Provider Demographics
NPI:1740551464
Name:LANDS, CHAKARA S (LVN)
Entity type:Individual
Prefix:
First Name:CHAKARA
Middle Name:S
Last Name:LANDS
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 1:2840 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-3610
Mailing Address - Country:US
Mailing Address - Phone:323-237-4350
Mailing Address - Fax:
Practice Address - Street 1:2840 WELLINGTON RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-3610
Practice Address - Country:US
Practice Address - Phone:323-237-4350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226076164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse