Healthcare Provider Details

I. General information

NPI: 1508317934
Provider Name (Legal Business Name): ROCELIZA DAQUIOAG MSN,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W FLORIDA AVE STE D
HEMET CA
92543-3869
US

IV. Provider business mailing address

1525 W FLORIDA AVE STE D
HEMET CA
92543-3869
US

V. Phone/Fax

Practice location:
  • Phone: 951-929-6777
  • Fax: 951-658-8390
Mailing address:
  • Phone: 951-929-6777
  • Fax: 951-658-8390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95005122
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: