Most Relevant Information
Provider Data
| NPI Number: | 1003404062 |
| Provider Name: | NICOLE RENTERIA RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 95231439 |
Most Important Dates
| Enumeration Date: | 01/05/2021 |
| Last Updated: | 01/05/2021 |
Provider Practice Location
3364 BEYER BLVD
SAN YSIDRO
CA
921731322
Practice Location Phone/Fax
| Phone: | 6196624100 |
| Fax: |
Provider Mailing Location
1430 WOODHAVEN DR
OCEANSIDE
CA
920562104
Provider Mailing Phone/Fax
| Phone: | 7604129102 |
| Fax: |