Provider Demographics
NPI:1497598957
Name:BERUMEN, MONIQUE LAUREEN (RN)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:LAUREEN
Last Name:BERUMEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:LAUREEN
Other - Last Name:DILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3335 M ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2714
Mailing Address - Country:US
Mailing Address - Phone:209-723-6559
Mailing Address - Fax:
Practice Address - Street 1:3335 M ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2714
Practice Address - Country:US
Practice Address - Phone:209-723-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95319510163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse