Provider Demographics
NPI:1831925643
Name:NUNEZ, MAYRA CRISTINA (LVN)
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:CRISTINA
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-4813
Mailing Address - Country:US
Mailing Address - Phone:909-913-9857
Mailing Address - Fax:
Practice Address - Street 1:303 E 52ND ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90011-4513
Practice Address - Country:US
Practice Address - Phone:323-918-2139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288964164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse