Provider Demographics
NPI:1205632981
Name:SERRANO, MARIEANN
Entity type:Individual
Prefix:
First Name:MARIEANN
Middle Name:
Last Name:SERRANO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 VIA PESCARA
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1412
Mailing Address - Country:US
Mailing Address - Phone:707-305-8926
Mailing Address - Fax:
Practice Address - Street 1:118 VIA PESCARA
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1412
Practice Address - Country:US
Practice Address - Phone:707-305-8926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95277070163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health