Provider Demographics
NPI:1417556374
Name:DELA SALDE, RAINVILLE LOVE (LVN)
Entity Type:Individual
Prefix:
First Name:RAINVILLE
Middle Name:LOVE
Last Name:DELA SALDE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:RAINVILLE
Other - Middle Name:LOVE
Other - Last Name:DELGADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 ADAMS AVE APT 12A
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-8315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 ADAMS AVE APT 12A
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-8315
Practice Address - Country:US
Practice Address - Phone:714-813-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA266768164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse