Provider Demographics
NPI:1619438900
Name:ROMERO, NEREIDA (LVN)
Entity Type:Individual
Prefix:MISS
First Name:NEREIDA
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7358 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-7241
Mailing Address - Country:US
Mailing Address - Phone:760-680-8014
Mailing Address - Fax:
Practice Address - Street 1:7358 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-7241
Practice Address - Country:US
Practice Address - Phone:760-680-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206705164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse