Provider Demographics
NPI:1093552697
Name:LEMUS SALAZAR, THANIA ALEJANDRA (LVN)
Entity type:Individual
Prefix:
First Name:THANIA
Middle Name:ALEJANDRA
Last Name:LEMUS SALAZAR
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18535 MAYALL ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1446
Mailing Address - Country:US
Mailing Address - Phone:186-404-5728
Mailing Address - Fax:
Practice Address - Street 1:732 MOTT ST
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4237
Practice Address - Country:US
Practice Address - Phone:818-963-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA695884164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse