Provider Demographics
NPI:1376061192
Name:PINA, EMILY (LVN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PINA
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 1:1919 APPLE ST STE G
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-4425
Mailing Address - Country:US
Mailing Address - Phone:760-547-1280
Mailing Address - Fax:
Practice Address - Street 1:1919 APPLE ST STE G
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-4425
Practice Address - Country:US
Practice Address - Phone:760-547-1280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA692629164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse