Individual provider Active NPI

Harold Andrew Palmer III, LVN

  • Registered Nurse
  • Lake Elsinore, CA
National Provider Identifier
1629424213
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95474632 Issued in CA
Practice address
39767 Strada Firenze
Lake Elsinore, CA 92532-2220
Phone
(562) 968-9573
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN281186 CA
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 95474632 CA Primary

Addresses

Primary practice location

39767 Strada Firenze
Lake Elsinore, CA 92532-2220

Mailing address

451 Holgate St
La Habra, CA 90631-4271
Phone (562) 968-9573

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
VN281186CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1629424213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HOLGATE ST",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906314271",
            "telephone_number": "562-968-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39767 STRADA FIRENZE",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322220",
            "telephone_number": "562-968-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "HAROLD",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN281186",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95474632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.