Provider Demographics
NPI:1912138991
Name:SIM-PARCASIO, LOVELLA C (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:LOVELLA
Middle Name:C
Last Name:SIM-PARCASIO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11334 BERTHA ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6531
Mailing Address - Country:US
Mailing Address - Phone:562-865-7906
Mailing Address - Fax:
Practice Address - Street 1:3205 N LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1733
Practice Address - Country:US
Practice Address - Phone:562-570-7119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527769163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA953893470OtherFEDERAL TAX ID