Provider Demographics
NPI:1740351337
Name:UBINA, ELEONOR RIVERA (RN)
Entity type:Individual
Prefix:MS
First Name:ELEONOR
Middle Name:RIVERA
Last Name:UBINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7190 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3927
Mailing Address - Country:US
Mailing Address - Phone:714-521-9887
Mailing Address - Fax:
Practice Address - Street 1:1725 W 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2316
Practice Address - Country:US
Practice Address - Phone:714-834-8017
Practice Address - Fax:714-834-8372
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHN 62407163WC1500X
CARN437716163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN437716OtherREGISTERED NURSE