Active NPI
Latrina Lynn Bradford, LVN
- Licensed Practical Nurse
- Sacramento, CA
National Provider Identifier
1487984894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 717222
- Practice address
- 1103 N B St
Sacramento, CA 95811-0326 - Phone
- (916) 378-8266
- NPI assigned
- Jan 6, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 303571-031 | WI | |
| Licensed Practical Nurse | 164W00000X | 717222 | CA | Primary |
Addresses
Primary practice location
1103 N B St
Sacramento, CA 95811-0326
Mailing address
1103 N B St
Sacramento, CA 95811-0326
Phone (916) 378-8266
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 |
|---|---|---|---|
| 717222 | CA | MD | Licensed Practical Nurse |
| 303571-031 | WI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1487984894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1103 N B ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958110326",
"telephone_number": "916-378-8266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 N B ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958110326",
"telephone_number": "916-378-8266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "LATRINA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LVN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-06",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WI",
"license": "303571-031",
"primary": false
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CA",
"license": "717222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.