Provider Demographics
NPI:1750927869
Name:PAPORLONTE, SHELLEY (LVN)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:PAPORLONTE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:AARALYN
Other - Middle Name:
Other - Last Name:PHOENIX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1655 ORO VISTA RD APT 128
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-4017
Mailing Address - Country:US
Mailing Address - Phone:619-248-3678
Mailing Address - Fax:
Practice Address - Street 1:1655 ORO VISTA RD APT 128
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-4017
Practice Address - Country:US
Practice Address - Phone:619-248-3678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-24
Last Update Date:2023-02-20
Deactivation Date:2022-06-20
Deactivation Code:
Reactivation Date:2022-07-21
Provider Licenses
StateLicense IDTaxonomies
CA718911164X00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse