Provider Demographics
NPI:1871874834
Name:CHANDIRAMANI, JIVANI (RN)
Entity type:Individual
Prefix:
First Name:JIVANI
Middle Name:
Last Name:CHANDIRAMANI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4051 W 28TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-2217
Mailing Address - Country:US
Mailing Address - Phone:612-642-1559
Mailing Address - Fax:
Practice Address - Street 1:4051 W 28TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-2217
Practice Address - Country:US
Practice Address - Phone:612-642-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN202436-9163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse