Provider Demographics
NPI:1073691101
Name:TEXEIRA, DUSTIN DREW (REGISTERED NURSE)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:DREW
Last Name:TEXEIRA
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19218 HILLWARD CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-6213
Mailing Address - Country:US
Mailing Address - Phone:951-358-6895
Mailing Address - Fax:951-358-6176
Practice Address - Street 1:769 W BLAINE ST
Practice Address - Street 2:SUITE A
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-3970
Practice Address - Country:US
Practice Address - Phone:951-358-6895
Practice Address - Fax:951-358-6176
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 362365163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent