Provider Demographics
NPI:1285062257
Name:GERONGA, ALDRIN GARRIDO (FNP)
Entity type:Individual
Prefix:
First Name:ALDRIN
Middle Name:GARRIDO
Last Name:GERONGA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:923 WALNUT ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4921
Mailing Address - Country:US
Mailing Address - Phone:510-552-1121
Mailing Address - Fax:510-864-0944
Practice Address - Street 1:39350 CIVIC CENTER DR
Practice Address - Street 2:SUITE 260
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2343
Practice Address - Country:US
Practice Address - Phone:510-931-4310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23574363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner