Provider Demographics
NPI:1467259945
Name:MUNOZ, BEVERLY GISSELLE (RN)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:GISSELLE
Last Name:MUNOZ
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 1:601 W GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3714
Mailing Address - Country:US
Mailing Address - Phone:951-400-3657
Mailing Address - Fax:
Practice Address - Street 1:601 W GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3714
Practice Address - Country:US
Practice Address - Phone:951-400-3657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95286133163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse