Provider Demographics
NPI:1093496200
Name:FERIA, RAULIN DADURAL (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:RAULIN
Middle Name:DADURAL
Last Name:FERIA
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 REDWOOD AVE UNIT 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5189
Mailing Address - Country:US
Mailing Address - Phone:323-229-3338
Mailing Address - Fax:
Practice Address - Street 1:23247 MAIN ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-5229
Practice Address - Country:US
Practice Address - Phone:310-429-0839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027595363LF0000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical