Individual provider Active NPI

Teresita C. Eustaquio, L.V.N.

  • Licensed Vocational Nurse
  • Fresno, CA
National Provider Identifier
1538226469
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN84551 Issued in CA
Practice address
2689 E Everglade Ave
Fresno, CA 93720-5376
Phone
(559) 325-0597
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 VN84551 CA Primary

Addresses

Primary practice location

2689 E Everglade Ave
Fresno, CA 93720-5376

Mailing address

2689 E Everglade Ave
Fresno, CA 93720-5376
Phone (559) 325-0597

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
VN84551CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538226469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2689 E EVERGLADE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937205376",
            "telephone_number": "559-325-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2689 E EVERGLADE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937205376",
            "telephone_number": "559-325-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSTAQUIO",
        "first_name": "TERESITA",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "L.V.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN84551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.