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General NPI Number Information
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NPI Number | 1831915529
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Entity Type | Individual
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Provider Name | H LAVERNE LAVERNE HARDIN
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Gender | Female
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 9240 19TH ST
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-4835
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Country | US
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Telephone | 909-455-7248
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Fax | 866-799-4635
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Provider Business Mailing Address
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Address Line | 1498 N SAN ANTONIO AVE
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City | UPLAND
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State | CA
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Zip | 91786-2752
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Country | US
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Telephone | 909-455-7248
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Fax | 866-799-4635
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number |
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License Number State |
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