Provider Demographics
NPI:1053893610
Name:DE OCAMPO, FLORANTE JOSE CONCHA (BSN RN)
Entity type:Individual
Prefix:
First Name:FLORANTE JOSE
Middle Name:CONCHA
Last Name:DE OCAMPO
Suffix:
Gender:M
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1800 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3302
Mailing Address - Country:US
Mailing Address - Phone:424-757-7296
Mailing Address - Fax:
Practice Address - Street 1:1800 MOUNT VERNON AVE FL 2
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3302
Practice Address - Country:US
Practice Address - Phone:661-868-1298
Practice Address - Fax:661-868-0218
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95141048163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse