Provider Demographics
NPI:1003210089
Name:POLICARPIO, IVONE Y
Entity Type:Individual
Prefix:
First Name:IVONE
Middle Name:Y
Last Name:POLICARPIO
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 1:13307 MEYER RD APT D
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-3569
Mailing Address - Country:US
Mailing Address - Phone:323-868-1412
Mailing Address - Fax:
Practice Address - Street 1:12130 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2339
Practice Address - Country:US
Practice Address - Phone:562-923-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator