Healthcare Provider Details

I. General information

NPI: 1225950132
Provider Name (Legal Business Name): MARIA ZONIETTA PEARL PONSICA SALABAO APRN-AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PEARL PONSICA SALABAO APRN-AGPCNP

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 E MAIN ST STE 100
SAN JACINTO CA
92583-4206
US

IV. Provider business mailing address

341 E MAIN ST STE 100
SAN JACINTO CA
92583-4206
US

V. Phone/Fax

Practice location:
  • Phone: 951-654-5590
  • Fax:
Mailing address:
  • Phone: 951-654-9367
  • Fax: 951-654-0839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95039740
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: