Kacee G Cross, LVN

Individual provider Active NPI Licensed Vocational Nurse · Highland, CA

NPI 1609762392 · NPPES record last updated Jun 17, 2025

Key facts

NPI
1609762392
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
695165 (CA)
Practice address
2727 Pacific St SPC 140
Highland, CA 92346-2366
Phone
(909) 503-3015
NPI assigned
Jun 17, 2025
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
695165CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 695165 CA Yes

Addresses

Primary practice location

2727 Pacific St SPC 140
Highland, CA 92346-2366

Mailing address

2727 Pacific St SPC 140
Highland, CA 92346-2366
Phone (909) 503-3015

Other providers in Highland, CA

All providers in Highland, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.