Individual provider Active NPI

Michael L Deneau, LVN

  • Licensed Vocational Nurse
  • Placerville, CA
National Provider Identifier
1235902693
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
276790 Issued in CA
Practice address
935 Spring St
Placerville, CA 95667-4543
Phone
(530) 748-4709
Fax
(530) 748-4750
NPI assigned
Nov 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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 276790 CA Primary

Addresses

Primary practice location

935 Spring St
Placerville, CA 95667-4543

Mailing address

PO Box 341151
Sacramento, CA 95834-9051
Phone (530) 925-6328

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
276790CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1235902693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 341151",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958349051",
            "telephone_number": "530-925-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 SPRING ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674543",
            "telephone_number": "530-748-4709",
            "fax_number": "530-748-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENEAU",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "276790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.