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NPI Code Detail

MEDICARE: MS. MARYANNE JOY TOLENTINO ATIENZA LVN

MEDICARE: MS. MARYANNE JOY TOLENTINO ATIENZA 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 Nurse250680CA

General Provider Information

NPI Number : 1528309895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARYANNE JOY TOLENTINO ATIENZA LVN
Provider Business Mailing Address
First Line : 5300 ANGELES VISTA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1648
Country : US
Telephone Number : 323-295-4555
Fax Number : 323-295-3021
Provider Business Practice Location Address
First Line : 5300 ANGELES VISTA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1648
Country : US
Telephone Number : 323-295-4555
Fax Number : 323-295-3021
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2013
Last Update Date : 03/11/2013

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