Individual provider Active NPI

Marcel Brown

  • Licensed Vocational Nurse
  • Fairfield, CA
National Provider Identifier
1376020172
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN695945 Issued in CA
Practice address
2101 Courage Dr
Fairfield, CA 94533-6717
Phone
(707) 428-1131
NPI assigned
Jul 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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 VN695945 CA Primary

Addresses

Primary practice location

2101 Courage Dr
Fairfield, CA 94533-6717

Mailing address

453 W Monte Vista Ave Apt C
Vacaville, CA 95688-3744
Phone (707) 624-9474

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
VN695945CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1376020172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 W MONTE VISTA AVE APT C",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956883744",
            "telephone_number": "707-624-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-428-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MARCEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN695945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.