Provider Demographics
NPI:1801537824
Name:ROMANCIK, DENISE MAUREEN (RN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MAUREEN
Last Name:ROMANCIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9452 CASTLEGATE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5918
Mailing Address - Country:US
Mailing Address - Phone:215-901-9239
Mailing Address - Fax:
Practice Address - Street 1:600 W SANTA ANA BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4575
Practice Address - Country:US
Practice Address - Phone:714-667-7926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95215907163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse