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Contact Information

DEBORA IVY, RN, BSN, PHN, CBIS
2070 CENTURY PARK E
LOS ANGELES, CA90067-1907
 Phone: 714-887-4997
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

163WR0400X
 

Community Health

163WC1500X
Indicates primary specialty

NPI Profile & details for DEBORA IVY · (Female)

NPI Number 1730843624
Status Active
Credentials RN, BSN, PHN, CBIS
Entity Individual
Enumeration date 10/26/2021
Last updated 10/26/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 562534
  • CA License # 95260258
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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