Basic Information
Provider Information
NPI: 1356840300
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZAINEA
FirstName: APRIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LAURESKI
OtherFirstName: APRIL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 255 TERRACINA BLVD
Address2: SUITE 205A
City: REDLANDS
State: CA
PostalCode: 92373
CountryCode: US
TelephoneNumber: 9093075736
FaxNumber:  
Practice Location
Address1: 255 TERRACINA BLVD
Address2: SUITE 205A
City: REDLANDS
State: CA
PostalCode: 92373
CountryCode: US
TelephoneNumber: 9093075736
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2018
LastUpdateDate: 02/06/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X95008414CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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