Provider Demographics
NPI:1104007335
Name:NAVEIRA, CINDY SUE (RN, NURSE PRACTITION)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:SUE
Last Name:NAVEIRA
Suffix:
Gender:F
Credentials:RN, NURSE PRACTITION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 SAN PABLO ST
Mailing Address - Street 2:STE 3800
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-0090
Mailing Address - Country:US
Mailing Address - Phone:323-442-7537
Mailing Address - Fax:323-442-7531
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:STE 3800
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0090
Practice Address - Country:US
Practice Address - Phone:323-442-7537
Practice Address - Fax:323-442-7531
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA401168363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9410OtherNURSE PRACTITIONER CERTIF
CA401168OtherCALIFORNIA RN LICENSE