Provider Demographics
NPI:1568848422
Name:TOVAR, VANESSA
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:TOVAR
Suffix:
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 1:5730 RIVERSIDE DR BLDG 625
Mailing Address - Street 2:
Mailing Address - City:MARCH ARB
Mailing Address - State:CA
Mailing Address - Zip Code:92518-1830
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5730 RIVERSIDE DR BLDG 625
Practice Address - Street 2:
Practice Address - City:MARCH ARB
Practice Address - State:CA
Practice Address - Zip Code:92518-1830
Practice Address - Country:US
Practice Address - Phone:951-655-5167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA769445163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient