Provider Demographics
NPI:1013363472
Name:THAO, SYLVIE EELEE C (LVN)
Entity Type:Individual
Prefix:MS
First Name:SYLVIE EELEE
Middle Name:C
Last Name:THAO
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 1:1200 SCOTT AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-2954
Mailing Address - Country:US
Mailing Address - Phone:559-978-0248
Mailing Address - Fax:
Practice Address - Street 1:1200 SCOTT AVE APT 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-2954
Practice Address - Country:US
Practice Address - Phone:559-978-0248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284262164X00000X
CA00792568376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide