Provider Demographics
NPI:1316828056
Name:GAXIOLA, ERNESTINA DAGNINO
Entity type:Individual
Prefix:
First Name:ERNESTINA
Middle Name:DAGNINO
Last Name:GAXIOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 PANNO ST
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-5100
Mailing Address - Country:US
Mailing Address - Phone:760-880-7131
Mailing Address - Fax:
Practice Address - Street 1:820 PANNO ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-5100
Practice Address - Country:US
Practice Address - Phone:760-880-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider