Healthcare Provider Details

I. General information

NPI: 1851091904
Provider Name (Legal Business Name): MARITZA ROMERO MEDICAL ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 FREMONT BLVD
SEASIDE CA
93955-5715
US

IV. Provider business mailing address

1156 FREMONT BLVD
SEASIDE CA
93955-5715
US

V. Phone/Fax

Practice location:
  • Phone: 831-899-8100
  • Fax:
Mailing address:
  • Phone: 831-899-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: