Provider Demographics
NPI:1144079013
Name:EARVIN, RODJALYNN NICOLE
Entity type:Individual
Prefix:
First Name:RODJALYNN
Middle Name:NICOLE
Last Name:EARVIN
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 1:948 W 80TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-5018
Mailing Address - Country:US
Mailing Address - Phone:323-822-6459
Mailing Address - Fax:
Practice Address - Street 1:948 W 80TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-5018
Practice Address - Country:US
Practice Address - Phone:323-822-6459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula