Individual provider Active NPI

Marie Lee Kathleen Jean

  • Licensed Practical Nurse
  • Los Angeles, CA
National Provider Identifier
1285109355
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
95000201 Issued in CA
Practice address
441 Bauchet St
Los Angeles, CA 90012-2906
Phone
(213) 972-2205
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 95000201 CA Primary

Addresses

Primary practice location

441 Bauchet St
Los Angeles, CA 90012-2906

Mailing address

270 San Marcos St Apt V
San Gabriel, CA 91776-1046
Phone (562) 756-4034

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
95000201CAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1285109355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 SAN MARCOS ST APT V",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761046",
            "telephone_number": "562-756-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 BAUCHET ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122906",
            "telephone_number": "213-972-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "MARIE LEE KATHLEEN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "95000201",
            "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 Oct 4, 2018; 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.