Active NPI
Kimberly Enticknap
- Licensed Vocational Nurse
- Lompoc, CA
National Provider Identifier
1477813608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 260468
- Practice address
- 401 E Cypress Ave
Lompoc, CA 93436-6806 - Phone
- (805) 737-6690
- NPI assigned
- May 22, 2012
- 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 | 260468 | CA | Primary |
Addresses
Primary practice location
401 E Cypress Ave
Lompoc, CA 93436-6806
Mailing address
401 E Cypress Ave
Lompoc, CA 93436-6806
Phone (805) 865-1940
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 |
|---|---|---|---|
| 260468 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620950400000",
"number": "1477813608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E CYPRESS AVE",
"city": "LOMPOC",
"state": "CA",
"postal_code": "934366806",
"telephone_number": "805-865-1940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E CYPRESS AVE",
"city": "LOMPOC",
"state": "CA",
"postal_code": "934366806",
"telephone_number": "805-737-6690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENTICKNAP",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-22",
"last_updated": "2021-05-14",
"certification_date": "2021-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "260468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lompoc, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.