MEDICARE: MRS. VALERIE TAGLE MSN-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	363L00000X	Nurse Practitioner	22397	CA

General Provider Information

NPI Number	:	1538680897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VALERIE TAGLE MSN-FNP

Provider Business Mailing Address
First Line	:	1811 W KATELLA AVE STE 218
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-6658
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6756 E SWARTHMORE DR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-5041
Country	:	US
Telephone Number	:	714-292-7010
Fax Number	:

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

Provider Enumeration Date	:	06/27/2017
Last Update Date	:	06/27/2017

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