Basic Information
| Provider Information | |||||||||
| NPI: | 1861726093 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CERVANTES-ELIA | ||||||||
| FirstName: | DANIELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | RN BSN MSN FNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CERVANTES | ||||||||
| OtherFirstName: | DANIELA | ||||||||
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| OtherCredential: | MSN FNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 51544 HARRISON ST | ||||||||
| Address2: | |||||||||
| City: | COACHELLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922361501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603983555 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 88775 AVENUE 76, STE. 1 | ||||||||
| Address2: | |||||||||
| City: | THERMAL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922749407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603972501 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2009 | ||||||||
| LastUpdateDate: | 05/22/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 580301 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.