Jesse Tommy Addington, LVN
Individual provider Active NPI Licensed Vocational Nurse · Ukiah, CA
NPI 1306416136 · NPPES record last updated Jun 24, 2021
Key facts
- NPI
- 1306416136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 698588 (CA)
- Practice address
- 1120 S Dora St
Ukiah, CA 95482-6340 - Phone
- (707) 472-2600
- Fax
- (707) 472-2714
- NPI assigned
- Jun 24, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 698588 | CA | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 698588 | CA | Yes |
Addresses
Primary practice location
1120 S Dora St
Ukiah, CA 95482-6340
Mailing address
1120 S Dora St
Ukiah, CA 95482-6340
Phone (707) 472-2600
Other providers in Ukiah, CA
- Brie Alexander Abbe
- Scott Whitney Abbott
- Amalia Opal Iolani Abrojena
- Eva A Acevedo
- Denise Mihelle Addison
- Advance Wellness Pearl L.L.C
- Adventist Health Heart Institute-Ukiah
- Adventist Health Physicians Network
- Adventist Health Physicians Network
All providers in Ukiah, CA · Licensed Vocational Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.