Individual provider Active NPI

Allen Tristan Rosario

  • Licensed Vocational Nurse
  • Lake Elsinore, CA
National Provider Identifier
1396669339
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
729652 Issued in CA
Practice address
19150 River Rock CT
Lake Elsinore, CA 92532-3907
Phone
(562) 303-7174
NPI assigned
Aug 4, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 729652 CA Primary

Addresses

Primary practice location

19150 River Rock CT
Lake Elsinore, CA 92532-3907

Mailing address

19150 River Rock CT
Lake Elsinore, CA 92532-3907
Phone (562) 303-7174

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

NPI Registry JSON

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

{
    "created_epoch": "1785801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1396669339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19150 RIVER ROCK CT",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925323907",
            "telephone_number": "562-303-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19150 RIVER ROCK CT",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925323907",
            "telephone_number": "562-303-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "ALLEN",
        "middle_name": "TRISTAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "729652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.