MEDICARE: MS. MONICA ELLYNOR CORPUZ RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95443955	CA

General Provider Information

NPI Number	:	1841142478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA ELLYNOR CORPUZ RN

Provider Business Mailing Address
First Line	:	516 ERMA AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-2023
Country	:	US
Telephone Number	:	209-298-3997
Fax Number	:

Provider Business Practice Location Address
First Line	:	2740 N CALIFORNIA ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-5529
Country	:	US
Telephone Number	:	209-466-3522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2026
Last Update Date	:	02/14/2026

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