Individual provider Active NPI

Lynette Van Heukelem, LVN

  • Licensed Vocational Nurse
  • San Diego, CA
National Provider Identifier
1336023365
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN129555 Issued in CA
Practice address
5580 Elgin Ave
San Diego, CA 92120-1839
Phone
(619) 988-1008
NPI assigned
Aug 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN129555 CA Primary

Addresses

Primary practice location

5580 Elgin Ave
San Diego, CA 92120-1839

Mailing address

5580 Elgin Ave
San Diego, CA 92120-1839
Phone (619) 988-1008

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

LicenseStateTypeSpecialty
VN129555CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1336023365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5580 ELGIN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921201839",
            "telephone_number": "619-988-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5580 ELGIN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921201839",
            "telephone_number": "619-988-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HEUKELEM",
        "first_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN129555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.