Individual provider Active NPI

Iris Yolanda Estrada Moore, LVN

  • Licensed Vocational Nurse
  • Fresno, CA
National Provider Identifier
1538472055
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN249525 Issued in CA
Practice address
539 N Van Ness Ave
Fresno, CA 93728-3419
Phone
(559) 266-9581
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 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 Nurse 164X00000X VN249525 CA Primary

Addresses

Primary practice location

539 N Van Ness Ave
Fresno, CA 93728-3419

Mailing address

5325 E Kings Canyon Rd Apt 121
Fresno, CA 93727-4862
Phone (559) 493-1846

Other practice location 1

1310 M St
Fresno, CA 93721-1808
Phone (559) 264-2700

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
VN249525CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1538472055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 E KINGS CANYON RD APT 121",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937274862",
            "telephone_number": "559-493-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 N VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937283419",
            "telephone_number": "559-266-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 M St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211808",
            "country_code": "US",
            "telephone_number": "559-264-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA MOORE",
        "first_name": "IRIS",
        "middle_name": "YOLANDA",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN249525",
            "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 Jan 3, 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.