Provider Demographics
NPI:1184855884
Name:DELATORRE, LETICIA MONICA (RN)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:MONICA
Last Name:DELATORRE
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 1:705 FLYWAY CT
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948-9625
Mailing Address - Country:US
Mailing Address - Phone:530-846-5941
Mailing Address - Fax:
Practice Address - Street 1:5 HILDA WAY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1417
Practice Address - Country:US
Practice Address - Phone:530-899-3759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA789427163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse