Suzette L Pornelos, RN

Primary specialty

Hospice Registered NurseTaxonomy code 163WH1000X

License

786944 Issued in CA

Practice address

2910 Inland Empire Blvd
Ontario, CA 91764-4896

Phone

(909) 522-4093

NPI assigned

Sep 3, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1114752805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13393 MARIPOSA RD SPC 213",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955328",
            "telephone_number": "760-985-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 INLAND EMPIRE BLVD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644896",
            "telephone_number": "909-522-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORNELOS",
        "first_name": "SUZETTE",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "CA",
            "license": "786944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latashelli Ponder
• Pauline Poon
• Libni Poot
• Stephen Wesley Pope, PTA
• Taylar Pope
• Katherine Gayle Porteous, AAS SUBSTANCE USE
• Dora Laverne Porter
• Geordon Porter
• Nicole Porter
• Raymond Porter

• Hospice Registered Nurse in Ontario, CA
• Providers in Ontario, CA by specialty
• Hospice Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.