Provider Demographics
NPI:1861925232
Name:CLARITO, PERCIVAL (LVN)
Entity type:Individual
Prefix:
First Name:PERCIVAL
Middle Name:
Last Name:CLARITO
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:VAL
Other - Middle Name:LIBUNAO
Other - Last Name:DINGLASAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16637 FOOTHILL BLVD APT 205
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1483
Mailing Address - Country:US
Mailing Address - Phone:818-730-9017
Mailing Address - Fax:
Practice Address - Street 1:5300 ANGELES VISTA BLVD
Practice Address - Street 2:
Practice Address - City:VIEW PARK
Practice Address - State:CA
Practice Address - Zip Code:90043-1648
Practice Address - Country:US
Practice Address - Phone:323-295-4556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA254676164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse