Provider Demographics
NPI:1811570583
Name:TRINIDAD, FLORENCE RAGUS (RN)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:RAGUS
Last Name:TRINIDAD
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 1:3736 ACKERMAN DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3506
Mailing Address - Country:US
Mailing Address - Phone:818-403-8890
Mailing Address - Fax:
Practice Address - Street 1:5900 SEPULVEDA BLVD STE 515
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2511
Practice Address - Country:US
Practice Address - Phone:818-528-5388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95239179163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse