Provider Demographics
NPI:1154949451
Name:AUEYONG, ORADEE BONNY (FNP)
Entity type:Individual
Prefix:
First Name:ORADEE
Middle Name:BONNY
Last Name:AUEYONG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15906 ATOKA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2749
Mailing Address - Country:US
Mailing Address - Phone:626-226-8706
Mailing Address - Fax:
Practice Address - Street 1:4065 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2556
Practice Address - Country:US
Practice Address - Phone:323-968-1170
Practice Address - Fax:323-968-1175
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily