Provider Demographics
NPI:1952844565
Name:ZELAYA, ALBA EDITH (RN)
Entity Type:Individual
Prefix:MS
First Name:ALBA
Middle Name:EDITH
Last Name:ZELAYA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ALBA
Other - Middle Name:EDITH
Other - Last Name:PERESSON-ZELAYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1776 E CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-3050
Mailing Address - Country:US
Mailing Address - Phone:323-374-6848
Mailing Address - Fax:
Practice Address - Street 1:1776 E CENTURY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3050
Practice Address - Country:US
Practice Address - Phone:323-374-6848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA736084163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management