Provider Demographics
NPI:1760238596
Name:ACEVEDO MIRAMONTES, LILIANA TERESITA (CNM, WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:TERESITA
Last Name:ACEVEDO MIRAMONTES
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:LILIANA
Other - Middle Name:
Other - Last Name:ACEVEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13651 MILLS RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3443
Mailing Address - Country:US
Mailing Address - Phone:714-914-1164
Mailing Address - Fax:
Practice Address - Street 1:13651 MILLS RD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3443
Practice Address - Country:US
Practice Address - Phone:714-914-1164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW236418367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife