Provider Demographics
NPI:1477217008
Name:RACION, LEIZYL
Entity Type:Individual
Prefix:
First Name:LEIZYL
Middle Name:
Last Name:RACION
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 1:1246 AVIGNON DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-9546
Mailing Address - Country:US
Mailing Address - Phone:209-631-7708
Mailing Address - Fax:209-349-8719
Practice Address - Street 1:3098 G ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-2137
Practice Address - Country:US
Practice Address - Phone:209-385-3438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA728329163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health