Provider Demographics
NPI:1952291494
Name:HALL, SHALOM EUNIQUE (LVN)
Entity type:Individual
Prefix:
First Name:SHALOM
Middle Name:EUNIQUE
Last Name:HALL
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 1:8614 RAMONA ST APT B
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6354
Mailing Address - Country:US
Mailing Address - Phone:424-229-4702
Mailing Address - Fax:
Practice Address - Street 1:21505 NORWALK BLVD
Practice Address - Street 2:
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-1121
Practice Address - Country:US
Practice Address - Phone:562-916-7581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA715996164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse