Individual provider Active NPI

Lauren La Violette, NP

  • Medical-Surgical Registered Nurse
  • Fresno, CA
National Provider Identifier
1285249276
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
95181727 Issued in CA
Practice address
2615 E Clinton Ave
Fresno, CA 93703-2223
Phone
(559) 225-6100
NPI assigned
Sep 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95029220 CA
Medical-Surgical Registered Nurse 163WM0705X 95181727 CA Primary

Addresses

Primary practice location

2615 E Clinton Ave
Fresno, CA 93703-2223

Mailing address

414 W Teague Ave
Fresno, CA 93711-6072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251103001724 CA Practitioner - Nurse Practitioner 3971092974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

414 W Teague Ave
Fresno, CA 93711-6072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95181727CAMDMedical-Surgical Registered Nurse
95029220CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
L&L Behavioral and Psychiatric Services Psychiatric/Mental Health CurrentSince Apr 25, 2024 Accepting new patients

Locations

1690 W Shaw Ave
Ste 220
Fresno, CA 93711
Phone (559) 691-3543

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1285249276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W TEAGUE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937116072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032223",
            "telephone_number": "559-225-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA VIOLETTE",
        "first_name": "LAUREN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95029220",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "95181727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.