Provider Demographics
NPI:1659517712
Name:VASCONEZ, AIDA F
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:F
Last Name:VASCONEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35889 ARNETT RD
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7653
Mailing Address - Country:US
Mailing Address - Phone:951-678-7383
Mailing Address - Fax:
Practice Address - Street 1:35889 ARNETT RD
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7653
Practice Address - Country:US
Practice Address - Phone:051-678-7383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other