MRS. MAVIS EFUETNGU


Address: 2670 N Main St. Ste 200, Santa Ana, CA 92705-6639
Phone: 7146275477

MRS. MAVIS EFUETNGU (NPI# 1538787239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538787239
Entity Type Individual
Full Name MRS. MAVIS EFUETNGU
Credential PMHNP
Practice Address 2670 N Main St. Ste 200
Santa Ana
CA 92705-6639
Mailing Address 2670 N Main St Ste 200
Santa Ana
CA 92705-6639
Practice Telephone 7146275477
Mailing Telephone 7146275477
Enumeration Date 2020-07-09
Last Update Date 2020-07-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
95014162 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2670 N MAIN ST. STE 200
City SANTA ANA
State CA
Zip Code 92705-6639

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1093005225 Rohzan Grace Altre Nurse Practitioner 515 Cabrillo Park Dr Ste 120, Santa Ana, CA 92701 2011-04-08
1598943805 Jeannie C. Blilie Nurse Practitioner 1530 E 1st St Ste 100, Santa Ana, CA 92701-6307 2008-02-08
1982229571 Ronnie Alvarez Corona Nurse Practitioner 1030 W Warner Ave, Santa Ana, CA 92707-3147 2020-06-10
1295355154 Gabrielle Gola Lewis Nurse Practitioner 505 N Tustin Ave Ste 150, Santa Ana, CA 92705-3735 2020-04-21
1437791381 Charlotte Maria Primo Mizuta Nurse Practitioner 2001 E 4th St Ste 200, Santa Ana, CA 92705-3916 2019-10-11
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Competitor

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City SANTA ANA
Zip Code 92705

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Dataset Information

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.

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