Individual provider Active NPI

Mayren Lara Estrada, LVN

  • Licensed Vocational Nurse
  • Ventura, CA
National Provider Identifier
1134448368
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN238133 Issued in CA
Practice address
300 Hillmont Ave
Ventura, CA 93003-1651
Phone
(805) 765-9050
Fax
(805) 653-0567
NPI assigned
May 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN238133 CA Primary

Addresses

Primary practice location

300 Hillmont Ave
Ventura, CA 93003-1651

Mailing address

646 Lemon Way
#24
Fillmore, CA 93015-1125
Phone (805) 765-9050

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

LicenseStateTypeSpecialty
VN238133CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1134448368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 LEMON WAY",
            "address_2": "#24",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151125",
            "telephone_number": "805-765-9050",
            "fax_number": "805-653-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-765-9050",
            "fax_number": "805-653-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "MAYREN",
        "middle_name": "LARA",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN238133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; 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.