Individual provider Active NPI

Luchia Lynette Hansen, BSN, RN, AGNP-S

  • Student in an Organized Health Care Education/Training Program
  • Loma Linda, CA
National Provider Identifier
1114716693
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
613082 Issued in CA
Practice address
11262 Campus St
Loma Linda, CA 92350-1727
Phone
(909) 558-1000
NPI assigned
May 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 613082 CA Primary

Addresses

Primary practice location

11262 Campus St
Loma Linda, CA 92350-1727

Mailing address

11262 Campus St
Loma Linda, CA 92350-1727
Phone (909) 558-1000

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
613082CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1114716693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11262 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501727",
            "telephone_number": "909-558-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11262 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501727",
            "telephone_number": "909-558-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "LUCHIA",
        "middle_name": "LYNETTE",
        "credential": "BSN, RN, AGNP-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "613082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.