Individual provider Active NPI

Stephen Werder, LVN

  • Licensed Vocational Nurse
  • Mount Shasta, CA
National Provider Identifier
1679486799
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN758035 Issued in CA
Practice address
824 Pine St
Mount Shasta, CA 96067-2137
Phone
(530) 926-4528
Fax
(530) 926-5070
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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 VN758035 CA Primary

Addresses

Primary practice location

824 Pine St
Mount Shasta, CA 96067-2137

Mailing address

824 Pine St
Mount Shasta, CA 96067-2137
Phone (530) 926-4528

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1679486799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672137",
            "telephone_number": "530-926-4528",
            "fax_number": "530-926-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672137",
            "telephone_number": "530-926-4528",
            "fax_number": "530-926-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERDER",
        "first_name": "STEPHEN",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN758035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Shasta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.