Provider Demographics
NPI:1003509662
Name:HERBERT-THORSLAND, VICTORIA (LVN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:HERBERT-THORSLAND
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 PAULINE CT
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5216
Mailing Address - Country:US
Mailing Address - Phone:209-288-0302
Mailing Address - Fax:
Practice Address - Street 1:691 PAULINE CT
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5216
Practice Address - Country:US
Practice Address - Phone:209-288-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA691886164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse