Individual provider Active NPI

Grace Van Doren, RN

  • Community Health Registered Nurse
  • Santa Maria, CA
National Provider Identifier
1306007349
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
540071 Issued in CA
Practice address
2115 Centerpointe Pkwy
Santa Maria, CA 93455-1334
Phone
(805) 346-7231
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 540071 CA Primary

Addresses

Primary practice location

2115 Centerpointe Pkwy
Santa Maria, CA 93455-1334

Mailing address

2115 Centerpointe Pkwy
Santa Maria, CA 93455-1334
Phone (805) 346-7231

Other identifiers 1

IdentifierTypeStateIssuer
540071OtherCARN

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
540071CAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1306007349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 CENTERPOINTE PKWY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551334",
            "telephone_number": "805-346-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 CENTERPOINTE PKWY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551334",
            "telephone_number": "805-346-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DOREN",
        "first_name": "GRACE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "540071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "540071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.