Provider Demographics
NPI:1013370915
Name:UBBAONU, CECILLE BERNAD (MSN, RN, AG-ACNP)
Entity Type:Individual
Prefix:
First Name:CECILLE
Middle Name:BERNAD
Last Name:UBBAONU
Suffix:
Gender:F
Credentials:MSN, RN, AG-ACNP
Other - Prefix:
Other - First Name:CECILLE
Other - Middle Name:
Other - Last Name:BERNAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, AG-ACNP
Mailing Address - Street 1:11285 MOUNTAIN VIEW AVE
Mailing Address - Street 2:40
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3862
Mailing Address - Country:US
Mailing Address - Phone:909-558-5844
Mailing Address - Fax:909-558-7873
Practice Address - Street 1:11285 MOUNTAIN VIEW AVE
Practice Address - Street 2:40
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3862
Practice Address - Country:US
Practice Address - Phone:909-558-5844
Practice Address - Fax:909-558-7873
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003683363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care