Individual provider Active NPI

Nicole Lee Sommers

  • Licensed Vocational Nurse
  • Santa Rosa, CA
National Provider Identifier
1205124351
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN256687 Issued in CA
Practice address
1901 Cleveland Ave Ste B
Santa Rosa, CA 95401-4298
Phone
(707) 576-0818
Fax
(707) 576-7845
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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 VN256687 CA Primary

Addresses

Primary practice location

1901 Cleveland Ave Ste B
Santa Rosa, CA 95401-4298

Mailing address

1901 Cleveland Ave Ste B
Santa Rosa, CA 95401-4298
Phone (707) 576-0818

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
VN256687CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1205124351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CLEVELAND AVE STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014298",
            "telephone_number": "707-576-0818",
            "fax_number": "707-576-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CLEVELAND AVE STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014298",
            "telephone_number": "707-576-0818",
            "fax_number": "707-576-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERS",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN256687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.