Provider Demographics
NPI:1649682030
Name:EVANGELHO, RACHAEL JOY (LVN)
Entity type:Individual
Prefix:MISS
First Name:RACHAEL
Middle Name:JOY
Last Name:EVANGELHO
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 1:4859 AVENIDA DE LOS ARBOLES
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-1424
Mailing Address - Country:US
Mailing Address - Phone:408-469-3577
Mailing Address - Fax:
Practice Address - Street 1:4859 AVENIDA DE LOS ARBOLES
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-1424
Practice Address - Country:US
Practice Address - Phone:408-469-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 256031164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse