Provider Demographics
NPI:1801414982
Name:REDOR, AMEURFINA HERRERA (RN)
Entity type:Individual
Prefix:
First Name:AMEURFINA
Middle Name:HERRERA
Last Name:REDOR
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 1:19308 FAGAN CT
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6932
Mailing Address - Country:US
Mailing Address - Phone:562-481-5902
Mailing Address - Fax:
Practice Address - Street 1:19308 FAGAN CT
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-6932
Practice Address - Country:US
Practice Address - Phone:562-481-5902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X, 3747A0650X
CA793108163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
No163W00000XNursing Service ProvidersRegistered Nurse