Provider Demographics
NPI:1346713856
Name:SERRA, KAREN CADAYONA (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:CADAYONA
Last Name:SERRA
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 1:9929 AZUAGA ST UNIT F101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-6054
Mailing Address - Country:US
Mailing Address - Phone:719-229-9814
Mailing Address - Fax:
Practice Address - Street 1:9929 AZUAGA ST UNIT F101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-6054
Practice Address - Country:US
Practice Address - Phone:719-229-9814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95151846163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse