Provider Demographics
NPI:1841487816
Name:LEVERATTO, MARIA LUISA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:LEVERATTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:L
Other - Last Name:SALAZAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:21000 CANYON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-0418
Mailing Address - Country:US
Mailing Address - Phone:951-505-7229
Mailing Address - Fax:
Practice Address - Street 1:21000 CANYON RIDGE DR
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0418
Practice Address - Country:US
Practice Address - Phone:951-505-7229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 175137164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse