Provider Demographics
NPI:1861145807
Name:WASHINGTON, ALEXIS TARAE (LVN / NHA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:TARAE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LVN / NHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 E HELMICK ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3039
Mailing Address - Country:US
Mailing Address - Phone:310-386-4626
Mailing Address - Fax:
Practice Address - Street 1:1003 E HELMICK ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3039
Practice Address - Country:US
Practice Address - Phone:310-386-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric