Provider Demographics
NPI:1669450722
Name:MACASINAG, NOEMI ESTEVEZ (RNFA)
Entity type:Individual
Prefix:MS
First Name:NOEMI
Middle Name:ESTEVEZ
Last Name:MACASINAG
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3406 GRANDI CIRCLE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-3913
Mailing Address - Country:US
Mailing Address - Phone:209-956-1949
Mailing Address - Fax:209-956-1949
Practice Address - Street 1:1205 E NORTH ST
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-4932
Practice Address - Country:US
Practice Address - Phone:209-239-8391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN360579163W00000X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant