Provider Demographics
NPI:1912158676
Name:GALEANA, MARY LOUISE
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LOUISE
Last Name:GALEANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:L
Other - Last Name:VENTURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1236 N GOWDY ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-3950
Mailing Address - Country:US
Mailing Address - Phone:559-623-7774
Mailing Address - Fax:
Practice Address - Street 1:1646 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4962
Practice Address - Country:US
Practice Address - Phone:559-625-8890
Practice Address - Fax:559-733-5053
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA203223164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse