Provider Demographics
NPI:1043927569
Name:CORTEZ, JOVELINE CASTADA (LVN)
Entity Type:Individual
Prefix:
First Name:JOVELINE
Middle Name:CASTADA
Last Name:CORTEZ
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 1:100 KNIGHTS CIR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8113
Mailing Address - Country:US
Mailing Address - Phone:971-601-2539
Mailing Address - Fax:
Practice Address - Street 1:100 KNIGHTS CIR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-8113
Practice Address - Country:US
Practice Address - Phone:971-601-2539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA727437164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse