Provider Demographics
NPI:1548652290
Name:LE, MY-LINH (LVN)
Entity type:Individual
Prefix:
First Name:MY-LINH
Middle Name:
Last Name:LE
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 1:1890 SCHULTE DR
Mailing Address - Street 2:103
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-2158
Mailing Address - Country:US
Mailing Address - Phone:408-786-8287
Mailing Address - Fax:
Practice Address - Street 1:1890 SCHULTE DR
Practice Address - Street 2:103
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-2158
Practice Address - Country:US
Practice Address - Phone:408-786-8287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276115164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse