Active NPI
Kelly K. Peterson, LVN
- Licensed Vocational Nurse
- Rosemead, CA
National Provider Identifier
1467648576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN224351
- Practice address
- 7600 Graves Ave
Rosemead, CA 91770-3414 - Phone
- (626) 280-6510
- NPI assigned
- Sep 21, 2007
- Sex
- Female
- 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 | VN224351 | CA | Primary |
Addresses
Primary practice location
7600 Graves Ave
Rosemead, CA 91770-3414
Mailing address
7600 Graves Ave
Rosemead, CA 91770-3414
Phone (626) 280-6510
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 |
|---|---|---|---|
| VN224351 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190332800000",
"number": "1467648576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7600 GRAVES AVE",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917703414",
"telephone_number": "626-280-6510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 GRAVES AVE",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917703414",
"telephone_number": "626-280-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "KELLY",
"middle_name": "K.",
"name_prefix": "Ms.",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-21",
"last_updated": "2007-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN224351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosemead, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.