Provider Demographics
NPI:1508679663
Name:PONCE FERNANDEZ, IVETT ZITA
Entity type:Individual
Prefix:
First Name:IVETT
Middle Name:ZITA
Last Name:PONCE FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IVETT
Other - Middle Name:ZITA
Other - Last Name:PONCE RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1575 DELUCCHI LN STE 114
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6581
Mailing Address - Country:US
Mailing Address - Phone:775-432-1223
Mailing Address - Fax:
Practice Address - Street 1:1575 DELUCCHI LN STE 114
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6581
Practice Address - Country:US
Practice Address - Phone:775-432-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV873759163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health