Provider Demographics
NPI:1790955755
Name:MUTHS, SYLVIA ANN (LVN)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ANN
Last Name:MUTHS
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 1:13782 SOUTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:MAGALIA
Mailing Address - State:CA
Mailing Address - Zip Code:95954
Mailing Address - Country:US
Mailing Address - Phone:530-873-1442
Mailing Address - Fax:
Practice Address - Street 1:5910 CLARK RD
Practice Address - Street 2:ST. W
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4856
Practice Address - Country:US
Practice Address - Phone:530-872-6328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 89371164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse