Ronnie Palache, FNP | |
5623 Kanan Rd, Agoura, CA 91301-3358 | |
(818) 991-5522 | |
Not Available |
Full Name | Ronnie Palache |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 5623 Kanan Rd, Agoura, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1588916878 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 22439 (California) | Primary |
Entity Name | Providence Facey Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1710031588 PECOS PAC ID: 3173436276 Enrollment ID: O20031105000822 |
Entity Name | Providence Saint Johns Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518438712 PECOS PAC ID: 0840548624 Enrollment ID: O20180810000904 |
Mailing Address | Practice Location Address |
---|---|
Ronnie Palache, FNP 5251 Villeboso Ave, Woodland Hills, CA 91364-1652 Ph: (818) 264-9263 | Ronnie Palache, FNP 5623 Kanan Rd, Agoura, CA 91301-3358 Ph: (818) 991-5522 |
Denise Hernandez, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5623 Kanan Rd, Agoura, CA 91301 Phone: 818-991-5522 | |
Mr. Brandon Moritz, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5623 Kanan Rd, Agoura, CA 91301 Phone: 818-991-5522 |