Provider Demographics
NPI:1851996896
Name:MECOZZI, MARIBEL A (NP)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:A
Last Name:MECOZZI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27405 ANNETTE JO CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-1704
Mailing Address - Country:US
Mailing Address - Phone:661-645-4252
Mailing Address - Fax:
Practice Address - Street 1:27405 ANNETTE JO CIR
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-1704
Practice Address - Country:US
Practice Address - Phone:661-645-4252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015893363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner