Provider Demographics
NPI:1942365648
Name:ALFARO, IVONE LUCILA (RNP)
Entity Type:Individual
Prefix:
First Name:IVONE
Middle Name:LUCILA
Last Name:ALFARO
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 JESSICA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-4152
Mailing Address - Country:US
Mailing Address - Phone:213-500-7741
Mailing Address - Fax:323-259-9093
Practice Address - Street 1:8781 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-2406
Practice Address - Country:US
Practice Address - Phone:818-920-0303
Practice Address - Fax:818-893-6479
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN276183163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse