Provider Demographics
NPI:1073862736
Name:ROSENDO, CHYLBERT MAGBANUA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MR
First Name:CHYLBERT
Middle Name:MAGBANUA
Last Name:ROSENDO
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 1:1102 LESTER AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-7542
Mailing Address - Country:US
Mailing Address - Phone:559-298-5469
Mailing Address - Fax:
Practice Address - Street 1:1102 LESTER AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-7542
Practice Address - Country:US
Practice Address - Phone:559-298-5469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610998163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health