Provider Demographics
NPI:1215644232
Name:AGUIRRE, ANDREW CRYSTIAN (FNP-C)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CRYSTIAN
Last Name:AGUIRRE
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:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92871-0073
Mailing Address - Country:US
Mailing Address - Phone:714-305-2119
Mailing Address - Fax:
Practice Address - Street 1:249 TIGER LN
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-4349
Practice Address - Country:US
Practice Address - Phone:714-305-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95021927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily