Provider Demographics
NPI:1124909585
Name:HALLS, VICTORIA JAYNE
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JAYNE
Last Name:HALLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 W CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-2501
Mailing Address - Country:US
Mailing Address - Phone:630-886-4978
Mailing Address - Fax:
Practice Address - Street 1:433 ENCLAVE CIR APT 205
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7088
Practice Address - Country:US
Practice Address - Phone:832-879-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-315652163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant