Provider Demographics
NPI:1730646001
Name:KANTOR, CHAVA C (LPN)
Entity Type:Individual
Prefix:MS
First Name:CHAVA
Middle Name:C
Last Name:KANTOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6863 TIDAL CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-1726
Mailing Address - Country:US
Mailing Address - Phone:760-568-3819
Mailing Address - Fax:815-642-8566
Practice Address - Street 1:6863 TIDAL CREEK AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-1726
Practice Address - Country:US
Practice Address - Phone:760-568-3819
Practice Address - Fax:815-642-8566
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78087164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA78087OtherCALIFORNIA BOARD OF NURSING