Provider Demographics
NPI:1083883854
Name:LIBID, LEONIDA A (LVN)
Entity Type:Individual
Prefix:
First Name:LEONIDA
Middle Name:A
Last Name:LIBID
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 1:11136 LORNE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-3990
Mailing Address - Country:US
Mailing Address - Phone:818-767-2482
Mailing Address - Fax:
Practice Address - Street 1:11136 LORNE ST APT 5
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3990
Practice Address - Country:US
Practice Address - Phone:818-767-2482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226465164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse