Provider Demographics
NPI:1962145334
Name:CERVANTES, APRIL (CMT)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15181 VAN BUREN BLVD SPC 267
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-5671
Mailing Address - Country:US
Mailing Address - Phone:951-318-1532
Mailing Address - Fax:
Practice Address - Street 1:15181 VAN BUREN BLVD SPC 267
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-5671
Practice Address - Country:US
Practice Address - Phone:951-318-1532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88883225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA88883OtherCMTC