Provider Demographics
NPI:1497133805
Name:ARREDONDO, LEONARD ANTHONY (LVN)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:ANTHONY
Last Name:ARREDONDO
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:LEONARD
Other - Middle Name:ANTHONY
Other - Last Name:ARREDONDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:500 N CENTRAL AVE
Mailing Address - Street 2:250
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3905
Mailing Address - Country:US
Mailing Address - Phone:818-539-8359
Mailing Address - Fax:855-245-8903
Practice Address - Street 1:500 N CENTRAL AVE
Practice Address - Street 2:250
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3905
Practice Address - Country:US
Practice Address - Phone:818-539-8359
Practice Address - Fax:855-245-8903
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251726164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse