Provider Demographics
NPI:1427435395
Name:RICAFRENTE, NAZARICA
Entity type:Individual
Prefix:
First Name:NAZARICA
Middle Name:
Last Name:RICAFRENTE
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 1:850 S ATLANTIC BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4730
Mailing Address - Country:US
Mailing Address - Phone:626-284-1350
Mailing Address - Fax:626-284-2454
Practice Address - Street 1:850 S ATLANTIC BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4730
Practice Address - Country:US
Practice Address - Phone:626-284-1350
Practice Address - Fax:626-284-2454
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily