Provider Demographics
NPI:1700663713
Name:ADAMS, CAREN ANNTOINETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAREN
Middle Name:ANNTOINETTE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CAREN
Other - Middle Name:ANNTOINETTE
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1900
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92334-1900
Mailing Address - Country:US
Mailing Address - Phone:909-815-9359
Mailing Address - Fax:
Practice Address - Street 1:7950 CHERRY AVE STE 110
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-4023
Practice Address - Country:US
Practice Address - Phone:909-357-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033048163WC0400X, 163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health