Provider Demographics
NPI:1720799307
Name:AVILES, KARINA DAWN ELMIDO (NP)
Entity type:Individual
Prefix:
First Name:KARINA DAWN
Middle Name:ELMIDO
Last Name:AVILES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1151 N BRANTFORD ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-1611
Mailing Address - Country:US
Mailing Address - Phone:714-270-0605
Mailing Address - Fax:
Practice Address - Street 1:1110 W LA PALMA AVE STE 1
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2822
Practice Address - Country:US
Practice Address - Phone:714-991-3180
Practice Address - Fax:714-991-1957
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95023325363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner