Individual provider Active NPI

Jessica Blair Macias, LVN

  • Licensed Vocational Nurse
  • San Diego, CA
National Provider Identifier
1538560396
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN277190 Issued in CA
Practice address
2865 Logan Ave
San Diego, CA 92113-2411
Phone
(619) 232-4357
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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 VN277190 CA Primary

Addresses

Primary practice location

2865 Logan Ave
San Diego, CA 92113-2411

Mailing address

231 E Orlando St
Chula Vista, CA 91911-3617
Phone (619) 721-7111

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
VN277190CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1538560396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 E ORLANDO ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919113617",
            "telephone_number": "619-721-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 LOGAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132411",
            "telephone_number": "619-232-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIAS",
        "first_name": "JESSICA",
        "middle_name": "BLAIR",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN277190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.