Jackosn, Tselane Edina

Jackosn, Tselane Edina is an sole proprietor health care provider with primary practice located at 10620 Sunburst Dr , Rancho Cucamonga CA 91730-6309. She recently has only one registered license in Nursing Service Providers / Licensed Vocational Nurse, which is considered as her primary health care specialty. Jackosn, Tselane Edina can be contacted via phone (909) 944-3042.

Contact Information

Primary practice address
10620 Sunburst Dr Rancho Cucamonga CA 91730-6309
Phone: (909) 944-3042
Fax: (909) 944-3042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Vocational Nurse 164X00000X 215086 California

Profile Details

NPI number 1215062435
LBN Legal business name Jackosn, Tselane Edina
Credentials Licensed Visiting Nurse (LVN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215062435 NPPES
California MEDICAID RVN004350
California MEDICAID EPS016200

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