Provider Demographics
NPI:1801009063
Name:DEVITO, ANJANETTE MARIE V (LVN)
Entity Type:Individual
Prefix:
First Name:ANJANETTE
Middle Name:MARIE
Last Name:DEVITO
Suffix:V
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 1:6130 MONTEREY HWY SPC 249
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1728
Mailing Address - Country:US
Mailing Address - Phone:408-225-9919
Mailing Address - Fax:408-272-6570
Practice Address - Street 1:2101 ALEXIAN DR STE D
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1901
Practice Address - Country:US
Practice Address - Phone:408-272-6554
Practice Address - Fax:408-272-6570
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN172521164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse