Provider Demographics
NPI:1235707217
Name:RABANAL-MICELI, JULIANNA M (RN)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNA
Middle Name:M
Last Name:RABANAL-MICELI
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 1:303 POTRERO ST STE 42-103
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2779
Mailing Address - Country:US
Mailing Address - Phone:831-466-9307
Mailing Address - Fax:
Practice Address - Street 1:303 POTRERO ST STE 42-103
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2779
Practice Address - Country:US
Practice Address - Phone:831-466-9307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95198769163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse