Individual provider Active NPI

Laurie Musgrave

  • Licensed Vocational Nurse
  • Fresno, CA
National Provider Identifier
1235603622
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
693990 Issued in CA
Practice address
3115 N Millbrook Ave
Fresno, CA 93703-1425
Phone
(559) 600-2382
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 693990 CA Primary

Addresses

Primary practice location

3115 N Millbrook Ave
Fresno, CA 93703-1425

Mailing address

3433 W Shaw Ave Ste 102
Fresno, CA 93711-3229
Phone (559) 558-4051

Other practice location 1

301 E 13th St Ste D
Merced, CA 95341-6211
Phone (209) 386-1096

Other practice location 2

496 S. Barton St
Fresno, CA 93702
Phone (559) 860-4422

Other practice location 3

4411 E Cesar Chavez Blvd # 319
Fresno, CA 93702-3604
Phone (559) 600-2382

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
693990CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central Star Behavioral Health, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1235603622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W SHAW AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113229",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 N MILLBROOK AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937031425",
            "telephone_number": "559-600-2382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E 13th St Ste D",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953416211",
            "country_code": "US",
            "telephone_number": "209-386-1096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "496 S. Barton St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93702",
            "country_code": "US",
            "telephone_number": "559-860-4422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4411 E Cesar Chavez Blvd # 319",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-600-2382",
            "fax_number": "559-475-7866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSGRAVE",
        "first_name": "LAURIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "693990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.