Basic Information
| Provider Information | |||||||||
| NPI: | 1568891752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AREVALO | ||||||||
| FirstName: | LILIANA | ||||||||
| MiddleName: | |||||||||
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| Credential: | L.V.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N. MAIN ST. | ||||||||
| Address2: | SUITE # 650 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148248140 | ||||||||
| FaxNumber: | 7148248142 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 N MAIN ST | ||||||||
| Address2: | SUITE # 650 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927013640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148248140 | ||||||||
| FaxNumber: | 7148248142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2013 | ||||||||
| LastUpdateDate: | 11/07/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | VN261275 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.