Basic Information
Provider Information
NPI: 1679816680
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARUSO
FirstName: KAREN
MiddleName: JEAN
NamePrefix:  
NameSuffix:  
Credential: MSN, RN, FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7087
Address2:  
City: ORANGE
State: CA
PostalCode: 928637087
CountryCode: US
TelephoneNumber: 7145715000
FaxNumber: 7145715055
Practice Location
Address1: 30230 RANCHO VIEJO RD
Address2: SUITE 200
City: SAN JUAN CAPISTRANO
State: CA
PostalCode: 926751557
CountryCode: US
TelephoneNumber: 9494434303
FaxNumber: 9494434033
Other Information
ProviderEnumerationDate: 03/28/2013
LastUpdateDate: 01/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPN001495NVN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000X23053CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home