Provider Demographics
NPI:1083748222
Name:PERALTA, NENITA AMPLAYO (RN)
Entity Type:Individual
Prefix:MRS
First Name:NENITA
Middle Name:AMPLAYO
Last Name:PERALTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:NENITA
Other - Middle Name:AMPLAYO
Other - Last Name:PERALTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:10182 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-5304
Mailing Address - Country:US
Mailing Address - Phone:951-509-2400
Mailing Address - Fax:
Practice Address - Street 1:10182 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5304
Practice Address - Country:US
Practice Address - Phone:951-509-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN370581163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent