Provider Demographics
NPI:1598123135
Name:CORTES, ANA CAROLINA (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:CAROLINA
Last Name:CORTES
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 1:135 CALLE RENATA
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3956
Mailing Address - Country:US
Mailing Address - Phone:909-638-6028
Mailing Address - Fax:
Practice Address - Street 1:135 CALLE RENATA
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3956
Practice Address - Country:US
Practice Address - Phone:909-638-6028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95045571163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse