Healthcare Provider Details

I. General information

NPI: 1083242531
Provider Name (Legal Business Name): ARNULFO VELASQUEZ NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 COLORADO AVE
TURLOCK CA
95382-2706
US

IV. Provider business mailing address

1801 COLORADO AVE
TURLOCK CA
95382-2706
US

V. Phone/Fax

Practice location:
  • Phone: 209-216-3300
  • Fax:
Mailing address:
  • Phone: 209-216-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95014142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: