Provider Demographics
NPI:1609488519
Name:CERON, CORINA ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:ELIZABETH
Last Name:CERON
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 1:9895 DEVON ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3613
Mailing Address - Country:US
Mailing Address - Phone:909-831-1723
Mailing Address - Fax:
Practice Address - Street 1:9895 DEVON ST
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3613
Practice Address - Country:US
Practice Address - Phone:909-831-1723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN492431163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical