Provider Demographics
NPI:1972061844
Name:MORENO PADILLA, EMILIA
Entity type:Individual
Prefix:
First Name:EMILIA
Middle Name:
Last Name:MORENO PADILLA
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 1:13 CABERNET PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-4728
Mailing Address - Country:US
Mailing Address - Phone:707-206-8951
Mailing Address - Fax:
Practice Address - Street 1:13 CABERNET PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-4728
Practice Address - Country:US
Practice Address - Phone:707-206-8951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant