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General NPI Number Information
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NPI Number | 1700582871
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Entity Type | Individual
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Provider Name | MARJORIE AVENO FNP
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Gender | Female
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 2571 W LA PALMA AVE
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City | ANAHEIM
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State | CA
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Zip | 92801-2619
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Country | US
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Telephone | 714-827-9797
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Fax |
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Provider Business Mailing Address
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Address Line | 4952 1/4 HAYTER AVE
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City | LAKEWOOD
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State | CA
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Zip | 90712-3133
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Country | US
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Telephone | 929-414-7288
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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