Provider Demographics
NPI:1043855547
Name:FADERA, ARLENE VALDRIZ (RN)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:VALDRIZ
Last Name:FADERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4671 N CERRITOS DR
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-1605
Mailing Address - Country:US
Mailing Address - Phone:562-715-5025
Mailing Address - Fax:
Practice Address - Street 1:4671 N CERRITOS DR
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-1605
Practice Address - Country:US
Practice Address - Phone:562-715-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider