Provider Demographics
NPI:1679976658
Name:RAYOS, JULIEANN O
Entity type:Individual
Prefix:
First Name:JULIEANN
Middle Name:O
Last Name:RAYOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE ANN
Other - Middle Name:O
Other - Last Name:RAYOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:11770 WARNER AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2661
Mailing Address - Country:US
Mailing Address - Phone:714-546-4133
Mailing Address - Fax:714-546-4220
Practice Address - Street 1:11770 WARNER AVE STE 210
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2661
Practice Address - Country:US
Practice Address - Phone:714-546-4133
Practice Address - Fax:714-546-4220
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002522251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based