Individual provider Active NPI

Brian Nelson, LVN

  • Licensed Vocational Nurse
  • Santa Ana, CA
National Provider Identifier
1508366964
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN253162 Issued in CA
Practice address
1200 N Main St Ste 650
Santa Ana, CA 92701-3613
Phone
(714) 824-8140
Fax
(714) 824-8142
NPI assigned
Feb 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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 VN253162 CA Primary

Addresses

Primary practice location

1200 N Main St Ste 650
Santa Ana, CA 92701-3613

Mailing address

1200 N Main St Ste 650
Santa Ana, CA 92701-3613
Phone (714) 824-8140

Other identifiers 1

IdentifierTypeStateIssuer
1235274804MedicaidCA

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
VN253162CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Ayala-Guzman Past Accepting new patients
College Community Services Past 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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1508366964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N MAIN ST STE 650",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927013613",
            "telephone_number": "714-824-8140",
            "fax_number": "714-824-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N MAIN ST STE 650",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927013613",
            "telephone_number": "714-824-8140",
            "fax_number": "714-824-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN253162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235274804",
            "state": "CA"
        }
    ],
    "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 Feb 12, 2018; 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.