Provider Demographics
NPI:1699164160
Name:NOCHIMSON, CHAD (LVN)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:NOCHIMSON
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S TUSTIN ST
Mailing Address - Street 2:BUILDING D
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2550
Mailing Address - Country:US
Mailing Address - Phone:714-289-3936
Mailing Address - Fax:714-289-3938
Practice Address - Street 1:401 S TUSTIN ST
Practice Address - Street 2:BUILDING D
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2550
Practice Address - Country:US
Practice Address - Phone:714-289-3936
Practice Address - Fax:714-289-3938
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 279717164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse