Provider Demographics
NPI:1013370915
Name:UBBAONU, CECILLE BERNAD (MSN, RN, AG-ACNP)
Entity type:Individual
Prefix:
First Name:CECILLE
Middle Name:BERNAD
Last Name:UBBAONU
Suffix:
Gender:
Credentials:MSN, RN, AG-ACNP
Other - Prefix:
Other - First Name:CECILLE
Other - Middle Name:
Other - Last Name:BERNAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, AG-ACNP
Mailing Address - Street 1:PO BOX 255228
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:770 MASON ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4646
Practice Address - Country:US
Practice Address - Phone:707-437-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003683363LA2100X
CANP95003683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care