Provider Demographics
NPI:1114603230
Name:MICHEL, RAQUEL VERONICA (NP)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:VERONICA
Last Name:MICHEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10053 WHITTWOOD DR UNIT 11532
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-9998
Mailing Address - Country:US
Mailing Address - Phone:626-422-2264
Mailing Address - Fax:
Practice Address - Street 1:15115 AMAR RD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-1914
Practice Address - Country:US
Practice Address - Phone:626-918-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty