Provider Demographics
NPI:1942401195
Name:REED, LYDIA BERNAL (LVN)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:BERNAL
Last Name:REED
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 1:10041 KAUFMAN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-5110
Mailing Address - Country:US
Mailing Address - Phone:858-271-6649
Mailing Address - Fax:
Practice Address - Street 1:9065 EDGEMOOR DR
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3037
Practice Address - Country:US
Practice Address - Phone:619-956-2910
Practice Address - Fax:619-956-2913
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN174646164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse