Provider Demographics
NPI:1831559848
Name:ALDACO, CARLA MICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MICHELLE
Last Name:ALDACO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13516 PERRY DR
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-9348
Mailing Address - Country:US
Mailing Address - Phone:559-280-6644
Mailing Address - Fax:559-623-9677
Practice Address - Street 1:13516 PERRY DR
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-9348
Practice Address - Country:US
Practice Address - Phone:559-280-6644
Practice Address - Fax:559-623-9677
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95003527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily