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General NPI Number Information
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NPI Number | 1093064362
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Entity Type | Individual
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Provider Name | ISABEL S. ROMENA FNP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2012
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Last Update Date | 09/02/2012
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Provider Practice Location Address
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Address Line | 832 S FAIRMONT AVE
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City | LODI
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State | CA
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Zip | 95240-5117
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Country | US
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Telephone | 209-365-9331
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Fax |
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Provider Business Mailing Address
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Address Line | 3613 HEPBURN CIR
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City | STOCKTON
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State | CA
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Zip | 95209-3906
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Country | US
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Telephone | 209-477-2813
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP 21888
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License Number State | CA
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