Provider Demographics
NPI:1952065856
Name:JOSE, CHARLOTTE CUETO (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:CUETO
Last Name:JOSE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:762 GLENDORA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-4044
Mailing Address - Country:US
Mailing Address - Phone:909-764-1054
Mailing Address - Fax:323-773-0019
Practice Address - Street 1:762 GLENDORA AVE STE B
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-4044
Practice Address - Country:US
Practice Address - Phone:909-764-1054
Practice Address - Fax:323-773-0019
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95212538163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator