Provider Demographics
NPI:1154468619
Name:DELA CRUZ, ARLENE AGUSTIN (REGISTERED NURSE)
Entity Type:Individual
Prefix:MISS
First Name:ARLENE
Middle Name:AGUSTIN
Last Name:DELA CRUZ
Suffix:
Gender:F
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 1:1058 S COUNTRY GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2609
Mailing Address - Country:US
Mailing Address - Phone:714-281-5932
Mailing Address - Fax:
Practice Address - Street 1:1058 S COUNTRY GLEN WAY
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-2609
Practice Address - Country:US
Practice Address - Phone:714-281-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies