Provider Demographics
NPI:1538948724
Name:FARINA, ALICIA DENLEY (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:DENLEY
Last Name:FARINA
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MARGARET
Other - Last Name:DENLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2904 W 133RD ST
Mailing Address - Street 2:N/A
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249
Mailing Address - Country:US
Mailing Address - Phone:131-075-3714
Mailing Address - Fax:
Practice Address - Street 1:2904 W 133RD ST
Practice Address - Street 2:N/A
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249
Practice Address - Country:US
Practice Address - Phone:310-753-7147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504065163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse