Provider Demographics
NPI:1306481130
Name:MEDRANO, DELAINA ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:DELAINA
Middle Name:ANN
Last Name:MEDRANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:DELAINA
Other - Middle Name:ANN
Other - Last Name:MEDRANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:1775 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-1674
Mailing Address - Country:US
Mailing Address - Phone:562-599-8444
Mailing Address - Fax:
Practice Address - Street 1:1775 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-1674
Practice Address - Country:US
Practice Address - Phone:562-599-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA699917164X00000X
CA95407302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse