Provider Demographics
NPI:1194420091
Name:VERGARA, JOSEPH SANCHEZ (FNP-C)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SANCHEZ
Last Name:VERGARA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16439 SYLVANWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6941
Mailing Address - Country:US
Mailing Address - Phone:562-922-2177
Mailing Address - Fax:
Practice Address - Street 1:4 HUGHES STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2043
Practice Address - Country:US
Practice Address - Phone:949-679-6874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily