Individual
ERNESTINA ANA TELLEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1072 SIMON WAY, OXNARD, CA 93036-1429
(805) 236-8993
Mailing address
PO BOX 50954, OXNARD, CA 93031-0954
(805) 236-8993
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 248996
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96952160E
MEDI-CAL
CA
Enumeration date
07/22/2013
Last updated
01/24/2014
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