Active NPI
Thaddeus Serna
- Licensed Vocational Nurse
- Anaheim, CA
National Provider Identifier
1386468155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 704915
- Practice address
- 1320 W Pearl St
Anaheim, CA 92801-5941 - Phone
- (714) 780-1174
- NPI assigned
- Nov 8, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 704915 | CA | Primary |
Addresses
Primary practice location
1320 W Pearl St
Anaheim, CA 92801-5941
Mailing address
1320 W Pearl St
Anaheim, CA 92801-5941
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
| License | State | Type | Specialty |
|---|---|---|---|
| 704915 | CA | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1386468155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 W PEARL ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928015941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 W PEARL ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928015941",
"telephone_number": "714-780-1174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERNA",
"first_name": "THADDEUS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-08",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "704915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.