Provider Demographics
NPI:1588676118
Name:GEANES, JAMI LOUISE (LVN)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:LOUISE
Last Name:GEANES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:LOUISE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:29650 BRADLEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-6521
Mailing Address - Country:US
Mailing Address - Phone:951-672-8226
Mailing Address - Fax:951-672-1101
Practice Address - Street 1:29650 BRADLEY RD STE A
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-6521
Practice Address - Country:US
Practice Address - Phone:951-672-8226
Practice Address - Fax:951-672-1101
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA216798164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARVN003850Medicare ID - Type UnspecifiedINP