Provider Demographics
NPI:1467940205
Name:WARNER, LARONDA D
Entity Type:Individual
Prefix:
First Name:LARONDA
Middle Name:D
Last Name:WARNER
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 1:1337 HOWE AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3361
Mailing Address - Country:US
Mailing Address - Phone:916-604-1934
Mailing Address - Fax:
Practice Address - Street 1:1337 HOWE AVE STE 215
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3361
Practice Address - Country:US
Practice Address - Phone:916-604-1934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8BKZ039343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)