Provider Demographics
NPI:1982422481
Name:HERRELLA, CHONA M
Entity type:Individual
Prefix:
First Name:CHONA
Middle Name:M
Last Name:HERRELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 LINCOLN AVE UNIT 110
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2643
Mailing Address - Country:US
Mailing Address - Phone:213-344-6007
Mailing Address - Fax:
Practice Address - Street 1:4550 LINCOLN AVE UNIT 110
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2643
Practice Address - Country:US
Practice Address - Phone:213-344-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant