Basic Information
| Provider Information | |||||||||
| NPI: | 1578187571 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STOYKOVICH | ||||||||
| FirstName: | ARACELI | ||||||||
| MiddleName: | AMANO | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5040 | ||||||||
| Address2: | |||||||||
| City: | OROVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959660040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307122171 | ||||||||
| FaxNumber: | 5307122149 | ||||||||
| Practice Location | |||||||||
| Address1: | 2450 ORO DAM BLVD E | ||||||||
| Address2: | |||||||||
| City: | OROVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959666052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307122171 | ||||||||
| FaxNumber: | 5307122149 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2020 | ||||||||
| LastUpdateDate: | 12/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95082806 | CA | N | Nursing Service Providers | Registered Nurse | 363L00000X | 95016269 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.