Provider Demographics
NPI:1427793439
Name:NUNEZ-SALAZAR, RAQUEL M (FNP)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:M
Last Name:NUNEZ-SALAZAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 W 6TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3349
Mailing Address - Country:US
Mailing Address - Phone:951-737-0910
Mailing Address - Fax:
Practice Address - Street 1:308 W 6TH ST STE 101
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3349
Practice Address - Country:US
Practice Address - Phone:951-737-0910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily