Provider Demographics
NPI:1679668016
Name:AQUINO-CARO, EVELYN B (MD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:B
Last Name:AQUINO-CARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:723 E. LOCUST AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720
Mailing Address - Country:US
Mailing Address - Phone:559-432-5722
Mailing Address - Fax:559-432-2413
Practice Address - Street 1:723 E LOCUST AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3021
Practice Address - Country:US
Practice Address - Phone:559-432-5722
Practice Address - Fax:559-432-2413
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA401982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE98183Medicare UPIN