Provider Demographics
NPI:1316391915
Name:NAZARENO, TRICHELE D (CRNA)
Entity type:Individual
Prefix:
First Name:TRICHELE
Middle Name:D
Last Name:NAZARENO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TRICHELE
Other - Middle Name:D
Other - Last Name:NUBLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 291264
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1264
Mailing Address - Country:US
Mailing Address - Phone:615-620-2320
Mailing Address - Fax:
Practice Address - Street 1:1418 E MAIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4833
Practice Address - Country:US
Practice Address - Phone:615-620-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000520367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered