Provider Demographics
NPI:1881926939
Name:ARANCIBIA, SERGIO G (NP)
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:G
Last Name:ARANCIBIA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47647 CALEO BAY DR STE 120
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-8857
Mailing Address - Country:US
Mailing Address - Phone:760-564-8200
Mailing Address - Fax:
Practice Address - Street 1:47647 CALEO BAY DR STE 120
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8857
Practice Address - Country:US
Practice Address - Phone:760-564-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-31
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168466363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily