Provider Demographics
NPI:1447848171
Name:MARISCAL, ADRIANA ANGELICA (FNP-C)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:ANGELICA
Last Name:MARISCAL
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 1:233 W SPARKLEBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-5012
Mailing Address - Country:US
Mailing Address - Phone:210-831-0517
Mailing Address - Fax:
Practice Address - Street 1:260 E ONTARIO AVE STE 204
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3507
Practice Address - Country:US
Practice Address - Phone:951-272-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily