Basic Information
| Provider Information | |||||||||
| NPI: | 1265080949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PADILLA ARECHIGA | ||||||||
| FirstName: | MAYRA | ||||||||
| MiddleName: | LETICIA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 52996 ASTRID WAY | ||||||||
| Address2: | |||||||||
| City: | LAKE ELSINORE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925327508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104181419 | ||||||||
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| Practice Location | |||||||||
| Address1: | 141 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LAKE ELSINORE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925304118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8555057467 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2019 | ||||||||
| LastUpdateDate: | 08/27/2019 | ||||||||
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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 | 363L00000X | NPF95012229 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.