Provider Demographics
NPI:1790319747
Name:PRATS, CARISSA (RN)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:PRATS
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 1:4949 W CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-1591
Mailing Address - Country:US
Mailing Address - Phone:559-624-3209
Mailing Address - Fax:559-635-6274
Practice Address - Street 1:4949 W CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-1591
Practice Address - Country:US
Practice Address - Phone:559-624-3209
Practice Address - Fax:559-635-6274
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95064560163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology