Healthcare Provider Details
I. General information
NPI: 1841325040
Provider Name (Legal Business Name): CHERRY ANN GABUYA OCULAM RN MS CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2020 CANYON VIEW LN
REDLANDS CA
92373-6975
US
IV. Provider business mailing address
2020 CANYON VIEW LN
REDLANDS CA
92373-6975
US
V. Phone/Fax
- Phone: 909-792-7366
- Fax:
- Phone: 909-792-7366
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WM0705X |
| Taxonomy | Medical-Surgical Registered Nurse |
| License Number | V381305 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: