Provider Demographics
NPI:1134623564
Name:SAUNDERS, KATHLEEN E (LVN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:SAUNDERS
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 1:920 LUCERNE DR
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-7220
Mailing Address - Country:US
Mailing Address - Phone:909-663-7951
Mailing Address - Fax:
Practice Address - Street 1:920 LUCERNE DR
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-7220
Practice Address - Country:US
Practice Address - Phone:909-663-7951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA182744164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse