Provider Demographics
NPI:1790912186
Name:LOYA, JIMMEY CAMPOS (REGISTERED NURSE)
Entity Type:Individual
Prefix:PROF
First Name:JIMMEY
Middle Name:CAMPOS
Last Name:LOYA
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:PROF
Other - First Name:JIMMEY
Other - Middle Name:CAMPOS
Other - Last Name:LOYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:7324 HANNON ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-2023
Mailing Address - Country:US
Mailing Address - Phone:562-480-4729
Mailing Address - Fax:213-351-2769
Practice Address - Street 1:695 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1349
Practice Address - Country:US
Practice Address - Phone:213-351-2813
Practice Address - Fax:213-351-2769
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA582053163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health