Healthcare Provider Details

I. General information

NPI: 1912502469
Provider Name (Legal Business Name): ANTOINETTE LEVIER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 N ORANGE AVE STE 100
WEST COVINA CA
91790-2032
US

IV. Provider business mailing address

15735 MCINTOSH AVE
CHINO CA
91708-9353
US

V. Phone/Fax

Practice location:
  • Phone: 626-800-1200
  • Fax:
Mailing address:
  • Phone: 909-815-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: