Healthcare Provider Details

I. General information

NPI: 1639033657
Provider Name (Legal Business Name): KARI ELIZABETH DAVIS-CRONIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 556
NUEVO CA
92567-0556
US

IV. Provider business mailing address

PO BOX 556
NUEVO CA
92567-0556
US

V. Phone/Fax

Practice location:
  • Phone: 951-290-5707
  • Fax: 866-272-5707
Mailing address:
  • Phone: 818-272-1280
  • Fax: 866-272-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95162658
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number95162658
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number95162658
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number95162658
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number95162658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: