Active NPI
Athena Sorensen, LVN
- Licensed Vocational Nurse
- San Luis Obispo, CA
National Provider Identifier
1487277232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 269130
- Practice address
- 735 Tank Farm Rd
San Luis Obispo, CA 93401-7064 - Phone
- (805) 610-9945
- NPI assigned
- May 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 269130 | CA | Primary |
Addresses
Primary practice location
735 Tank Farm Rd
San Luis Obispo, CA 93401-7064
Mailing address
PO Box 2451
Paso Robles, CA 93447-2451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 269130 | Other | CA | LICENSE NUMBER |
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 |
|---|---|---|---|
| 269130 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1487277232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2451",
"city": "PASO ROBLES",
"state": "CA",
"postal_code": "934472451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 TANK FARM RD",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934017064",
"telephone_number": "805-610-9945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN",
"first_name": "ATHENA",
"name_prefix": "Mrs.",
"credential": "LVN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-27",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "269130",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "269130",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.