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JODI BLADES LVN
>> Licensed Vocational Nurse >> Nursing Service ProvidersRegistrant NPI Number: 1932559309
Individual Registrant: JODI BLADES LVN
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1904 RICHLAND AVE CERES, CA 95307-4562 US
Tel: 209-300-8800 Fax: --
Tel: 209-300-8800 Fax: --
Contact information for business:
1733 DALIA LN MANTECA, CA 95337-8785 US
Tel: 209-640-3562 Fax: --
Tel: 209-640-3562 Fax: --
Registration Information:
NPI: 1932559309
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 164X00000X | Nursing Service Providers Licensed Vocational Nurse | CA | 285373 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 164X00000X | CA | 05 |
