Individual provider Active NPI

Michelle Etherington, LVN

  • Licensed Vocational Nurse
  • La Mesa, CA
National Provider Identifier
1730017690
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
203996 Issued in CA
Practice address
5525 Grossmont Center Dr
La Mesa, CA 91942-3009
Phone
(619) 750-3670
NPI assigned
May 11, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 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 NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164X00000X 203996 CA Primary

Addresses

Primary practice location

5525 Grossmont Center Dr
La Mesa, CA 91942-3009

Mailing address

9625 Pino Dr
Lakeside, CA 92040-4334
Phone (619) 750-3670

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
203996CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1730017690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 PINO DR",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920404334",
            "telephone_number": "619-750-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423009",
            "telephone_number": "619-750-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERINGTON",
        "first_name": "MICHELLE",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "203996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.