Healthcare Provider Details

I. General information

NPI: 1578216883
Provider Name (Legal Business Name): FRANK CERVANTES RN-BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 HALL RD
LAMONT CA
93241-1953
US

IV. Provider business mailing address

8787 HALL RD
LAMONT CA
93241-1953
US

V. Phone/Fax

Practice location:
  • Phone: 661-845-3731
  • Fax: 661-845-1157
Mailing address:
  • Phone: 661-845-3731
  • Fax: 661-845-1157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPF95025562
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: