Provider Demographics
NPI:1740923184
Name:ASUNCION, JERICK MARQUEZ (RN)
Entity type:Individual
Prefix:
First Name:JERICK
Middle Name:MARQUEZ
Last Name:ASUNCION
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:VERGEL JERICK
Other - Middle Name:MARQUEZ
Other - Last Name:ASUNCION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14850 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4677
Mailing Address - Country:US
Mailing Address - Phone:818-904-3569
Mailing Address - Fax:818-904-3662
Practice Address - Street 1:14850 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4677
Practice Address - Country:US
Practice Address - Phone:818-904-3569
Practice Address - Fax:818-904-3662
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA818185163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency