Doctor Name: | MRS. LIDA CORNELIA VANGEEST |
NPI Number: | 1003064296 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 310946 |
Business Practice Address: | 22161 N 6th St Castro Valley, CA - 945467038 |
Business Phone Number: | 9713441424 |
Business Fax Number: | |
Mailing Address: | 22161 N 6th St, CASTRO VALLEY |
State: | CA |
Postal Code: | 945467038 |
Phone Number: | 9713441424 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2008 |
NPI Last Update Date: | 12/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 310946 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |