Provider Demographics
NPI:1427357201
Name:LEFLORE, DEVETTE (RN, PHN CASE MANAGER)
Entity Type:Individual
Prefix:MS
First Name:DEVETTE
Middle Name:
Last Name:LEFLORE
Suffix:
Gender:F
Credentials:RN, PHN CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24085 AMADOR ST STE 110
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-1278
Mailing Address - Country:US
Mailing Address - Phone:510-670-8452
Mailing Address - Fax:510-670-8466
Practice Address - Street 1:24085 AMADOR ST STE 110
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1278
Practice Address - Country:US
Practice Address - Phone:510-670-8452
Practice Address - Fax:510-670-8466
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA756031163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management