK RD STE 236
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-7302
Mailing Address - Country:US
Mailing Address - Phone:925-550-1494
Mailing Address - Fax:
Practice Address - Street 1:50 SAND CREEK RD STE 236
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-7302
Practice Address - Country:US
Practice Address - Phone:925-550-1494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95017186363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care