Provider Demographics
NPI:1295246502
Name:RAMOS, HEIDI CELESTE (LVN)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:CELESTE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:CELESTE
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1551 S TONOPAH AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3362
Mailing Address - Country:US
Mailing Address - Phone:323-532-0120
Mailing Address - Fax:
Practice Address - Street 1:867 N FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3050
Practice Address - Country:US
Practice Address - Phone:626-798-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283223164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse