Provider Demographics
NPI:1285785725
Name:ARAGON, RACHEL CRUZ (NP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:CRUZ
Last Name:ARAGON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ERPIRITU
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:12900 PARK PLAZA DRIVE
Mailing Address - Street 2:#150
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:562-677-2494
Mailing Address - Fax:562-622-2971
Practice Address - Street 1:10000 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240
Practice Address - Country:US
Practice Address - Phone:562-862-3684
Practice Address - Fax:562-344-1155
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR.N. 625167363L00000X
CACNS 2552363L00000X
CAN.P. 16696363L00000X
CARN625167363L00000X
CANP16696363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB7275535OtherDRIVERS LICENSE