Individual provider Active NPI

Sparkle Haywood

  • Licensed Vocational Nurse
  • Santa Ana, CA
National Provider Identifier
1487439725
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
690552 Issued in CA
Practice address
1207 E Fruit St
Santa Ana, CA 92701-4296
Phone
(714) 953-9374
NPI assigned
Aug 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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 690552 CA Primary

Addresses

Primary practice location

1207 E Fruit St
Santa Ana, CA 92701-4296

Mailing address

1073 E 4TH St Apt 23
Long Beach, CA 90802-1641
Phone (310) 735-5406

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
690552CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1487439725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 E 4TH ST APT 23",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021641",
            "telephone_number": "310-735-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014296",
            "telephone_number": "714-953-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "SPARKLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "690552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.