Provider Demographics
NPI:1467785766
Name:BONILLA PARADA, KARLA EVELYN (LVN)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:EVELYN
Last Name:BONILLA PARADA
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 1:629 E 4TH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-2690
Mailing Address - Country:US
Mailing Address - Phone:323-640-7181
Mailing Address - Fax:562-513-3541
Practice Address - Street 1:629 E 4TH ST APT 8
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-2690
Practice Address - Country:US
Practice Address - Phone:323-640-7181
Practice Address - Fax:562-513-3541
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221021164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse