Provider Demographics
NPI:1760663868
Name:ACCESS STAFFING
Entity Type:Organization
Organization Name:ACCESS STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRENALYN
Authorized Official - Middle Name:B
Authorized Official - Last Name:DOMINGO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:909-709-7941
Mailing Address - Street 1:11467 VIA LAGOS
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3851
Mailing Address - Country:US
Mailing Address - Phone:909-709-7941
Mailing Address - Fax:
Practice Address - Street 1:11467 VIA LAGOS
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3851
Practice Address - Country:US
Practice Address - Phone:909-709-7941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 13242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty