Provider Demographics
NPI:1174315543
Name:SERNA, EMILIE MARIE
Entity type:Individual
Prefix:
First Name:EMILIE
Middle Name:MARIE
Last Name:SERNA
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 1:50346 CORONADO ST
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-3317
Mailing Address - Country:US
Mailing Address - Phone:760-609-8094
Mailing Address - Fax:
Practice Address - Street 1:50346 CORONADO ST
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-3317
Practice Address - Country:US
Practice Address - Phone:760-609-8094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program