MIRASOL FAJARDO (NPI# 1174573448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174573448 |
| Entity Type | Individual |
| Full Name | MIRASOL FAJARDO |
| Credential | N.P. |
| Practice Address |
6240 Descanso Ave Buena Park CA 90620-1013 |
| Mailing Address |
3520 Clarington Ave Los Angeles CA 90034-4922 |
| Practice Telephone | 7145229794 |
| Mailing Telephone | 3236204617 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
15932 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6240 DESCANSO AVE |
| City | BUENA PARK |
| State | CA |
| Zip Code | 90620-1013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346889110 | Soon Ae Yoon | Acupuncturist | 8600 Beach Blvd. #104, Buena Park, CA 90620 | 2019-12-27 |
| 1649755380 | Rosemary Lynn Nielsen | Social Worker | 1850 Knott Ave, Buena Park, CA 90620 | 2018-09-28 |
| 1730608118 | Arpita Bhavsar | Pharmacist | 7072 Santa Marta Circle, Buena Park, CA 90620 | 2017-09-16 |
| 1740715663 | Gabriela Peinado | Assistant Behavior Analyst | 8669 Holder St, Buena Park, CA 90620 | 2017-04-28 |
| 1679958862 | Aum Pharmacy Corporation | Pharmacy | 6970 Aragon Circle, # 3, Buena Park, CA 90620 | 2015-07-29 |
| 1457600330 | Daniel D. Chung Dds Inc | Dentist | 8884 Knott Ave., Buena Park, CA 90620 | 2012-09-06 |
| 1942531447 | Baltazar Mendoza | Dental Assistant | 7691 El Chaco Drive, Buena Park, CA 90620 | 2010-01-22 |
| 1760509947 | Marcela Torralba Espiritu | Dentist | 7540 Orangethorpe Ave, C4, Buena Park, CA 90620 | 2007-03-23 |
| 1508924457 | Randall Tay Kanemaki | Dentist | 8751 Valley View Street, Suite B, Buena Park, CA 90620 | 2006-12-04 |
| 1346338282 | J and P Homes Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6891 San Pedro Circle, Buena Park, CA 90620 | 2006-10-10 |
| Find all providers in zip 90620 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700358116 | Young Eun Song | Nurse Practitioner | 6261 Stanton Ave, Buena Park, CA 90621-2436 | 2018-12-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388504 | Daniel Ngo | Nurse Practitioner | 1180 S Hilda St, Anaheim, CA 92806-5007 | 2020-08-28 |
| 1407464522 | Laura Bradigan | Nurse Practitioner | 1744 Grand Ave Unit 2, Long Beach, CA 90804-2022 | 2020-07-15 |
| 1538787031 | Kelly Olcott | Nurse Practitioner | 4004 Via Lucero Apt 12, Santa Barbara, CA 93110-1692 | 2020-07-10 |
| 1629695440 | Kelley Ibarra | Nurse Practitioner | 1613 Celeste Dr, Modesto, CA 95355-5039 | 2020-06-26 |
| 1497379333 | Gloria Jean Campbell | Nurse Practitioner | 5055 E Garford St Apt 6, Long Beach, CA 90815-2861 | 2020-06-06 |
| 1851913115 | Lilly Fong | Nurse Practitioner | 15821 Square Top Ln, Fontana, CA 92336-4586 | 2020-05-09 |
| 1548880750 | Sharkeiya Terrell | Nurse Practitioner | 2752 Harrison Ave Ste A, Eureka, CA 95501-4738 | 2020-04-17 |
| 1730714007 | Julissa Leonides Caraballo | Nurse Practitioner | 4044 Promontory St, San Diego, CA 92109-5334 | 2020-03-07 |
| 1194355404 | Bethany Leda Donowho | Nurse Practitioner | 845 Via De La Paz Ste 16, Pacific Palisades, CA 90272-3627 | 2020-01-26 |
| 1518507078 | Rachel Saake Collar | Nurse Practitioner | 5100, 1000 Executive Pkwy, Oroville, CA 95966 | 2020-01-13 |
| Find all providers with the same taxonomy | ||||
| City | BUENA PARK |
| Zip Code | 90620 |
Please comment or provide details below to improve the information on MIRASOL FAJARDO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.