Provider Demographics
NPI:1881676849
Name:MALDONADO, ANA (PA-C/MPH)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:PA-C/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1870
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95077-1870
Mailing Address - Country:US
Mailing Address - Phone:831-728-0222
Mailing Address - Fax:831-707-2777
Practice Address - Street 1:7 HAVILAND ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-2683
Practice Address - Country:US
Practice Address - Phone:617-927-6117
Practice Address - Fax:617-536-8602
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1406363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant