Jamie Detels, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

725390 Issued in CA

Practice address

1687 Yulupa Ave
Santa Rosa, CA 95405-7778

Phone

(707) 546-6183

Fax

(707) 528-8027

NPI assigned

Sep 2, 2025

Last updated

Sep 2, 2025By the provider in NPPES

Sex

Unspecified or another gender identity

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

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1700766748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 DEL ORO CIR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949545728",
            "telephone_number": "707-393-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 YULUPA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057778",
            "telephone_number": "707-546-6183",
            "fax_number": "707-528-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETELS",
        "first_name": "JAMIE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "725390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abhijit G Deshpande, MD
• Stacy A Desjardins, NMT, CMT
• Audrey B. Desky, MD
• Vanessa Lee Desousa, D.O.
• Andrew James Desruisseau, M.D.
• Sarah Marie Determan, PHD
• Carolyn Detierra, MFT
• Renee Dettloff, CNM
• Dixie Lee Deuth
• Charlynn Devenny, RASI

• Licensed Vocational Nurse in Santa Rosa, CA
• Providers in Santa Rosa, 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 Sep 2, 2025; 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.