Provider Demographics
NPI:1003519778
Name:ANIMASHAUN, HABIBAT AJOKE (LVN)
Entity Type:Individual
Prefix:
First Name:HABIBAT
Middle Name:AJOKE
Last Name:ANIMASHAUN
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 1:10034 ETON AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3033
Mailing Address - Country:US
Mailing Address - Phone:818-290-0382
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:818-290-0382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN267316164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse