Provider Demographics
NPI:1255086443
Name:DE VERA, MAICA CHERLCIE (NP)
Entity type:Individual
Prefix:
First Name:MAICA
Middle Name:CHERLCIE
Last Name:DE VERA
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 SUNNY CREST DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3616
Mailing Address - Country:US
Mailing Address - Phone:714-446-5831
Mailing Address - Fax:714-446-7910
Practice Address - Street 1:1837 SUNNY CREST DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3616
Practice Address - Country:US
Practice Address - Phone:714-446-5831
Practice Address - Fax:714-446-7910
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily