MEDICARE: MS. ENDORA CAPRICE JONES LVN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	VN230864	CA

General Provider Information

NPI Number	:	1679731160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ENDORA CAPRICE JONES LVN

Provider Business Mailing Address
First Line	:	724 ASHLAND AVE
Second Line	:	APARTMENT 2
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-4536
Country	:	US
Telephone Number	:	310-359-2577
Fax Number	:

Provider Business Practice Location Address
First Line	:	724 ASHLAND AVE
Second Line	:	APARTMENT 2
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-4536
Country	:	US
Telephone Number	:	310-359-2577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	05/30/2008

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