Provider Demographics
NPI:1518771922
Name:RACELA, LYORA THERESE COCOS
Entity type:Individual
Prefix:
First Name:LYORA THERESE
Middle Name:COCOS
Last Name:RACELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7755 TIERRA DEL SOL PKWY UNIT 506
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7501
Mailing Address - Country:US
Mailing Address - Phone:916-945-1094
Mailing Address - Fax:
Practice Address - Street 1:7755 TIERRA DEL SOL PKWY UNIT 506
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-7501
Practice Address - Country:US
Practice Address - Phone:916-945-1094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV880913163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health