Provider Demographics
NPI:1386765899
Name:VIRATA, ROSALINA LARINO (LVN)
Entity type:Individual
Prefix:MRS
First Name:ROSALINA
Middle Name:LARINO
Last Name:VIRATA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 E MARLENA ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-2209
Mailing Address - Country:US
Mailing Address - Phone:626-912-2165
Mailing Address - Fax:
Practice Address - Street 1:15229 E AMAR RD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744
Practice Address - Country:US
Practice Address - Phone:626-855-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN158898164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse