Provider Demographics
NPI:1760785026
Name:HIRSCH, CARYN RANDY (LVN)
Entity Type:Individual
Prefix:MRS
First Name:CARYN
Middle Name:RANDY
Last Name:HIRSCH
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 1:10915 ROSE AVE APT 13
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-5336
Mailing Address - Country:US
Mailing Address - Phone:310-713-2533
Mailing Address - Fax:310-839-2424
Practice Address - Street 1:10915 ROSE AVE APT 13
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5336
Practice Address - Country:US
Practice Address - Phone:310-713-2533
Practice Address - Fax:310-839-2424
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN197957164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse