Individual provider Active NPI

Alex Rene Moreno, LVN

  • Licensed Vocational Nurse
  • Huntington Park, CA
National Provider Identifier
1235408832
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
251414 Issued in CA
Practice address
2539 Palm PL
Huntington Park, CA 90255-6620
Phone
(213) 353-1140
NPI assigned
Dec 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 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 251414 CA Primary

Addresses

Primary practice location

2539 Palm PL
Huntington Park, CA 90255-6620

Mailing address

2539 Palm PL
Huntington Park, CA 90255-6620
Phone (213) 353-1140

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
251414CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1235408832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 PALM PL",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902556620",
            "telephone_number": "213-353-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 PALM PL",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902556620",
            "telephone_number": "213-353-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ALEX",
        "middle_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "251414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.