Pedro Tabernero Jr., R.N.

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

794686 Issued in CA

Practice address

1904 Richland Ave
Ceres, CA 95307-4562

Phone

(209) 300-8800

NPI assigned

Jan 16, 2016

Sex

Male

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": "1452902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452902400000",
    "number": "1427415744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 MAEHL DR",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377215",
            "telephone_number": "925-216-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 RICHLAND AVE",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953074562",
            "telephone_number": "209-300-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABERNERO",
        "first_name": "PEDRO",
        "name_suffix": "Jr.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-16",
        "last_updated": "2016-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "794686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Amanda Struck, CCC-SLP
• Regina Ortiz Sturges, BHS II
• Shabana Sunesara, APRN-FNP
• Sutter Gould Medical Foundation
• Valeria Tabarez
• Christine Tallent
• Evelia Tapia
• Laura P Tapia
• Tyra Shavon Tate
• Elizabeth Taylor

• Psychiatric/Mental Health Registered Nurse in Ceres, CA
• Providers in Ceres, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2016; 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.