Nimfa Realeza Punzalan, REGISTERED NURSE

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Practice address

3313 El Pinole Way
Fairfield, CA 94533-7208

Phone

(707) 425-2202

Fax

(707) 425-6060

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paradise Valley Icf-DDH

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fairfield, CA
  • NPI 1730360082

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902017064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 EL PINOLE WAY",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945337208",
            "telephone_number": "707-425-2202",
            "fax_number": "707-425-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 EL PINOLE WAY",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945337208",
            "telephone_number": "707-425-2202",
            "fax_number": "707-425-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNZALAN",
        "first_name": "NIMFA",
        "middle_name": "REALEZA",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER IDENTIFICATION #",
            "identifier": "LTC61010F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni Pullium, LVN
• Pulmonary and Sleep Associates of California, Inc
• Michelle Lynn Punla, ASW
• Maria Adelma Puno, M.D.
• Allyzza Mae Garcia Punzalan
• Q & R Home Care Services LLC
• Yingfeng Qiao, RPH
• Brian Quaife, AMFT/APPC
• Rodelin Quanico-Damian
• Estrella Quarry

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.