Provider Demographics
NPI:1174260921
Name:CONTRERAS, IRENE OLIVIA (LVN)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:OLIVIA
Last Name:CONTRERAS
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 1:7236 S RECOVERY RD
Mailing Address - Street 2:
Mailing Address - City:FRENCH CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95231-8901
Mailing Address - Country:US
Mailing Address - Phone:209-888-6595
Mailing Address - Fax:209-888-6596
Practice Address - Street 1:7236 S RECOVERY RD
Practice Address - Street 2:
Practice Address - City:FRENCH CAMP
Practice Address - State:CA
Practice Address - Zip Code:95231-8901
Practice Address - Country:US
Practice Address - Phone:209-888-6595
Practice Address - Fax:209-888-6596
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA724129164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse