Individual provider Active NPI

Jeannette Sandoval Larios

  • Licensed Vocational Nurse
  • San Jose, CA
National Provider Identifier
1720258494
Registry record updated Mar 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
225490 Issued in CA
Practice address
2310 Olivegate LN
San Jose, CA 95136-3209
Phone
(408) 510-4091
NPI assigned
Mar 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2008

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 225490 CA Primary

Addresses

Primary practice location

2310 Olivegate LN
San Jose, CA 95136-3209

Mailing address

2310 Olivegate LN
San Jose, CA 95136-3209

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
225490CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1205020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205020800000",
    "number": "1720258494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 OLIVEGATE LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951363209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 OLIVEGATE LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951363209",
            "telephone_number": "408-510-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARIOS",
        "first_name": "JEANNETTE",
        "middle_name": "SANDOVAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-09",
        "last_updated": "2008-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "225490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2008; 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.