Provider Demographics
NPI:1629855697
Name:ALSAYEH, HALA (CNA/RCFE OWNER (ATYP)
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:
Last Name:ALSAYEH
Suffix:
Gender:F
Credentials:CNA/RCFE OWNER (ATYP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20461 MYRON STREET
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-9853
Mailing Address - Country:US
Mailing Address - Phone:951-349-3440
Mailing Address - Fax:
Practice Address - Street 1:20461 MYRON STREET
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-9853
Practice Address - Country:US
Practice Address - Phone:951-349-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA331880889310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA331880889OtherRCPE