Provider Demographics
NPI:1386879740
Name:PILLADO, CHRISTA TERESE (LVN)
Entity type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:TERESE
Last Name:PILLADO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MRS
Other - First Name:CHRISTA
Other - Middle Name:TERESE
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:1227 E LOS ANGELES AVENUE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-582-3329
Mailing Address - Fax:805-582-4804
Practice Address - Street 1:1227 E LOS ANGELES AVE.
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065
Practice Address - Country:US
Practice Address - Phone:805-582-4075
Practice Address - Fax:805-582-4804
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 225318164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse