Provider Demographics
NPI:1427681345
Name:JAUREGUI, RITA ELVIRA
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:ELVIRA
Last Name:JAUREGUI
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 1:9575 STANWIN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-5535
Mailing Address - Country:US
Mailing Address - Phone:818-269-5831
Mailing Address - Fax:
Practice Address - Street 1:732 MOTT ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4240
Practice Address - Country:US
Practice Address - Phone:818-361-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator