Provider Demographics
NPI:1639862477
Name:HINOJOSA, SIU H (LVN)
Entity Type:Individual
Prefix:
First Name:SIU
Middle Name:H
Last Name:HINOJOSA
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 1:7118 FARMLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3928
Mailing Address - Country:US
Mailing Address - Phone:818-726-8788
Mailing Address - Fax:
Practice Address - Street 1:7118 FARMLAND AVE
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3928
Practice Address - Country:US
Practice Address - Phone:818-726-8788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285230164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse