Provider Demographics
NPI:1881887578
Name:MCKENNEY, VALERIE FLORENCE (LVN)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:FLORENCE
Last Name:MCKENNEY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22847 PASEO PL
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-6607
Mailing Address - Country:US
Mailing Address - Phone:510-538-5802
Mailing Address - Fax:
Practice Address - Street 1:22847 PASEO PL
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-6607
Practice Address - Country:US
Practice Address - Phone:510-538-5802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-25
Last Update Date:2007-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN198343164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse