Healthcare Provider Details

I. General information

NPI: 1417510199
Provider Name (Legal Business Name): MARIA SAQUIC FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4288 KATELLA AVE
LOS ALAMITOS CA
90720-3562
US

IV. Provider business mailing address

9802 SANTA GERTRUDES AVE
WHITTIER CA
90603-1346
US

V. Phone/Fax

Practice location:
  • Phone: 562-296-8514
  • Fax:
Mailing address:
  • Phone: 424-263-7275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95008923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: