Individual provider Active NPI

Nicole Lynn Santa Cruz, LVN

  • Licensed Vocational Nurse
  • Long Beach, CA
National Provider Identifier
1669049193
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
247436 Issued in CA
Practice address
1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone
(310) 231-6336
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 247436 CA Primary

Addresses

Primary practice location

1501 Hughes Way Ste 150
Long Beach, CA 90810-1878

Mailing address

1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (310) 231-6336

Other practice location 1

37763 Silk Tree Ln
Palmdale, CA 93550-6979
Phone (661) 974-3033

Other practice location 2

415 East Avenue I
Lancaster, CA 93535
Phone (661) 522-6770

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
247436CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Star View Behavioral Health, Inc. PastSince Sep 6, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1669049193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101878",
            "telephone_number": "310-231-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101878",
            "telephone_number": "310-231-6336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37763 Silk Tree Ln",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935506979",
            "country_code": "US",
            "telephone_number": "661-974-3033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 East Avenue I",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "93535",
            "country_code": "US",
            "telephone_number": "661-522-6770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTA CRUZ",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "247436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.