Provider Demographics
NPI:1083327159
Name:NEUBLE, DELORES-MONIQUE
Entity Type:Individual
Prefix:
First Name:DELORES-MONIQUE
Middle Name:
Last Name:NEUBLE
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 1:13255 WARNICK BLVD
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4872
Mailing Address - Country:US
Mailing Address - Phone:716-361-7883
Mailing Address - Fax:
Practice Address - Street 1:13255 WARNICK BLVD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4872
Practice Address - Country:US
Practice Address - Phone:716-361-7883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240245164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse