Provider Demographics
NPI:1639594088
Name:DAWSON, RAKIYA (LVN)
Entity Type:Individual
Prefix:
First Name:RAKIYA
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 UNIVERSITY AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-5355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:951-955-9840
Practice Address - Street 1:1820 UNIVERSITY AVE # 2B
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-5355
Practice Address - Country:US
Practice Address - Phone:951-420-5113
Practice Address - Fax:951-955-9840
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 214748164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse