Provider Demographics
NPI:1588690796
Name:PRADO, JESUS MENDOZA (RN)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:MENDOZA
Last Name:PRADO
Suffix:
Gender:M
Credentials:RN
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Mailing Address - Street 1:1141 PEAR TREE LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558
Mailing Address - Country:US
Mailing Address - Phone:707-254-1778
Mailing Address - Fax:707-251-2993
Practice Address - Street 1:1141 PEAR TREE LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558
Practice Address - Country:US
Practice Address - Phone:707-254-1778
Practice Address - Fax:707-251-2993
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA525892163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse