Healthcare Provider Details

I. General information

NPI: 1104737469
Provider Name (Legal Business Name): LORENA SERNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 GREEN VALLEY RD
WATSONVILLE CA
95076-1359
US

IV. Provider business mailing address

615 ORCHARD ST
WATSONVILLE CA
95076-4034
US

V. Phone/Fax

Practice location:
  • Phone: 831-786-2100
  • Fax:
Mailing address:
  • Phone: 831-331-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number830837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: