Basic Information
| Provider Information | |||||||||
| NPI: | 1154693042 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROOKS | ||||||||
| FirstName: | RANETA | ||||||||
| MiddleName: | ANN | ||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | ROOKS | ||||||||
| OtherFirstName: | RITA | ||||||||
| OtherMiddleName: | ANN | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 427 C ST | ||||||||
| Address2: | 212 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921015100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192384180 | ||||||||
| FaxNumber: | 6192384245 | ||||||||
| Practice Location | |||||||||
| Address1: | 427 C ST | ||||||||
| Address2: | 212 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921015100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192384180 | ||||||||
| FaxNumber: | 6192384245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2012 | ||||||||
| LastUpdateDate: | 02/07/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | VN259344 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.