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Individual
MR. TIMOTHY CERECERES
Active
Individual
MR. TIMOTHY CERECERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
958001706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95001706
CALIFORNIA BOARD OF REGISTERED NURSES
CA
Enumeration date
04/17/2015
Last updated
04/17/2015
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