Active NPI
Lydia T Grant, FNP
- Family Nurse Practitioner
- Livingston, CA
National Provider Identifier
1740457761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 8657
- Practice address
- 1140 Main St
Livingston, CA 95334-1257 - Phone
- (209) 394-7075
- NPI assigned
- May 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8657 | CA | Primary |
Addresses
Primary practice location
1140 Main St
Livingston, CA 95334-1257
Mailing address
1140 Main St
Livingston, CA 95334-1257
Phone (209) 394-7075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8657 | Other | CA | FNP NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8657 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1740457761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 MAIN ST",
"city": "LIVINGSTON",
"state": "CA",
"postal_code": "953341257",
"telephone_number": "209-394-7075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 MAIN ST",
"city": "LIVINGSTON",
"state": "CA",
"postal_code": "953341257",
"telephone_number": "209-394-7075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "LYDIA",
"middle_name": "T",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-08",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "8657",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FNP NUMBER",
"identifier": "8657",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livingston, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.