Provider Demographics
NPI:1265808315
Name:MARIA NOLASCO NP A NURSING CORP
Entity type:Organization
Organization Name:MARIA NOLASCO NP A NURSING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:NOLASCO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:818-823-5933
Mailing Address - Street 1:10523 CROCKETT ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-4121
Mailing Address - Country:US
Mailing Address - Phone:818-823-5933
Mailing Address - Fax:
Practice Address - Street 1:10523 CROCKETT ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-4121
Practice Address - Country:US
Practice Address - Phone:818-823-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care