Provider Demographics
NPI:1679320097
Name:REMOT, DHANA CABANTAC (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DHANA
Middle Name:CABANTAC
Last Name:REMOT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 LUCIA JADE LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-3700
Mailing Address - Country:US
Mailing Address - Phone:727-687-9431
Mailing Address - Fax:
Practice Address - Street 1:794 MARSOPA DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6437
Practice Address - Country:US
Practice Address - Phone:727-687-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95128249163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator