Provider Demographics
NPI:1992049910
Name:GRANFLOR, ELIZA AJERO (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELIZA
Middle Name:AJERO
Last Name:GRANFLOR
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10729 SUNDANCE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6616
Mailing Address - Country:US
Mailing Address - Phone:951-206-0757
Mailing Address - Fax:
Practice Address - Street 1:10729 SUNDANCE DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6616
Practice Address - Country:US
Practice Address - Phone:951-206-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA710843163WC0200X
CA22574363LA2100X
CA3901364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care