Remy Boyal

Individual provider Active NPI Licensed Vocational Nurse · Ceres, CA

NPI 1083094973 · NPPES record last updated Jun 4, 2015

Key facts

NPI
1083094973
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
VN 286582 (CA)
Practice address
1904 Richland Ave
Ceres, CA 95307-4562
Phone
(209) 300-8800
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
VN 286582CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN 286582 CA Yes

Addresses

Primary practice location

1904 Richland Ave
Ceres, CA 95307-4562

Mailing address

513 Fort Sumpter Dr
Modesto, CA 95354-2112
Phone (209) 818-5799

Other identifiers

IdentifierTypeStateIssuer
F1376961MedicaidCA

Other providers in Ceres, CA

All providers in Ceres, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.