Covarrubias, Agatha J
Covarrubias, Agatha J is an individual health care provider with primary practice located at 3105 Mchenry Ave Ste 101 , Modesto CA 95350-1439. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Covarrubias, Agatha J can be contacted via phone (209) 575-2700.Contact Information
Primary practice address
3105 Mchenry Ave Ste 101
Modesto CA 95350-1439
Phone: (209) 575-2700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A70897 | California |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 95069913 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A76562 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 364SA2200X | 60579117 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 95002944 | California |
Profile Details
| NPI number | 1417329640 |
|---|---|
| LBN Legal business name | Covarrubias, Agatha J |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2015 |
| Last updated | Dec 16th, 2021 - about 4 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 | 1417329640 | NPPES |
| California | MEDICAID | 1093183261 |
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