Sonny De Wayne De Hart, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN198057 Issued in CA

Practice address

225 Justin Ave Apt D
Glendale, CA 91201-2927

Phone

(818) 929-0932

NPI assigned

Jun 21, 2018

Last updated

Jun 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1346734399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 JUSTIN AVE APT D",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912012927",
            "telephone_number": "818-929-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 JUSTIN AVE APT D",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912012927",
            "telephone_number": "818-929-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE HART",
        "first_name": "SONNY",
        "middle_name": "DE WAYNE",
        "name_prefix": "Mr.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN198057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Vocational Nurse in Glendale, CA
• Providers in Glendale, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.