MEDICARE: MR. JOEL HOPE 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
1	164X00000X	Licensed Vocational Nurse	VN151751	CA

General Provider Information

NPI Number	:	1265771638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOEL HOPE LVN

Provider Business Mailing Address
First Line	:	3904 ANNADALE LN
Second Line	:	155
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2038
Country	:	US
Telephone Number	:	916-505-1620
Fax Number	:

Provider Business Practice Location Address
First Line	:	3904 ANNADALE LN
Second Line	:	155
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2038
Country	:	US
Telephone Number	:	916-505-1620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2013
Last Update Date	:	02/05/2013

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