Individual provider Active NPI

Paula Yvette Gray, LICENSE VOCATIONAL N

  • Licensed Vocational Nurse
  • Los Angeles, CA
National Provider Identifier
1366729394
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN188082 Issued in CA
Practice address
1733 West 65TH Place
Los Angeles, CA 90047-4235
Phone
(310) 425-6612
NPI assigned
Nov 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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 VN188082 CA Primary

Addresses

Primary practice location

1733 West 65TH Place
Los Angeles, CA 90047-4235

Mailing address

1733 West 65TH Place
Los Angeles, CA 90047-4235
Phone (310) 425-6612

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
VN188082CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1366729394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 WEST 65TH PLACE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900474235",
            "telephone_number": "310-425-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 WEST 65TH PLACE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900474235",
            "telephone_number": "310-425-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "PAULA",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "LICENSE VOCATIONAL N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN188082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.