Provider Demographics
NPI:1700275518
Name:WORTHY, EVELYN LAJOYCE (LVN)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:LAJOYCE
Last Name:WORTHY
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 1:2748 S ORANGE DR APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-2734
Mailing Address - Country:US
Mailing Address - Phone:562-786-0938
Mailing Address - Fax:
Practice Address - Street 1:2748 S ORANGE DR APT 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-2734
Practice Address - Country:US
Practice Address - Phone:562-786-0938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94815164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse