Individual provider Active NPI

Bessie Bennett

  • Licensed Vocational Nurse
  • San Diego, CA
National Provider Identifier
1013215540
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
174740 Issued in CA
Practice address
1450 Frazee Rd
Suite 306
San Diego, CA 92108-4337
Phone
(888) 748-3711
Fax
(888) 675-7798
NPI assigned
Mar 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 174740 CA Primary

Addresses

Primary practice location

1450 Frazee Rd
Suite 306
San Diego, CA 92108-4337

Mailing address

1450 Frazee Rd
Suite 306
San Diego, CA 92108-4337
Phone (888) 748-3711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
174740CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1013215540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 FRAZEE RD",
            "address_2": "SUITE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084337",
            "telephone_number": "888-748-3711",
            "fax_number": "888-675-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 FRAZEE RD",
            "address_2": "SUITE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084337",
            "telephone_number": "888-748-3711",
            "fax_number": "888-675-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BESSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "174740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.