Angellena Laval Desousa, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

282758 Issued in CA

Practice address

12240 Hesperia Rd
Victorville, CA 92395-8309

Phone

(760) 245-8837

NPI assigned

Mar 23, 2021

Last updated

Mar 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Valley Star Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Victorville, CA
  • NPI 1275947426
  NPD (past)

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1285210849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12240 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958309",
            "telephone_number": "760-245-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12240 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958309",
            "telephone_number": "760-245-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOUSA",
        "first_name": "ANGELLENA",
        "middle_name": "LAVAL",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "282758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adesousa@starsinc.com",
            "affiliation": "Y",
            "affiliationName": "Stars Behavioral Health Group",
            "address_1": "545 Estudillo Ave",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945774611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Desert Valley Medical Transport Inc (American Medical Response)
• Desert View Endoscopy Center, LLC.
• Desert View Hospice, Inc.
• Desert Vista Anesthesiology Medical Group, Inc.
• Desert Wind Hospice, Inc.
• Ashley Deveze
• Deandra Devine
• Aditya Devineni, MD, MS
• Venkat Devineni, MD
• Renae Devolld

• Licensed Vocational Nurse in Victorville, CA
• Providers in Victorville, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.