Basic Information
| Provider Information | |||||||||
| NPI: | 1376532531 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RONQUILLO | ||||||||
| FirstName: | FLORENTINA | ||||||||
| MiddleName: | MAGAT | ||||||||
| NamePrefix: | |||||||||
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| Credential: | APRN-BC, WHCNP, MSN. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MAGAT | ||||||||
| OtherFirstName: | FLORENTINA | ||||||||
| OtherMiddleName: | ESTRELLA | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1910 CUSTOMER CARE WAY | ||||||||
| Address2: | |||||||||
| City: | ATWATER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953015167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093846488 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1500 FLORIDA AVE | ||||||||
| Address2: | |||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953504408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095741365 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | RN 399867 NPF 8989 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.