Healthcare Provider Details

I. General information

NPI: 1649195876
Provider Name (Legal Business Name): CARLA RUDETTE HERRING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26001 REDLANDS BLVD
REDLANDS CA
92373-7762
US

IV. Provider business mailing address

2731 IRVINGTON AVE
SAN BERNARDINO CA
92407-2113
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-7084
  • Fax:
Mailing address:
  • Phone: 909-825-7084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number739908
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: