Provider Demographics
NPI:1851960751
Name:BAESA, GINALYN ASUNCION
Entity Type:Individual
Prefix:
First Name:GINALYN
Middle Name:ASUNCION
Last Name:BAESA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13964 RAMHURST DR APT 12
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-1742
Mailing Address - Country:US
Mailing Address - Phone:562-217-0314
Mailing Address - Fax:
Practice Address - Street 1:13964 RAMHURST DR APT 12
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-1742
Practice Address - Country:US
Practice Address - Phone:562-217-0314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide