Provider Demographics
NPI:1982364378
Name:GUENTHER, ALIVIA HENRY (RN)
Entity type:Individual
Prefix:
First Name:ALIVIA
Middle Name:HENRY
Last Name:GUENTHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ALIVIA
Other - Middle Name:ANN
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15350 SUTTON STREET
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403
Mailing Address - Country:US
Mailing Address - Phone:818-617-9119
Mailing Address - Fax:818-617-9119
Practice Address - Street 1:15350 SUTTON AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-9140
Practice Address - Country:US
Practice Address - Phone:818-617-9119
Practice Address - Fax:818-617-9119
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95082402163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult