Provider Demographics
NPI:1184403180
Name:BALOTO, ROWENA URBINA (RN)
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:URBINA
Last Name:BALOTO
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 1:587 CHAPARRAL LOOP
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3132
Mailing Address - Country:US
Mailing Address - Phone:707-342-4018
Mailing Address - Fax:
Practice Address - Street 1:587 CHAPARRAL LOOP
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3132
Practice Address - Country:US
Practice Address - Phone:707-342-4018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA848159163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse