Loretta Botello
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Pacoima, CA
NPI 1992130199 · NPPES record last updated Sep 18, 2013
Key facts
- NPI
- 1992130199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 12450 Van Nuys Blvd Ste 200
Pacoima
Pacoima, CA 91331-1393 - Phone
- (818) 896-1161
- Fax
- (818) 896-5069
- NPI assigned
- Sep 6, 2013
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
12450 Van Nuys Blvd Ste 200
Pacoima
Pacoima, CA 91331-1393
Mailing address
281 N Madison Ave Apt 426
Pasadena
Pasadena, CA 91101-4467
Phone (559) 623-6067
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6758 | Medicaid | CA | |
| 7068 | Medicaid | CA | |
| 7420 | Medicaid | CA |
Other providers in Pacoima, CA
- Blanc Medical Supplies Inc
- Marie Bohui
- Ana Bolanos
- Heidi Linette Bolanos
- Michael Bonilla
- Melissa Diane Boudin
- Destiny Dawn Bowie
- Arden Boykin
- Carol Bradley
- Elizabeth Dianne Bragg-Hamilton
All providers in Pacoima, CA · Student in an Organized Health Care Education/Training Program in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.