Provider Demographics
NPI:1376780676
Name:RAFANAN, EMILIA ROSARIO (RN)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:ROSARIO
Last Name:RAFANAN
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 1:8367 WHITMORE ST
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2648
Mailing Address - Country:US
Mailing Address - Phone:626-864-4621
Mailing Address - Fax:
Practice Address - Street 1:100 W 1ST ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-4112
Practice Address - Country:US
Practice Address - Phone:213-996-1343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA655789163W00000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse