Provider Demographics
NPI:1477372852
Name:SANDOVAL HERNANDEZ, BLANCA MARGARITA (LVN LICENCE 693423)
Entity type:Individual
Prefix:MRS
First Name:BLANCA
Middle Name:MARGARITA
Last Name:SANDOVAL HERNANDEZ
Suffix:
Gender:F
Credentials:LVN LICENCE 693423
Other - Prefix:MRS
Other - First Name:BLANCA
Other - Middle Name:MARGARITA
Other - Last Name:SANDOVAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17149 DONMETZ ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4124
Mailing Address - Country:US
Mailing Address - Phone:818-231-7772
Mailing Address - Fax:
Practice Address - Street 1:17149 DONMETZ ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4124
Practice Address - Country:US
Practice Address - Phone:818-231-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA693423164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse