Active NPI
Estelita Discipulo Avera, LVN
- Licensed Vocational Nurse
- Sacramento, CA
National Provider Identifier
1093806903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN111149
- Practice address
- 7171 Bowling Dr
300
Sacramento, CA 95823 - Phone
- (916) 875-0802
- Fax
- (916) 875-0854
- NPI assigned
- Sep 27, 2006
- 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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | VN111149 | CA | Primary |
Addresses
Primary practice location
7171 Bowling Dr
300
Sacramento, CA 95823
Mailing address
6808 Rio Tejo Way
Elk Grove, CA 95757
Phone (916) 875-0802
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
| License | State | Type | Specialty |
|---|---|---|---|
| VN111149 | CA | MD | Licensed Vocational Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacramento County DHHS | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Elk Grove, CA
- NPI 1467558783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093806903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6808 RIO TEJO WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "95757",
"telephone_number": "916-875-0802",
"fax_number": "916-875-0854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7171 BOWLING DR",
"address_2": "300",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95823",
"telephone_number": "916-875-0802",
"fax_number": "916-875-0854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERA",
"first_name": "ESTELITA",
"middle_name": "DISCIPULO",
"name_prefix": "Mrs.",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN111149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.