Basic Information
| Provider Information | |||||||||
| NPI: | 1194077214 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAKANO | ||||||||
| FirstName: | GABRIELA | ||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VALENCIA | ||||||||
| OtherFirstName: | GABRIELA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | ACNP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8114 1/2 WILCOX AVE | ||||||||
| Address2: | |||||||||
| City: | CUDAHY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902016026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3233041147 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18111 BROOKHURST ST | ||||||||
| Address2: | |||||||||
| City: | FOUNTAIN VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927086728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143787000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 95007081 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.