Provider Demographics
NPI:1366687113
Name:STEVENSON, RENANDA ARCADIA (DNP, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RENANDA
Middle Name:ARCADIA
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 TOWN AND COUNTRY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3611
Mailing Address - Country:US
Mailing Address - Phone:951-737-8141
Mailing Address - Fax:951-817-1759
Practice Address - Street 1:1901 TOWN AND COUNTRY DR STE 104
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3611
Practice Address - Country:US
Practice Address - Phone:951-737-8141
Practice Address - Fax:951-817-1759
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12634363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care