Provider Demographics
NPI:1417743659
Name:VASALLO, RIZZYANNMAE APOLDO (LVN)
Entity type:Individual
Prefix:
First Name:RIZZYANNMAE
Middle Name:APOLDO
Last Name:VASALLO
Suffix:
Gender:
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10953 RAMONA BLVD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2629
Mailing Address - Country:US
Mailing Address - Phone:626-434-2500
Mailing Address - Fax:
Practice Address - Street 1:10953 RAMONA BLVD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2629
Practice Address - Country:US
Practice Address - Phone:626-434-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA258779164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse