Provider Demographics
NPI:1154773620
Name:DEBBIE T. NEMECEK
Entity type:Organization
Organization Name:DEBBIE T. NEMECEK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIABETES EDUCATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:NEMECEK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CDE
Authorized Official - Phone:818-399-1963
Mailing Address - Street 1:260 N PRIMROSE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2164
Mailing Address - Country:US
Mailing Address - Phone:818-399-1963
Mailing Address - Fax:626-303-2515
Practice Address - Street 1:260 N PRIMROSE AVE
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2164
Practice Address - Country:US
Practice Address - Phone:818-399-1963
Practice Address - Fax:626-303-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272962163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty