Individual provider Active NPI

Jane W Simmons, L.V.N

  • Licensed Vocational Nurse
  • North Highlands, CA
National Provider Identifier
1508505348
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN288145 Issued in CA
Practice address
4111 Elkhorn Blvd
North Highlands, CA 95660-3502
Phone
(916) 459-0025
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164X00000X VN288145 CA Primary

Addresses

Primary practice location

4111 Elkhorn Blvd
North Highlands, CA 95660-3502

Mailing address

4111 Elkhorn Blvd
North Highlands, CA 95660-3502
Phone (916) 459-0025

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
VN288145CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1508505348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 ELKHORN BLVD",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956603502",
            "telephone_number": "916-459-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 ELKHORN BLVD",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956603502",
            "telephone_number": "916-459-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JANE",
        "middle_name": "W",
        "credential": "L.V.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN288145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Highlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.