Provider Demographics
NPI:1346950078
Name:MATCHEM, LECOLE
Entity Type:Individual
Prefix:
First Name:LECOLE
Middle Name:
Last Name:MATCHEM
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 1:1400 N KRAEMER BLVD UNIT 413
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92871-1418
Mailing Address - Country:US
Mailing Address - Phone:626-298-9076
Mailing Address - Fax:
Practice Address - Street 1:110 SUNSET DR
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-4925
Practice Address - Country:US
Practice Address - Phone:626-298-9076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No332U00000XSuppliersHome Delivered Meals
No374U00000XNursing Service Related ProvidersHome Health Aide