Provider Demographics
NPI:1134316458
Name:ANDRES, INOCENSIA (LVN)
Entity Type:Individual
Prefix:MS
First Name:INOCENSIA
Middle Name:
Last Name:ANDRES
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 1:900 HURON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4026
Mailing Address - Country:US
Mailing Address - Phone:415-585-3951
Mailing Address - Fax:
Practice Address - Street 1:900 HURON AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-4026
Practice Address - Country:US
Practice Address - Phone:415-585-3951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN103959164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse