Agustin, Elaine Grace
Agustin, Elaine Grace is an individual health care provider with primary practice located at 401 E Highland Ave Suite 551, San Bernardino CA 92404-3803. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Agustin, Elaine Grace can be contacted via phone (909) 882-9150.Contact Information
Primary practice address
401 E Highland Ave Suite 551
San Bernardino CA 92404-3803
Phone: (909) 882-9150
Fax: (909) 883-8972
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | NP 13423 | California |
Profile Details
NPI number | 1992837843 |
---|---|
LBN Legal business name | Agustin, Elaine Grace |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 9th, 2007 |
Last updated | Jan 21st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1992837843 | NPPES |
California | Other | RN 549365 | REGISTERED NURSE |
California | Other | NP 13423 | REGISTERED NURSE |
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