Provider Demographics
NPI:1912265844
Name:KAMPMEYER, MARCELA CATALINA (LVN)
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:CATALINA
Last Name:KAMPMEYER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MISS
Other - First Name:MARCELA
Other - Middle Name:CATALINA
Other - Last Name:PACHECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:4088 BLAIRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3011
Mailing Address - Country:US
Mailing Address - Phone:310-902-9268
Mailing Address - Fax:
Practice Address - Street 1:4088 BLAIRWOOD DR
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-3011
Practice Address - Country:US
Practice Address - Phone:310-902-9268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-28
Last Update Date:2012-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN242198164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse