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NPI Code Detail

MEDICARE: RUBY NICOLE CAMACHO LVN

MEDICARE: RUBY NICOLE CAMACHO LVN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse723120CA

General Provider Information

NPI Number : 1487570305
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBY NICOLE CAMACHO LVN
Provider Business Mailing Address
First Line : 11682 ATLANTIC AVE
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-3832
Country : US
Telephone Number : 310-361-9060
Fax Number :
Provider Business Practice Location Address
First Line : 11682 ATLANTIC AVE
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-3832
Country : US
Telephone Number : 310-361-9060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2026
Last Update Date : 06/25/2026

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Directions to “ RUBY NICOLE CAMACHO LVN” Practice Location

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