MEDICARE: TRINA ACOSTA-TECSON FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	19474	CA

General Provider Information

NPI Number	:	1205167822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINA ACOSTA-TECSON FNP

Provider Business Mailing Address
First Line	:	318 W EL NORTE PKWY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-1925
Country	:	US
Telephone Number	:	760-489-1505
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 W EL NORTE PKWY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-1925
Country	:	US
Telephone Number	:	760-489-1505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	07/17/2013

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