Provider Demographics
NPI:1255977575
Name:PEREZ, RODOLCITA C (LVN)
Entity type:Individual
Prefix:
First Name:RODOLCITA
Middle Name:C
Last Name:PEREZ
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 1:13938 HALCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3507
Mailing Address - Country:US
Mailing Address - Phone:562-382-7080
Mailing Address - Fax:
Practice Address - Street 1:8207 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2521
Practice Address - Country:US
Practice Address - Phone:562-695-0737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281013164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse