Provider Demographics
NPI:1982060174
Name:BALDONADO, ANALIZA (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:ANALIZA
Middle Name:
Last Name:BALDONADO
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 FUTAMASE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-1006
Mailing Address - Country:US
Mailing Address - Phone:408-623-4821
Mailing Address - Fax:408-293-5859
Practice Address - Street 1:2436 FUTAMASE CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-1006
Practice Address - Country:US
Practice Address - Phone:408-623-4821
Practice Address - Fax:408-293-5859
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily