Provider Demographics
NPI:1255656898
Name:TORNEROS, ELAINE BOCALBOS (LVN)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:BOCALBOS
Last Name:TORNEROS
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 1:9781 EGEN CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-4017
Mailing Address - Country:US
Mailing Address - Phone:916-730-3356
Mailing Address - Fax:
Practice Address - Street 1:9781 EGEN CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-4017
Practice Address - Country:US
Practice Address - Phone:916-730-3356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233849164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse