Healthcare Provider Details

I. General information

NPI: 1720744253
Provider Name (Legal Business Name): SABRINA LYNN URENA LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S 2ND AVE
COVINA CA
91723-3017
US

IV. Provider business mailing address

510 S 2ND AVE
COVINA CA
91723-3017
US

V. Phone/Fax

Practice location:
  • Phone: 626-974-8123
  • Fax: 626-974-8198
Mailing address:
  • Phone: 626-974-8123
  • Fax: 626-974-8198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number270677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: