Provider Demographics
NPI:1467078048
Name:CAJINA, VIOLET DEL CARMEN I
Entity Type:Individual
Prefix:
First Name:VIOLET
Middle Name:DEL CARMEN
Last Name:CAJINA
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 E RUDDOCK ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1411
Mailing Address - Country:US
Mailing Address - Phone:626-257-6586
Mailing Address - Fax:
Practice Address - Street 1:21730 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2196
Practice Address - Country:US
Practice Address - Phone:213-266-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37754167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician