Healthcare Provider Details

I. General information

NPI: 1295940765
Provider Name (Legal Business Name): MARIA ROSALINA M. DAYRIT L.V.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 BONITA AVE APT 5
MOUNTAIN VIEW CA
94040-2666
US

IV. Provider business mailing address

251 CRESTMOOR CIR
PACIFICA CA
94044-1517
US

V. Phone/Fax

Practice location:
  • Phone: 650-390-9371
  • Fax:
Mailing address:
  • Phone: 650-355-4302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN 201417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: