Active NPI
Charlemagne Previlon, DRIVER
- Vehicle Modifications Contractor
- Sacramento, CA
National Provider Identifier
1306483193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vehicle Modifications Contractor
- License
- GNB32019-03411
- Practice address
- 4323 Carmelo Oaks CT
Sacramento, CA 95841-3474 - Phone
- (916) 532-0058
- NPI assigned
- Nov 29, 2019
- Last updated
- Nov 29, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vehicle Modifications Contractor | 171WV0202X | GNB32019-03411 | CA | Primary |
Addresses
Primary practice location
4323 Carmelo Oaks CT
Sacramento, CA 95841-3474
Mailing address
4323 Carmelo Oaks CT
Sacramento, CA 95841-3474
Phone (916) 532-0058
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
| License | State | Type | Specialty |
|---|---|---|---|
| GNB32019-03411 | CA | MD | Vehicle Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574985600000",
"number": "1306483193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4323 CARMELO OAKS CT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958413474",
"telephone_number": "916-532-0058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4323 CARMELO OAKS CT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958413474",
"telephone_number": "916-532-0058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREVILON",
"first_name": "CHARLEMAGNE",
"credential": "DRIVER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-29",
"last_updated": "2019-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "171WV0202X",
"taxonomy_group": "",
"desc": "Contractor, Vehicle Modifications",
"state": "CA",
"license": "GNB32019-03411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.