Provider Demographics
NPI:1851490437
Name:HALL, LA TONAYA RENEE (RN)
Entity Type:Individual
Prefix:
First Name:LA TONAYA
Middle Name:RENEE
Last Name:HALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 E MOBECK ST
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-6705
Mailing Address - Country:US
Mailing Address - Phone:626-338-7560
Mailing Address - Fax:
Practice Address - Street 1:918 W FOOTHILL BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3772
Practice Address - Country:US
Practice Address - Phone:909-985-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA609355163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse