Provider Demographics
NPI:1710703673
Name:YERENA, NORA SUE
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:SUE
Last Name:YERENA
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 1:117 CALABASAS RD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-1032
Mailing Address - Country:US
Mailing Address - Phone:559-287-8934
Mailing Address - Fax:
Practice Address - Street 1:1205 FREEDOM BLVD # 3B
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2777
Practice Address - Country:US
Practice Address - Phone:559-287-8934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No172V00000XOther Service ProvidersCommunity Health Worker
No374J00000XNursing Service Related ProvidersDoula