Provider Demographics
NPI:1518629526
Name:CACHO, JUNETTE EVANS AUSTRIA (NP)
Entity Type:Individual
Prefix:
First Name:JUNETTE EVANS
Middle Name:AUSTRIA
Last Name:CACHO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25652 HURON ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3703
Mailing Address - Country:US
Mailing Address - Phone:909-723-2671
Mailing Address - Fax:
Practice Address - Street 1:25652 HURON ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3703
Practice Address - Country:US
Practice Address - Phone:909-723-2671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily