Provider Demographics
NPI:1801760111
Name:COLBERT, MARIA ANNETTE (LVN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANNETTE
Last Name:COLBERT
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 1:1205 1/2 W 53RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-4094
Mailing Address - Country:US
Mailing Address - Phone:213-293-3213
Mailing Address - Fax:
Practice Address - Street 1:1205 1/2 W 53RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-4094
Practice Address - Country:US
Practice Address - Phone:213-293-3213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA222895164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse