Healthcare Provider Details

I. General information

NPI: 1184481202
Provider Name (Legal Business Name): VANESSA YVONNE CORDOVA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA YVONNE ORELLANA

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W SUNFLOWER AVE STE 100
SANTA ANA CA
92704-7916
US

IV. Provider business mailing address

5425 POMONA BLVD
LOS ANGELES CA
90022-1716
US

V. Phone/Fax

Practice location:
  • Phone: 714-338-1115
  • Fax:
Mailing address:
  • Phone: 323-728-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN95341708
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95341708
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: