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General NPI Number Information
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NPI Number | 1497274385
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Entity Type | Individual
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Provider Name | LEDA RICAMORA LAUC NP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2017
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 7130 N MILLBROOK AVE
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City | FRESNO
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State | CA
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Zip | 93720-3347
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Country | US
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Telephone | 559-326-1222
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Fax | 559-326-1230
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Provider Business Mailing Address
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Address Line | PO BOX 25100
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City | FRESNO
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State | CA
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Zip | 93729-5100
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Country | US
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Telephone | 559-326-1222
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Fax | 559-326-1230
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9500734
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 9500734
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95007384
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License Number State | CA
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