Olga Devitt, LVN

Individual provider Active NPI Licensed Vocational Nurse · Ladera Ranch, CA

NPI 1164032579 · NPPES record last updated Aug 1, 2020

Key facts

NPI
1164032579
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
181256 (CA)
Practice address
2000 Corporate Dr Apt 901
Ladera Ranch, CA 92694-1118
Phone
(949) 429-9713
NPI assigned
Aug 1, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
181256CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 181256 CA Yes

Addresses

Primary practice location

2000 Corporate Dr Apt 901
Ladera Ranch, CA 92694-1118

Mailing address

25214 Clemens LN
Lake Forest, CA 92630-4103
Phone (949) 395-4877

Other identifiers

IdentifierTypeStateIssuer
B7322796OtherCADRIVERS LICENSE

Other providers in Ladera Ranch, CA

All providers in Ladera Ranch, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.