Basic Information
Provider Information
NPI: 1689955262
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AYER
FirstName: DARCY
MiddleName: JEANNE
NamePrefix: MS.
NameSuffix:  
Credential: LVN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 769 W BLAINE ST STE B
Address2:  
City: RIVERSIDE
State: CA
PostalCode: 925073970
CountryCode: US
TelephoneNumber: 9513584705
FaxNumber:  
Practice Location
Address1: 769 W BLAINE ST STE B
Address2:  
City: RIVERSIDE
State: CA
PostalCode: 925073970
CountryCode: US
TelephoneNumber: 9513584705
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/08/2011
LastUpdateDate: 09/08/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164X00000X251298CAY Nursing Service ProvidersLicensed Vocational Nurse 

No ID Information.


Home