Lydia Butler, 167G00000X

Individual provider Active NPI Licensed Vocational Nurse · Altadena, CA

NPI 1508091190 · NPPES record last updated Feb 7, 2013

Key facts

NPI
1508091190
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
VN153640 (CA)
Practice address
3126 N Glenrose Street
Altadena, CA 91001
Phone
(626) 254-5000
NPI assigned
May 26, 2009
Sex
Female
Sole proprietor
No

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
VN153640CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN153640 CA Yes

Addresses

Primary practice location

3126 N Glenrose Street
Altadena, CA 91001

Mailing address

1234 6 TH St
Los Angeles, CA 90012

Other providers in Altadena, CA

All providers in Altadena, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.