Provider Demographics
NPI:1134656929
Name:CHIMA, ROSALYN (LVN)
Entity Type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:
Last Name:CHIMA
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 1:317 E HILLCREST BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-2405
Mailing Address - Country:US
Mailing Address - Phone:310-292-9941
Mailing Address - Fax:310-933-8889
Practice Address - Street 1:317 E HILLCREST BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-2405
Practice Address - Country:US
Practice Address - Phone:310-292-9941
Practice Address - Fax:310-933-8889
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN199024164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse