Individual provider Active NPI

Vivian Dang Le

  • Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1467088666
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95013834 Issued in CA
Practice address
10459 Mountain View Ave Ste F
Loma Linda, CA 92354-2033
Phone
(909) 478-7651
NPI assigned
Mar 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95013834 CA Primary

Addresses

Primary practice location

10459 Mountain View Ave Ste F
Loma Linda, CA 92354-2033

Mailing address

12931 Dungan LN
Garden Grove, CA 92840-5709
Phone (714) 326-3539

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Other

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
95013834CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1467088666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12931 DUNGAN LN",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405709",
            "telephone_number": "714-326-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10459 MOUNTAIN VIEW AVE STE F",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542033",
            "telephone_number": "909-478-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "VIVIAN",
        "middle_name": "DANG",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "address_1": "10459 Mountain View Ave Ste F",
            "city": "Loma Linda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923542033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.