Provider Demographics
NPI:1912443524
Name:TAGUINES, PAMELA RUMA (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:RUMA
Last Name:TAGUINES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25590 PROSPECT AVE APT 21H
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3148
Mailing Address - Country:US
Mailing Address - Phone:323-336-7595
Mailing Address - Fax:
Practice Address - Street 1:7755 CENTER AVE
Practice Address - Street 2:SUITE #630
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3007
Practice Address - Country:US
Practice Address - Phone:310-562-7257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566888163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse