Nicole Marie Ivery Davis, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN705598 Issued in CA

Practice address

20331 Flanagan Rd.
Trabuco Canyon, CA 92679-9267

Phone

(818) 582-8832

NPI assigned

Jul 19, 2018

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Footprints Behavioral Interventions, Inc.

  dba Footprints Behavioral Interventions

  • Early Intervention Provider Agency
  • Santa Ana, CA
  • NPI 1780978858

  Behavior Technician

  NPD (past)
• The Teen Project, Inc.

  dba Vera's Sanctuary

  • Children's Substance Abuse Rehabilitation Facility
  • Trabuco Canyon, CA
  • NPI 1609345743
  NPD (past)

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1700363074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 PIEDMONT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202846",
            "telephone_number": "714-310-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20331 FLANAGAN RD.",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926799267",
            "telephone_number": "818-582-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERY DAVIS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN705598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Hilliard
• Jessyca Hinshaw
• Ashley Lauren Hee Hoevelkamp, RADT
• Karla Inzunza, LCSW
• Alysia Israel
• Michael Justin James, D.C.
• Gina Marie Jamieson, RADT
• Tana Jimenez, PT
• Daniel Scott Jimmerson, APCC
• Victoria Lynn Johnston

• Licensed Vocational Nurse in Trabuco Canyon, CA
• Providers in Trabuco Canyon, 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 Mar 2, 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.