Individual
IVY NGENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
735 W 157TH ST, GARDENA, CA 90247-4220
(310) 590-8740
(310) 532-0719
Mailing address
735 W 157TH STREET, GARDENA, CA 90247-4220
(310) 590-8740
(310) 532-0719
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
283094
CA
Other
Enumeration date
09/02/2014
Last updated
11/02/2016
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