Provider Demographics
NPI:1598922817
Name:JONES-ALT, CARLA DALE (LVN)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:DALE
Last Name:JONES-ALT
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:D
Other - Last Name:JONES-ALT, LVN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:VN
Mailing Address - Street 1:2401 SAN ANSELINE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2044
Mailing Address - Country:US
Mailing Address - Phone:562-596-8777
Mailing Address - Fax:
Practice Address - Street 1:2401 SAN ANSELINE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2044
Practice Address - Country:US
Practice Address - Phone:562-596-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN227168164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse