Provider Demographics
NPI:1063088920
Name:HARRIS-BRIDINGER, LASHONDA NICOLE (LVN)
Entity type:Individual
Prefix:MS
First Name:LASHONDA
Middle Name:NICOLE
Last Name:HARRIS-BRIDINGER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:LASHONDA
Other - Middle Name:NICOLE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:30865 HIGHLAND VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-7264
Mailing Address - Country:US
Mailing Address - Phone:951-466-7559
Mailing Address - Fax:
Practice Address - Street 1:30865 HIGHLAND VISTA CIR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-7264
Practice Address - Country:US
Practice Address - Phone:951-466-7559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 251E00000X, 374U00000X, 376K00000X, 385H00000X, 385HR2065X
CAVN712923164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child