Provider Demographics
NPI:1588903462
Name:SKELTON, HELEN S
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:S
Last Name:SKELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9007 XAVIER AVE
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:93505-2134
Mailing Address - Country:US
Mailing Address - Phone:760-718-9242
Mailing Address - Fax:
Practice Address - Street 1:9007 XAVIER AVE
Practice Address - Street 2:
Practice Address - City:CALIFORNIA CITY
Practice Address - State:CA
Practice Address - Zip Code:93505-2134
Practice Address - Country:US
Practice Address - Phone:760-718-9242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15-70303899251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health