Provider Demographics
NPI:1164543567
Name:ATIABET, VICTORINE AKUH (LVN)
Entity Type:Individual
Prefix:MISS
First Name:VICTORINE
Middle Name:AKUH
Last Name:ATIABET
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 1:1324 S WINCHESTER BLVD
Mailing Address - Street 2:72
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4341
Mailing Address - Country:US
Mailing Address - Phone:408-829-1203
Mailing Address - Fax:
Practice Address - Street 1:6027 SYLVANER WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-1735
Practice Address - Country:US
Practice Address - Phone:408-268-1301
Practice Address - Fax:408-927-9279
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 201143164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse