Active NPI
Stephen Nnachetam, LVN
- Licensed Vocational Nurse
- Los Angeles, CA
National Provider Identifier
1265394209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 743578
- Practice address
- 1926 Beverly Blvd
Los Angeles, CA 90057-2402 - Phone
- (213) 353-1140
- NPI assigned
- Nov 28, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 743578 | CA | Primary |
Addresses
Primary practice location
1926 Beverly Blvd
Los Angeles, CA 90057-2402
Mailing address
9140 S Nobel Way
Inglewood, CA 90305-1881
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
| License | State | Type | Specialty |
|---|---|---|---|
| 743578 | CA | MD | Pediatric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764288000000",
"number": "1265394209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9140 S NOBEL WAY",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903051881",
"telephone_number": "213-353-1140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1926 BEVERLY BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572402",
"telephone_number": "213-353-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NNACHETAM",
"first_name": "STEPHEN",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-28",
"last_updated": "2025-11-28",
"certification_date": "2025-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "743578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.