Provider Demographics
NPI:1225500572
Name:WELCH, CERISSE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:CERISSE
Middle Name:ANN
Last Name:WELCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CERISSE
Other - Middle Name:ANN
Other - Last Name:HAMMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 PISCO LN
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-2743
Mailing Address - Country:US
Mailing Address - Phone:805-750-8411
Mailing Address - Fax:
Practice Address - Street 1:2034 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3814
Practice Address - Country:US
Practice Address - Phone:805-681-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335462163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse