Michael Dan Ancheta Cariaso

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

688008 Issued in CA

Practice address

405 W 5TH St
Santa Ana, CA 92701-4599

Phone

(714) 834-3101

NPI assigned

Sep 25, 2024

Sex

Male

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": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1710704184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 POTTER ST",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504738",
            "telephone_number": "562-608-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014599",
            "telephone_number": "714-834-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARIASO",
        "first_name": "MICHAEL DAN",
        "middle_name": "ANCHETA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "688008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Vocational Nurse in Santa Ana, CA
• Providers in Santa Ana, 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 25, 2024; 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.