Provider Demographics
NPI:1851179493
Name:PRECIADO, PAULINE BALDUEZA (RN)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:BALDUEZA
Last Name:PRECIADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 DUNKIRK DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-1286
Mailing Address - Country:US
Mailing Address - Phone:805-320-4682
Mailing Address - Fax:
Practice Address - Street 1:3544 DUNKIRK DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-1286
Practice Address - Country:US
Practice Address - Phone:805-320-4682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68711163WC1500X
CA644357163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health