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General NPI Number Information
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NPI Number | 1710320031
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Entity Type | Individual
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Provider Name | NORALDA QUITAIN TAN MSN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 27341 ROSE MALLOW LN
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-6954
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Country | US
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Telephone | 661-645-9357
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Fax | 661-367-4571
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Provider Business Mailing Address
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Address Line | 27341 ROSE MALLOW LN
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-6954
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Country | US
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Telephone | 661-645-9357
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Fax | 661-367-4571
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NPF 22780
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP 22780
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License Number State | CA
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