Provider Demographics
NPI:1427778901
Name:CUMMINGS, LEVI-LIN ROQUE (NP)
Entity type:Individual
Prefix:MRS
First Name:LEVI-LIN
Middle Name:ROQUE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LEVI-LIN
Other - Middle Name:
Other - Last Name:FERRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3660 PARK SIERRA DR STE 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3071
Mailing Address - Country:US
Mailing Address - Phone:951-687-3400
Mailing Address - Fax:951-687-7630
Practice Address - Street 1:22555 ALESSANDRO BLVD STE B
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-8533
Practice Address - Country:US
Practice Address - Phone:951-656-7081
Practice Address - Fax:951-656-1710
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-02
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily