Provider Demographics
NPI:1700074218
Name:PIEL, LUZMINDA VILLANUEVA (LVN)
Entity Type:Individual
Prefix:MRS
First Name:LUZMINDA
Middle Name:VILLANUEVA
Last Name:PIEL
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 1:9240 S MCCALL AVE
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-9776
Mailing Address - Country:US
Mailing Address - Phone:559-999-0150
Mailing Address - Fax:559-896-3435
Practice Address - Street 1:9240 S MCCALL AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-9776
Practice Address - Country:US
Practice Address - Phone:559-999-0150
Practice Address - Fax:559-896-3435
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109273164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEPS011140OtherMEDI-CAL PROVIDER NUMBER