Healthcare Provider Details

I. General information

NPI: 1740351337
Provider Name (Legal Business Name): ELEONOR RIVERA UBINA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W 17TH ST
SANTA ANA CA
92706-2316
US

IV. Provider business mailing address

7190 KENSINGTON DR
BUENA PARK CA
90621-3927
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-8017
  • Fax: 714-834-8372
Mailing address:
  • Phone: 714-521-9887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberPHN 62407
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN437716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: