Provider Demographics
NPI:1992903959
Name:RANESES, EMMANUEL EDGARDO (LVN)
Entity type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:EDGARDO
Last Name:RANESES
Suffix:
Gender:M
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:PO BOX 981176
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95798-1176
Mailing Address - Country:US
Mailing Address - Phone:916-524-7218
Mailing Address - Fax:
Practice Address - Street 1:1492 BARONA ST
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-4942
Practice Address - Country:US
Practice Address - Phone:916-524-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN179682164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse