Provider Demographics
NPI:1881048171
Name:KUMAR, SHAILJA (LVN)
Entity type:Individual
Prefix:
First Name:SHAILJA
Middle Name:
Last Name:KUMAR
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 1:7050 E CORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93737-9221
Mailing Address - Country:US
Mailing Address - Phone:559-389-8892
Mailing Address - Fax:
Practice Address - Street 1:7050 E CORTLAND AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93737-9221
Practice Address - Country:US
Practice Address - Phone:559-389-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN273051164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse