Provider Demographics
NPI:1184192817
Name:RAMONES, VIVENCIA GATCHALIAN
Entity Type:Individual
Prefix:
First Name:VIVENCIA
Middle Name:GATCHALIAN
Last Name:RAMONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9158 AEGINA CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5105
Mailing Address - Country:US
Mailing Address - Phone:916-807-5792
Mailing Address - Fax:
Practice Address - Street 1:9158 AEGINA CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5105
Practice Address - Country:US
Practice Address - Phone:916-807-5792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN206825164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse