Basic Information
Provider Information
NPI: 1285095877
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARNSWORTH
FirstName: RHONDA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: LVN II
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1484 LEAR WAY
Address2:  
City: REDDING
State: CA
PostalCode: 960012323
CountryCode: US
TelephoneNumber: 5305152085
FaxNumber:  
Practice Location
Address1: 2640 BRESLAUER WAY
Address2:  
City: REDDING
State: CA
PostalCode: 960014246
CountryCode: US
TelephoneNumber: 5302255200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/10/2016
LastUpdateDate: 03/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164X00000XVN 185668CAY Nursing Service ProvidersLicensed Vocational Nurse 

No ID Information.


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