Active NPI
Crystal Carroll
- Licensed Vocational Nurse
- Camarillo, CA
National Provider Identifier
1124497078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN291016
- Practice address
- 1722 S Lewis Rd
Camarillo, CA 93012-8520 - Phone
- (805) 366-4268
- NPI assigned
- Sep 22, 2015
- 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 | VN291016 | CA | Primary |
Addresses
Primary practice location
1722 S Lewis Rd
Camarillo, CA 93012-8520
Mailing address
1722 S Lewis Rd
Camarillo, CA 93012-8520
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 |
|---|---|---|---|
| VN291016 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487289600000",
"number": "1124497078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1722 S LEWIS RD",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930128520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1722 S LEWIS RD",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930128520",
"telephone_number": "805-366-4268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-22",
"last_updated": "2017-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN291016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.