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General NPI Number Information
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NPI Number | 1013738061
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Entity Type | Individual
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Provider Name | RAHA NOORAFSHANI LVN
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Gender | Female
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 2460 MAIN ST
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City | MORRO BAY
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State | CA
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Zip | 93442-1552
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Country | US
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Telephone | 805-772-2212
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Fax |
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Provider Business Mailing Address
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Address Line | 8850 EL CAMINO REAL SPC 2
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City | ATASCADERO
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State | CA
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Zip | 93422-5330
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Country | US
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Telephone | 310-422-9813
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN230152
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License Number State | CA
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