Provider Demographics
NPI:1801859756
Name:DELA PENA, FLORA RAYMUNDO (R N)
Entity Type:Individual
Prefix:MS
First Name:FLORA
Middle Name:RAYMUNDO
Last Name:DELA PENA
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 METZ RD
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-6459
Mailing Address - Country:US
Mailing Address - Phone:831-242-4532
Mailing Address - Fax:
Practice Address - Street 1:473 CABRILLO ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93944-3201
Practice Address - Country:US
Practice Address - Phone:831-242-4532
Practice Address - Fax:831-242-6719
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284148163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health