Individual provider Active NPI

Crista Jude Renteria, LVN

  • Licensed Vocational Nurse
  • Oceanside, CA
National Provider Identifier
1487285243
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
LVN683245 Issued in CA
Practice address
3230 Waring CT Ste a
Oceanside, CA 92056-4509
Phone
(760) 305-7528
Fax
(760) 509-4410
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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 LVN683245 CA Primary

Addresses

Primary practice location

3230 Waring CT Ste a
Oceanside, CA 92056-4509

Mailing address

161 N Date St
Escondido, CA 92025-3405
Phone (760) 745-7786

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
LVN683245CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc PastSince Feb 1, 2020 Accepting new patients
Community Research Foundation Inc PastSince Feb 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1487285243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 N DATE ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253405",
            "telephone_number": "760-745-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 WARING CT STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564509",
            "telephone_number": "760-305-7528",
            "fax_number": "760-509-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTERIA",
        "first_name": "CRISTA",
        "middle_name": "JUDE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "LVN683245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.