# AGATHA J COVARRUBIAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1417329640
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 95069913 | CA | — |
| 207R00000X | Internal Medicine Physician | A70897 | CA | — |
| 207R00000X | Internal Medicine Physician | A76562 | CA | — |
| 363L00000X | Nurse Practitioner | 95002944 | CA | Yes |
| 364SA2200X | Adult Health Clinical Nurse Specialist | 60579117 | WA | — |

## Other

- **Enumeration date:** 10/27/2015
- **Last updated:** 12/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1093183261 | — | CA |