Active NPI
Martha Irene Vandeventer, R.N.
- Registered Nurse
- Placentia, CA
National Provider Identifier
1083909899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 275799
- Practice address
- 2001 E Orangethorpe Ave Ste D
Placentia, CA 92870-6759 - Phone
- (714) 524-5545
- NPI assigned
- Jun 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 275799 | CA | Primary |
Addresses
Primary practice location
2001 E Orangethorpe Ave Ste D
Placentia, CA 92870-6759
Mailing address
19561 Shadow Hill Dr
Yorba Linda, CA 92886-4331
Phone (714) 691-7077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33-0150193 | Other | CA | MEDI-CAL |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 275799 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1083909899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19561 SHADOW HILL DR",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928864331",
"telephone_number": "714-691-7077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 E ORANGETHORPE AVE STE D",
"city": "PLACENTIA",
"state": "CA",
"postal_code": "928706759",
"telephone_number": "714-524-5545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEVENTER",
"first_name": "MARTHA",
"middle_name": "IRENE",
"name_prefix": "Mrs.",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-09",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "275799",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "33-0150193",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Placentia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.