Individual provider Active NPI

Moesha Regine Martin, LVN

  • Licensed Vocational Nurse
  • Fresno, CA
National Provider Identifier
1417815218
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
755798 Issued in CA
Practice address
539 N Van Ness Ave
Fresno, CA 93728-3419
Phone
(559) 266-9581
NPI assigned
Jan 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 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 755798 CA Primary

Addresses

Primary practice location

539 N Van Ness Ave
Fresno, CA 93728-3419

Mailing address

2567 S Rowell Ave Apt F
Fresno, CA 93725-1560
Phone (559) 970-0393

Other practice location 1

3103 E Cartwright Ave
Fresno, CA 93725-9385
Phone (559) 525-7692

Other practice location 2

1235 E St
Fresno, CA 93706-2024
Phone (559) 844-1599

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
755798CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1417815218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2567 S ROWELL AVE APT F",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937251560",
            "telephone_number": "559-970-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 N VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937283419",
            "telephone_number": "559-266-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3103 E Cartwright Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937259385",
            "country_code": "US",
            "telephone_number": "559-525-7692",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1235 E St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937062024",
            "country_code": "US",
            "telephone_number": "559-844-1599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MOESHA",
        "middle_name": "REGINE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "755798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

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