Provider Demographics
NPI:1184482630
Name:CERON, JOHANA ELIZABETH SR
Entity type:Individual
Prefix:
First Name:JOHANA
Middle Name:ELIZABETH
Last Name:CERON
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3474 17TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1166
Mailing Address - Country:US
Mailing Address - Phone:415-879-3737
Mailing Address - Fax:
Practice Address - Street 1:3474 17TH ST APT 7
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1166
Practice Address - Country:US
Practice Address - Phone:415-879-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty