Thorn Eang, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

689051 Issued in CA

Practice address

829 Allacante Dr
Ceres, CA 95307-7308

Phone

(209) 681-6030

NPI assigned

May 19, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1003553017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 ALLACANTE DR",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953077308",
            "telephone_number": "209-681-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 ALLACANTE DR",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953077308",
            "telephone_number": "209-681-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EANG",
        "first_name": "THORN",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "689051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bekazn@gmail.com",
            "affiliation": "N",
            "address_1": "829 Allacante Dr",
            "city": "Ceres",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953077308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shanika Duliepe, MSN, FNP-BC
• Alejandro Duran, PPS
• Griffin Allen Dye
• Felicia Dyer
• Eag Professional Medical Corp.
• Christine Marie Ehrler, RN
• Mary A Elese
• Elite Family Systems
• Elite Family Systems
• Elite Family Systems

• Licensed Vocational Nurse in Ceres, CA
• Providers in Ceres, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.