Healthcare Provider Details

I. General information

NPI: 1477416576
Provider Name (Legal Business Name): JOEVILYN TRANCE DELOS TRINO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9515 AZOR LN
ATASCADERO CA
93422-6146
US

IV. Provider business mailing address

9515 AZOR LN
ATASCADERO CA
93422-6146
US

V. Phone/Fax

Practice location:
  • Phone: 917-495-4590
  • Fax:
Mailing address:
  • Phone: 917-495-4590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95037545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: