Provider Demographics
NPI:1053754952
Name:CASPE, CAROLINE MATIBAG (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MATIBAG
Last Name:CASPE
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Gender:F
Credentials:MSN, FNP-C
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Other - First Name:
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Mailing Address - Street 1:12375 BASELINE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-5992
Mailing Address - Country:US
Mailing Address - Phone:909-899-6969
Mailing Address - Fax:909-899-9922
Practice Address - Street 1:1300 S SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3342
Practice Address - Country:US
Practice Address - Phone:626-960-6999
Practice Address - Fax:626-960-5246
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2015-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA22778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily