Provider Demographics
NPI:1871784033
Name:LAABS, MICHELLE SANTOS (MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:SANTOS
Last Name:LAABS
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 CONCORDIA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-3203
Mailing Address - Country:US
Mailing Address - Phone:949-854-8002
Mailing Address - Fax:949-854-6876
Practice Address - Street 1:1530 CONCORDIA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-3203
Practice Address - Country:US
Practice Address - Phone:949-854-8002
Practice Address - Fax:949-854-6876
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553885363LS0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool