Provider Demographics
NPI:1316694300
Name:JONES, LADRIENA D (LVN)
Entity type:Individual
Prefix:
First Name:LADRIENA
Middle Name:D
Last Name:JONES
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:PO BOX 2520
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-0520
Mailing Address - Country:US
Mailing Address - Phone:562-479-3767
Mailing Address - Fax:
Practice Address - Street 1:10418 S PRAIRIE AVE STE A
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-1832
Practice Address - Country:US
Practice Address - Phone:562-479-3767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X, 385H00000X
CA271644164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No385H00000XRespite Care FacilityRespite Care