Provider Demographics
NPI:1811274814
Name:RAMOS, MARIA LORETO
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LORETO
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19168 BROKEN BOW DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-6008
Mailing Address - Country:US
Mailing Address - Phone:951-235-4859
Mailing Address - Fax:
Practice Address - Street 1:19168 BROKEN BOW DR.
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-6008
Practice Address - Country:US
Practice Address - Phone:951-235-4859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA205372164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse