Provider Demographics
NPI:1952849143
Name:DEMONT, CHRISTINE (LVN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DEMONT
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 1:10408 VACCO ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-3328
Mailing Address - Country:US
Mailing Address - Phone:626-398-6300
Mailing Address - Fax:
Practice Address - Street 1:10408 VACCO ST
Practice Address - Street 2:
Practice Address - City:SOUTH EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-3328
Practice Address - Country:US
Practice Address - Phone:626-398-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA682731164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse