Individual provider Active NPI

Jodian Natalia Lyn

  • Registered Nurse
  • Hesperia, CA
National Provider Identifier
1336972983
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95057038 Issued in CA
Practice address
13025 Clear Creek St
Hesperia, CA 92344-3818
Phone
(786) 547-1181
NPI assigned
Aug 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95057038 CA Primary

Addresses

Primary practice location

13025 Clear Creek St
Hesperia, CA 92344-3818

Mailing address

13025 Clear Creek St
Hesperia, CA 92344-3818

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
95057038CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1336972983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13025 CLEAR CREEK ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923443818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13025 CLEAR CREEK ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923443818",
            "telephone_number": "786-547-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYN",
        "first_name": "JODIAN",
        "middle_name": "NATALIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95057038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.