Provider Demographics
NPI:1023981313
Name:DYKES, RENEE ANGELA (LVN)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:ANGELA
Last Name:DYKES
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 1:3031 MOUNTAIN TOP DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-4848
Mailing Address - Country:US
Mailing Address - Phone:909-708-6444
Mailing Address - Fax:
Practice Address - Street 1:14075 HESPERIA RD STE 106
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4500
Practice Address - Country:US
Practice Address - Phone:909-793-1078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267763164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse