Provider Demographics
NPI:1801200803
Name:MEJIA, ARLENE COTACO (RN)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:COTACO
Last Name:MEJIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:TUAZON
Other - Last Name:COTACO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 MAGNOLIA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3123
Mailing Address - Country:US
Mailing Address - Phone:951-817-8820
Mailing Address - Fax:
Practice Address - Street 1:800 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3123
Practice Address - Country:US
Practice Address - Phone:951-817-8820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA777941163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse