Provider Demographics
NPI:1962901900
Name:SITORUS, ANITA (RN)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:SITORUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25590 PROSPECT AVE APT 50B
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3157
Mailing Address - Country:US
Mailing Address - Phone:909-894-3370
Mailing Address - Fax:909-894-3370
Practice Address - Street 1:25590 PROSPECT AVE APT 50B
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3157
Practice Address - Country:US
Practice Address - Phone:909-894-3370
Practice Address - Fax:909-894-3370
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA702745163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA702745OtherREGISTERED NURSE