Provider Demographics
NPI:1386793800
Name:HRIVNAK, ALIDA SHEVELLE (RN)
Entity type:Individual
Prefix:MRS
First Name:ALIDA
Middle Name:SHEVELLE
Last Name:HRIVNAK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 QUAIL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-9636
Mailing Address - Country:US
Mailing Address - Phone:530-671-0554
Mailing Address - Fax:
Practice Address - Street 1:137 N. COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695
Practice Address - Country:US
Practice Address - Phone:530-666-8672
Practice Address - Fax:530-666-7447
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332384163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator