Provider Demographics
NPI:1366002818
Name:WAROUW, FRANKE
Entity Type:Individual
Prefix:
First Name:FRANKE
Middle Name:
Last Name:WAROUW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 CRYSTAL COVE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-8136
Mailing Address - Country:US
Mailing Address - Phone:916-706-4328
Mailing Address - Fax:
Practice Address - Street 1:5405 CRYSTAL COVE DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-8136
Practice Address - Country:US
Practice Address - Phone:916-706-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA695890164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse