Provider Demographics
NPI:1629610589
Name:HERVEY, ALLISON RENEE VANOS
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RENEE VANOS
Last Name:HERVEY
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 1:4685 PESCADERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3538
Mailing Address - Country:US
Mailing Address - Phone:619-972-3585
Mailing Address - Fax:
Practice Address - Street 1:4685 PESCADERO AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-3538
Practice Address - Country:US
Practice Address - Phone:619-972-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula