Provider Demographics
NPI:1780417642
Name:CHEREME, NANA OPON
Entity type:Individual
Prefix:MR
First Name:NANA
Middle Name:OPON
Last Name:CHEREME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 RALSTON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6042
Mailing Address - Country:US
Mailing Address - Phone:805-336-1120
Mailing Address - Fax:
Practice Address - Street 1:5450 RALSTON ST STE 101
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6042
Practice Address - Country:US
Practice Address - Phone:805-336-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95321324163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health