Provider Demographics
NPI:1790555860
Name:ELIGIO, AUBREY MARIE RAZALAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:AUBREY MARIE
Middle Name:RAZALAN
Last Name:ELIGIO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AUBREY MARIE SHALIMA
Other - Middle Name:DULAY
Other - Last Name:RAZALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7155 CITRUS AVE UNIT 128
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-6002
Mailing Address - Country:US
Mailing Address - Phone:818-272-2984
Mailing Address - Fax:
Practice Address - Street 1:1701 E CESAR E CHAVEZ AVE STE 128
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2483
Practice Address - Country:US
Practice Address - Phone:323-223-2338
Practice Address - Fax:323-225-2340
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily