Healthcare Provider Details

I. General information

NPI: 1295654820
Provider Name (Legal Business Name): XENIA JAZMIN VASQUEZ LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 S ATLANTIC BLVD
LOS ANGELES CA
90022-2621
US

IV. Provider business mailing address

6900 CALIFORNIA AVE APT P
BELL CA
90201-3378
US

V. Phone/Fax

Practice location:
  • Phone: 323-268-9191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number762137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: