Provider Demographics
NPI:1689918484
Name:BELLEZA, JAY DELA CRUZ (LVN)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:DELA CRUZ
Last Name:BELLEZA
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 1:2421 ALA WAI BLVD APT 406
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3411
Mailing Address - Country:US
Mailing Address - Phone:808-294-9393
Mailing Address - Fax:
Practice Address - Street 1:21738 HARDY OAK BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4864
Practice Address - Country:US
Practice Address - Phone:210-496-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALVN194795282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital