Provider Demographics
NPI:1952716839
Name:CONTRERAS, MARIA (LVN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CONTRERAS
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 1:660 STANFORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021
Mailing Address - Country:US
Mailing Address - Phone:213-688-2964
Mailing Address - Fax:213-688-2925
Practice Address - Street 1:6319 MARBRISA AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-3535
Practice Address - Country:US
Practice Address - Phone:213-688-2924
Practice Address - Fax:213-688-2925
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232002164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse