Provider Demographics
NPI:1477267284
Name:SUAREZ, JAHYRA NOELLY (LVN)
Entity Type:Individual
Prefix:
First Name:JAHYRA
Middle Name:NOELLY
Last Name:SUAREZ
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 1:1572 CALLE NUEVE
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-1707
Mailing Address - Country:US
Mailing Address - Phone:805-717-8951
Mailing Address - Fax:
Practice Address - Street 1:401 E OCEAN AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6828
Practice Address - Country:US
Practice Address - Phone:805-737-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA708843164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse