Provider Demographics
NPI:1417775750
Name:DERES, SEHINE ESTFINOS (LVN)
Entity type:Individual
Prefix:
First Name:SEHINE
Middle Name:ESTFINOS
Last Name:DERES
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 1:5713 WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2431
Mailing Address - Country:US
Mailing Address - Phone:310-945-8320
Mailing Address - Fax:323-294-4342
Practice Address - Street 1:5713 WEST BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2431
Practice Address - Country:US
Practice Address - Phone:310-945-8320
Practice Address - Fax:323-294-4342
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN232206164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse