Kimberly Gaye Sasser-Wills, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

V222540 Issued in CA

Practice address

22842 Azalia Lane
Crestline, CA 92325-6281

Phone

(909) 338-9367

NPI assigned

Jun 12, 2013

Last updated

Jun 12, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1548608532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6281",
            "city": "CRESTLINE",
            "state": "CA",
            "postal_code": "923256281",
            "telephone_number": "909-338-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22842 AZALIA LANE",
            "city": "CRESTLINE",
            "state": "CA",
            "postal_code": "923256281",
            "telephone_number": "909-338-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASSER-WILLS",
        "first_name": "KIMBERLY",
        "middle_name": "GAYE",
        "name_prefix": "Ms.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "V222540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Vocational Nurse in Crestline, CA
• Providers in Crestline, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.