Basic Information
| Provider Information | |||||||||
| NPI: | 1639330269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABAR-CALICA | ||||||||
| FirstName: | ABIGAIL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4516 MARTIN ST | ||||||||
| Address2: | |||||||||
| City: | UNION CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945875632 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 795 WILLOW RD | ||||||||
| Address2: | BUILDING 331, B-WING, OFFICE B-147 | ||||||||
| City: | MENLO PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940252539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504935000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2008 | ||||||||
| LastUpdateDate: | 06/17/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 556803 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
ID Information
| ID | Type | State | Issuer | Description | 556803 | 01 | CA | REGISTERED NURSE LICENSE | OTHER | 14374 | 01 | CA | NURSE PRACTITIONER CERTIFICATE | OTHER |