Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95003683 | CA |
NPI | 1013370915 |
---|---|
Provider Name | Cecille Bernad |
First Address | Loma Linda, CA 92354-3862 |
Second Address | Loma Linda, CA 92354-3862 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2016 |
Last Update Date | 08/04/2016 |