Healthcare Provider Details

I. General information

NPI: 1598956815
Provider Name (Legal Business Name): GENEVIEVE TAGUINOD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 N HARBOR BLVD STE 3200
FULLERTON CA
92835-3826
US

IV. Provider business mailing address

2151 N HARBOR BLVD STE 3200
FULLERTON CA
92835-3826
US

V. Phone/Fax

Practice location:
  • Phone: 714-446-5600
  • Fax:
Mailing address:
  • Phone: 714-446-5600
  • Fax: 714-446-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP16941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: