Provider Demographics
NPI:1780654624
Name:ADORADOR, ANITA CORINA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:CORINA
Last Name:ADORADOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:ANITA
Other - Middle Name:CORINA
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, DNP
Mailing Address - Street 1:802 W COLTON AVE STE E
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2905
Mailing Address - Country:US
Mailing Address - Phone:909-335-5799
Mailing Address - Fax:909-793-6614
Practice Address - Street 1:802 W COLTON AVE STE E
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2905
Practice Address - Country:US
Practice Address - Phone:909-335-5799
Practice Address - Fax:909-793-6614
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11380NP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11380NPOtherNURSE PRACTIONER
CABJ821ZMedicare PIN