Provider Demographics
NPI:1346058211
Name:CHAVEZ, MARIA DELROSARIO (LVN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DELROSARIO
Last Name:CHAVEZ
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 1:159 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95110-3144
Mailing Address - Country:US
Mailing Address - Phone:408-677-9728
Mailing Address - Fax:
Practice Address - Street 1:90 HIGHLAND AVE BLDG J
Practice Address - Street 2:
Practice Address - City:SAN MARTIN
Practice Address - State:CA
Practice Address - Zip Code:95046-9504
Practice Address - Country:US
Practice Address - Phone:408-852-2420
Practice Address - Fax:408-686-0370
Is Sole Proprietor?:No
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA188747164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse