Provider Demographics
NPI:1801557129
Name:BERROA, YUDELKA (CNA)
Entity type:Individual
Prefix:MRS
First Name:YUDELKA
Middle Name:
Last Name:BERROA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 PAVILION AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-1607
Mailing Address - Country:US
Mailing Address - Phone:401-585-9298
Mailing Address - Fax:
Practice Address - Street 1:807 BROAD ST RM 233
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1678
Practice Address - Country:US
Practice Address - Phone:401-585-9298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide