Provider Demographics
NPI:1952065856
Name:JOSE, CHARLOTTE CUETO (RN)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:CUETO
Last Name:JOSE
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15697 PORTENZA DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-4618
Mailing Address - Country:US
Mailing Address - Phone:909-764-1054
Mailing Address - Fax:
Practice Address - Street 1:15697 PORTENZA DR
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-4618
Practice Address - Country:US
Practice Address - Phone:909-764-1054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95212538163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator