Provider Demographics
NPI:1700930674
Name:NEWELL, LUZ MARIE PARANGALAN (NP)
Entity Type:Individual
Prefix:
First Name:LUZ MARIE
Middle Name:PARANGALAN
Last Name:NEWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LUZ
Other - Middle Name:PARANGALAN
Other - Last Name:NEWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4910 E CLINTON WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1560
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2823 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1324
Practice Address - Country:US
Practice Address - Phone:559-499-6493
Practice Address - Fax:559-499-6501
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN290934363LG0600X
CAN8727363LC0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS30886Medicare UPIN