Provider Demographics
NPI:1871832360
Name:ANDERSEN, MARCELA MARINS (RN, CPNP-PC)
Entity Type:Individual
Prefix:MISS
First Name:MARCELA
Middle Name:MARINS
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:RN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 S ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-2621
Mailing Address - Country:US
Mailing Address - Phone:323-268-9191
Mailing Address - Fax:323-268-9119
Practice Address - Street 1:1121 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2214
Practice Address - Country:US
Practice Address - Phone:619-344-2819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP22056363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics