Provider Demographics
NPI:1063303279
Name:DEALDO, ANN MARI AQUINO (FNP-C)
Entity type:Individual
Prefix:
First Name:ANN MARI
Middle Name:AQUINO
Last Name:DEALDO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12728 N WATT LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4890
Mailing Address - Country:US
Mailing Address - Phone:213-265-1211
Mailing Address - Fax:
Practice Address - Street 1:20554 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-1746
Practice Address - Country:US
Practice Address - Phone:818-341-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily