Provider Demographics
NPI:1295062305
Name:CHINDAH LYNCH, EBERECHI (LVN)
Entity type:Individual
Prefix:
First Name:EBERECHI
Middle Name:
Last Name:CHINDAH LYNCH
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:PO BOX 2943
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-7421
Mailing Address - Country:US
Mailing Address - Phone:916-534-5317
Mailing Address - Fax:
Practice Address - Street 1:6512 HAZEL AVE
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-4028
Practice Address - Country:US
Practice Address - Phone:916-534-5317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 242620164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse