NPIMap

Organization Active NPI

Evelyn Lavern Thompson

  • Pediatric Skilled Nursing Facility
  • Moreno Valley, CA
National Provider Identifier
1104003763
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
VN129832 Issued in CA
Legal business name
EVELYN LAVERN THOMPSON
Practice address
12279 Lasselle St
Moreno Valley, CA 92557-7705
Phone
(951) 485-6847
NPI assigned
Jan 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Evelyn Lavern ThompsonNPI 1851579288
Title
L.V.N
Phone
(951) 485-6847

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X VN129832 CA Primary

Addresses

Primary practice location

12279 Lasselle St
Moreno Valley, CA 92557-7705

Mailing address

12279 Lasselle St
Moreno Valley, CA 92557-7705
Phone (951) 485-6847

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1104003763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12279 LASSELLE ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577705",
            "telephone_number": "951-485-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12279 LASSELLE ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577705",
            "telephone_number": "951-485-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN LAVERN THOMPSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "LAVERN",
        "authorized_official_title_or_position": "L.V.N",
        "authorized_official_telephone_number": "951-485-6847"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "CA",
            "license": "VN129832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.