Healthcare Provider Details

I. General information

NPI: 1770403362
Provider Name (Legal Business Name): AILIN VASSEUR
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CITY PKWY W
ORANGE CA
92868-2941
US

IV. Provider business mailing address

500 CITY PKWY W
ORANGE CA
92868-2941
US

V. Phone/Fax

Practice location:
  • Phone: 714-246-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number95342461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: