Healthcare Provider Details

I. General information

NPI: 1841321817
Provider Name (Legal Business Name): PATRICIA MARIE GRECO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 S MAIN ST STE 106
CORONA CA
92882-2501
US

IV. Provider business mailing address

940 N HAVEN AVE STE 180-25
ONTARIO CA
91764-4970
US

V. Phone/Fax

Practice location:
  • Phone: 951-371-2703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP9693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: