Provider Demographics
NPI:1871169532
Name:THARANEE, VINITA PREM (LVN BHS)
Entity type:Individual
Prefix:MRS
First Name:VINITA
Middle Name:PREM
Last Name:THARANEE
Suffix:
Gender:F
Credentials:LVN BHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20445 VIA MEDICI
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4066
Mailing Address - Country:US
Mailing Address - Phone:818-400-1938
Mailing Address - Fax:818-960-0039
Practice Address - Street 1:20445 VIA MEDICI
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-4066
Practice Address - Country:US
Practice Address - Phone:818-400-1938
Practice Address - Fax:818-960-0039
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA136559164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse