Active NPI
Lucille Nowakowski, RN
- Registered Nurse
- Tracy, CA
National Provider Identifier
1356761209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 693652
- Practice address
- 95 West 11 TH St
Tracy, CA 95376 - Phone
- (209) 814-4015
- NPI assigned
- Apr 18, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 693652 | CA | Primary |
Addresses
Primary practice location
95 West 11 TH St
Tracy, CA 95376
Mailing address
95 W 11TH St
Tracy, CA 95376-3959
Phone (209) 814-4015
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 693652 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lucille'S Elite Team Home Health Care | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Tracy, CA
- NPI 1841602505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397779200000",
"number": "1356761209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 W 11TH ST",
"city": "TRACY",
"state": "CA",
"postal_code": "953763959",
"telephone_number": "209-814-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 WEST 11 TH ST",
"city": "TRACY",
"state": "CA",
"postal_code": "95376",
"telephone_number": "209-814-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOWAKOWSKI",
"first_name": "LUCILLE",
"name_prefix": "Miss",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-18",
"last_updated": "2014-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "693652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.