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General NPI Number Information
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NPI Number | 1093496200
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Entity Type | Individual
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Provider Name | RAULIN DADURAL FERIA APRN, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 23247 MAIN ST
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City | CARSON
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State | CA
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Zip | 90745-5229
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Country | US
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Telephone | 310-429-0839
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Fax |
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Provider Business Mailing Address
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Address Line | 4055 REDWOOD AVE UNIT 104
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City | LOS ANGELES
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State | CA
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Zip | 90066-5189
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Country | US
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Telephone | 323-229-3338
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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 | 95027595
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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