Marvin Funiestas, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

261947 Issued in CA

Practice address

9328 Elk Grove Blvd
Ste 105-126
Elk Grove, CA 95624-5063

Phone

(916) 718-7745

NPI assigned

Nov 16, 2011

Last updated

Nov 16, 2011By the provider in NPPES

Sex

Male

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1588931752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9328 ELK GROVE BLVD",
            "address_2": "STE 105-126",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245063",
            "telephone_number": "916-718-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9328 ELK GROVE BLVD",
            "address_2": "STE 105-126",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245063",
            "telephone_number": "916-718-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNIESTAS",
        "first_name": "MARVIN",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "261947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cyd Charisse Dionaldo Fuentes, RPH
• Megan Fuhrman
• Kris Fujikawa, OT/L
• Anna Fukuhara
• Hope Fuller
• G Sekhon Apc (Laguna Smiles)
• Dalise Gada, MS, LMFT
• Priscilla D Gaddy
• Rain Gaines
• Ronnica Lynn Gaines, AMFT

• Licensed Vocational Nurse in Elk Grove, CA
• Providers in Elk Grove, 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 Nov 16, 2011; 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.