Individual
JASMINE CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1021 W LA CADENA DR, RIVERSIDE, CA 92501-1413
(951) 784-8010
Mailing address
2027 S CAMPUS AVE, APT. C, ONTARIO, CA 91761-5491
(909) 545-0639
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
684752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164X00000X
MEDICAL
CA
Enumeration date
12/07/2016
Last updated
12/07/2016
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