Provider Demographics
NPI:1184196826
Name:LOMELI, DENA SHELAN
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:SHELAN
Last Name:LOMELI
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 1:12616 BRENDA JEAN CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6589
Mailing Address - Country:US
Mailing Address - Phone:661-201-6728
Mailing Address - Fax:
Practice Address - Street 1:1624 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-5512
Practice Address - Country:US
Practice Address - Phone:661-837-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553710163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool