Provider Demographics
NPI:1841644606
Name:RIOJAS, LUIS (LVN)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:RIOJAS
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 S KOLEEN AVE
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-7602
Mailing Address - Country:US
Mailing Address - Phone:559-567-8166
Mailing Address - Fax:
Practice Address - Street 1:741 S KOLEEN AVE
Practice Address - Street 2:
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-7602
Practice Address - Country:US
Practice Address - Phone:559-567-8166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 293065164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse