Healthcare Provider Details

I. General information

NPI: 1992895759
Provider Name (Legal Business Name): DELORES DONNISHA ARMSTRONG LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8226 DEER SPRING CIR
ANTELOPE CA
95843-6116
US

IV. Provider business mailing address

8226 DEER SPRING CIR
ANTELOPE CA
95843-6116
US

V. Phone/Fax

Practice location:
  • Phone: 510-830-7981
  • Fax:
Mailing address:
  • Phone: 510-830-7981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN189302
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: