Provider Demographics
NPI:1558985952
Name:RAFOLS-JARABE, CLARIZE JOIE AMAR
Entity Type:Individual
Prefix:
First Name:CLARIZE JOIE
Middle Name:AMAR
Last Name:RAFOLS-JARABE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLARIZE JOIE
Other - Middle Name:AMAR
Other - Last Name:RAFOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7051 ALDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1832
Mailing Address - Country:US
Mailing Address - Phone:909-549-1469
Mailing Address - Fax:
Practice Address - Street 1:3110 E GUASTI RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-1219
Practice Address - Country:US
Practice Address - Phone:909-549-1469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023036163W00000X
CA95017247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse