Basic Information
| Provider Information | |||||||||
| NPI: | 1750898441 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMBROSINI | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | ANDRUZZI | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24422 AVENIDA DE LA CARLOTA STE 300 | ||||||||
| Address2: | |||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926533628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495992423 | ||||||||
| FaxNumber: | 9495992430 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 CORPORATE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | LADERA RANCH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926942179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493477200 | ||||||||
| FaxNumber: | 9493477217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2018 | ||||||||
| LastUpdateDate: | 03/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | AMBR-6FP0U6 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 95017172 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.