Provider Demographics
NPI:1376755934
Name:ARONSON, NANCY LOUISE (LVN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LOUISE
Last Name:ARONSON
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 1:2711 MAR VISTA DR SPC 7
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3610
Mailing Address - Country:US
Mailing Address - Phone:831-688-6358
Mailing Address - Fax:
Practice Address - Street 1:1150 GREENBANK DR
Practice Address - Street 2:
Practice Address - City:BEN LOMOND
Practice Address - State:CA
Practice Address - Zip Code:95005-9308
Practice Address - Country:US
Practice Address - Phone:831-336-5367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN165329164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARVN002610OtherDHS MEDI-CAL