Provider Demographics
NPI:1487846333
Name:BERNAL, RHODORA HALILI (RN)
Entity Type:Individual
Prefix:
First Name:RHODORA
Middle Name:HALILI
Last Name:BERNAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RHODORA
Other - Middle Name:HALILI
Other - Last Name:LAVISTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:32443 VIA DESTELLO
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3961
Mailing Address - Country:US
Mailing Address - Phone:951-303-0310
Mailing Address - Fax:951-303-0310
Practice Address - Street 1:32443 VIA DESTELLO
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3961
Practice Address - Country:US
Practice Address - Phone:951-303-0310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA702284163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical