Provider Demographics
NPI:1861665705
Name:DIZON, CECILE VALERA (CNS)
Entity Type:Individual
Prefix:
First Name:CECILE
Middle Name:VALERA
Last Name:DIZON
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:CECILE
Other - Middle Name:A
Other - Last Name:VALERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,MS,CNS
Mailing Address - Street 1:4150 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNS 2427163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical