Individual provider Active NPI

Clara Jimenez

  • Licensed Vocational Nurse
  • Fontana, CA
National Provider Identifier
1245532811
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN195253 Issued in CA
Practice address
14919 El Molino St
Fontana, CA 92335-7202
Phone
(909) 641-1694
NPI assigned
Dec 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 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 VN195253 CA Primary

Addresses

Primary practice location

14919 El Molino St
Fontana, CA 92335-7202

Mailing address

14919 El Molino St
Fontana, CA 92335-7202
Phone (909) 641-1694

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
VN195253CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1245532811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14919 EL MOLINO ST",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923357202",
            "telephone_number": "909-641-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14919 EL MOLINO ST",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923357202",
            "telephone_number": "909-641-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "CLARA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN195253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.