Individual
DWAYNE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN, CNA.
Contact information
Practice address
2892 N BELLFLOWER BLVD, SUITE 281, LONG BEACH, CA 90815-1125
(714) 614-5387
(888) 316-1604
Mailing address
P.O. BOX 8321, CHULA VISTA, CA 91912-8321
(714) 278-7622
(888) 316-1604
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
164X00000X
Licensed Vocational Nurse
Primary
691103
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
02/26/2013
Last updated
05/16/2017
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