Provider Demographics
NPI:1790276491
Name:AQUINO, ELIZABETH MERCADO (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MERCADO
Last Name:AQUINO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 CAROLINE CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-1411
Mailing Address - Country:US
Mailing Address - Phone:925-828-4790
Mailing Address - Fax:
Practice Address - Street 1:7950 CAROLINE CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-1411
Practice Address - Country:US
Practice Address - Phone:925-828-4790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540721163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care