Provider Demographics
NPI:1558719583
Name:LOEWEN, RONALD DICK (LVN)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DICK
Last Name:LOEWEN
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 COUNTY ROAD XX
Mailing Address - Street 2:
Mailing Address - City:GLENN
Mailing Address - State:CA
Mailing Address - Zip Code:95943-9668
Mailing Address - Country:US
Mailing Address - Phone:530-934-2915
Mailing Address - Fax:
Practice Address - Street 1:2402 COUNTY ROAD XX
Practice Address - Street 2:
Practice Address - City:GLENN
Practice Address - State:CA
Practice Address - Zip Code:95943-9668
Practice Address - Country:US
Practice Address - Phone:530-934-2915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN258165164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVN258165OtherCALIFORNIA BOARD OF VOCATIONAL NURSING AND PSYCHIATRIC TECHNICIANS