Provider Demographics
NPI:1376708917
Name:MCPHERSON, ERLINDA LANDERO (LICENSE NURSE)
Entity Type:Individual
Prefix:MRS
First Name:ERLINDA
Middle Name:LANDERO
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:LICENSE NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 W VINE ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-3863
Mailing Address - Country:US
Mailing Address - Phone:209-334-0214
Mailing Address - Fax:209-367-4696
Practice Address - Street 1:1507 W VINE ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3863
Practice Address - Country:US
Practice Address - Phone:209-334-0214
Practice Address - Fax:209-367-4696
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN210465374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide