Provider Demographics
NPI:1881102044
Name:RAMIREZ ALCALA, ANGELA MARIA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:RAMIREZ ALCALA
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 1:3060 ROBAR ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-2259
Mailing Address - Country:US
Mailing Address - Phone:702-426-7678
Mailing Address - Fax:
Practice Address - Street 1:3060 ROBAR ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-2259
Practice Address - Country:US
Practice Address - Phone:702-426-7678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1705232722OtherLIMITED TERM IDENTIFICATION CARD