Active NPI
Vivian Le
- Gerontology Nurse Practitioner
- Fountain Valley, CA
National Provider Identifier
1356223408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 95034048
- Practice address
- 11376 Primrose Ave
Fountain Valley, CA 92708-1751 - Phone
- (714) 702-7034
- NPI assigned
- Jul 21, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 95034048 | CA | Primary |
Addresses
Primary practice location
11376 Primrose Ave
Fountain Valley, CA 92708-1751
Mailing address
11376 Primrose Ave
Fountain Valley, CA 92708-1751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95034048 | Other | CA | STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95034048 | CA | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753056000000",
"number": "1356223408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11376 PRIMROSE AVE",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927081751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11376 PRIMROSE AVE",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927081751",
"telephone_number": "714-702-7034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "VIVIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-21",
"last_updated": "2025-07-21",
"certification_date": "2025-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "95034048",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "95034048",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.