Provider Demographics
NPI:1891354544
Name:CARUSO, CHERYL ANN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:CARUSO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3311
Mailing Address - Country:US
Mailing Address - Phone:805-474-3000
Mailing Address - Fax:805-473-1587
Practice Address - Street 1:227 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3311
Practice Address - Country:US
Practice Address - Phone:805-474-3000
Practice Address - Fax:805-473-1587
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA377762163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool