Provider Demographics
NPI:1699892224
Name:SERNA, MARIA (LVN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SERNA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 UNION PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1865
Mailing Address - Country:US
Mailing Address - Phone:805-524-4185
Mailing Address - Fax:805-981-5672
Practice Address - Street 1:4333 E VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1013
Practice Address - Country:US
Practice Address - Phone:805-981-5574
Practice Address - Fax:805-981-5672
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA195284164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse