Provider Demographics
NPI:1225562291
Name:ACUNA, CAMILLE JOYCE (RN)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:JOYCE
Last Name:ACUNA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6581 SHAWNA AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-4458
Mailing Address - Country:US
Mailing Address - Phone:760-774-1212
Mailing Address - Fax:
Practice Address - Street 1:17296 SLOVER AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-7585
Practice Address - Country:US
Practice Address - Phone:909-609-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA648606163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse