Individual
CHANAE TARVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40700 CALIFORNIA OAKS RD STE 202, MURRIETA, CA 92562-5789
(951) 894-5072
Mailing address
40700 CALIFORNIA OAKS RD STE 202, MURRIETA, CA 92562-5789
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
282452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578665790
—
CA
Enumeration date
07/01/2019
Last updated
07/12/2019
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