1679156558 NPI number — CLAUDINNE MAGNO URBANAVAGE BSN, RN

Table of content: CLAUDINNE MAGNO URBANAVAGE BSN, RN (NPI 1679156558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679156558 NPI number — CLAUDINNE MAGNO URBANAVAGE BSN, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URBANAVAGE
Provider First Name:
CLAUDINNE
Provider Middle Name:
MAGNO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BSN, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAGNO
Provider Other First Name:
CLAUDINNE MARIA D
Provider Other Middle Name:
GALIMBA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679156558
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3851 ROSECRANS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92110-3115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-531-5800
Provider Business Mailing Address Fax Number:
619-542-4186

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3851 ROSECRANS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92110-3115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-531-5800
Provider Business Practice Location Address Fax Number:
619-542-4186
Provider Enumeration Date:
04/29/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  95169819 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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