Individual provider Active NPI

Abraham A. Camello

  • Licensed Vocational Nurse
  • Merced, CA
National Provider Identifier
1508335480
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
236983 Issued in CA
Practice address
300 E 15TH St Ste C
Merced, CA 95341-6217
Phone
(209) 386-1092
NPI assigned
Nov 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 236983 CA Primary

Addresses

Primary practice location

300 E 15TH St Ste C
Merced, CA 95341-6217

Mailing address

2112 Piro Dr
Atwater, CA 95301-2576
Phone (209) 201-1412

Other practice location 1

301 E 13th St Ste D
Merced, CA 95341-6211
Phone (209) 386-1096

Other practice location 2

1904 Richland Ave Bldg A
Ceres, CA 95307-4562
Phone (209) 300-8800

Other practice location 3

4411 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 453-1008

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
236983CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1508335480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 PIRO DR",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953012576",
            "telephone_number": "209-201-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 15TH ST STE C",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416217",
            "telephone_number": "209-386-1092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E 13th St Ste D",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953416211",
            "country_code": "US",
            "telephone_number": "209-386-1096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1904 Richland Ave Bldg A",
            "address_purpose": "LOCATION",
            "city": "Ceres",
            "state": "CA",
            "postal_code": "953074562",
            "country_code": "US",
            "telephone_number": "209-300-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4411 E Kings Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMELLO",
        "first_name": "ABRAHAM",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-20",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "236983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.

Verify at the official NPI Registry.