Provider Demographics
NPI:1447637715
Name:VASCULAR ACCESS EXPERT
Entity type:Organization
Organization Name:VASCULAR ACCESS EXPERT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANI
Authorized Official - Middle Name:
Authorized Official - Last Name:DELA NOCHE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:714-558-8038
Mailing Address - Street 1:515 CABRILLO PARK DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-5016
Mailing Address - Country:US
Mailing Address - Phone:714-558-8038
Mailing Address - Fax:714-558-6033
Practice Address - Street 1:515 CABRILLO PARK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-5016
Practice Address - Country:US
Practice Address - Phone:714-558-8038
Practice Address - Fax:714-558-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA659713RN/BSN261QC1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA16455OtherPROVIDER ID
CA659713RN/BSNOtherREGISTERED NURSE LICENSE NUMBER