Provider Demographics
NPI:1285277152
Name:MAIKI, RESHMI LATA (LVN)
Entity type:Individual
Prefix:
First Name:RESHMI
Middle Name:LATA
Last Name:MAIKI
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 1:8321 MALLETT WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-1696
Mailing Address - Country:US
Mailing Address - Phone:916-271-1871
Mailing Address - Fax:
Practice Address - Street 1:8321 MALLETT WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-1696
Practice Address - Country:US
Practice Address - Phone:916-271-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276281164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse