Provider Demographics
NPI:1699316182
Name:ZABLOCKI, LUCIA
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:ZABLOCKI
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:PO BOX 5848
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93005-0848
Mailing Address - Country:US
Mailing Address - Phone:805-832-0632
Mailing Address - Fax:
Practice Address - Street 1:6194 BRYNDALE AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-5846
Practice Address - Country:US
Practice Address - Phone:805-832-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA163487164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse