Provider Demographics
NPI:1023599206
Name:CARRIZALES, DARIELA (LVN)
Entity type:Individual
Prefix:
First Name:DARIELA
Middle Name:
Last Name:CARRIZALES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 TREBLE CRK APT 413
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4554
Mailing Address - Country:US
Mailing Address - Phone:210-410-1419
Mailing Address - Fax:
Practice Address - Street 1:2727 TREBLE CRK APT 413
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4554
Practice Address - Country:US
Practice Address - Phone:210-410-1419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313940164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse