Provider Demographics
NPI:1669994406
Name:ARREDONDO, ARETE MORAINE (FNP)
Entity type:Individual
Prefix:
First Name:ARETE
Middle Name:MORAINE
Last Name:ARREDONDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ARETE
Other - Middle Name:
Other - Last Name:ALFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:5250 SAN BENITO RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-1960
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 E COTA ST SPC 1
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1624
Practice Address - Country:US
Practice Address - Phone:559-593-3925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA844758163W00000X
CA95006953363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse