Provider Demographics
NPI:1922511682
Name:NEVAREZ, HECTOR (LVN)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:NEVAREZ
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7670 VIA CRISTAL UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4683
Mailing Address - Country:US
Mailing Address - Phone:619-852-6075
Mailing Address - Fax:
Practice Address - Street 1:7670 VIA CRISTAL UNIT 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-4683
Practice Address - Country:US
Practice Address - Phone:619-852-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225698164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse