Individual provider Active NPI

Laseana Ancrum, LVN

  • Licensed Vocational Nurse
  • Oceanside, CA
National Provider Identifier
1740647080
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
LVN273175 Issued in CA
Practice address
1738 S Tremont St
Oceanside, CA 92054-5309
Phone
(760) 439-2800
NPI assigned
Jan 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 273175 CA
Licensed Vocational Nurse 164X00000X LVN273175 CA Primary

Addresses

Primary practice location

1738 S Tremont St
Oceanside, CA 92054-5309

Mailing address

1738 S Tremont St
Oceanside, CA 92054-5309
Phone (760) 439-2800

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
273175CAMDLicensed Vocational Nurse
LVN273175CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1740647080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 S TREMONT ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545309",
            "telephone_number": "760-439-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 S TREMONT ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545309",
            "telephone_number": "760-439-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCRUM",
        "first_name": "LASEANA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-18",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "273175",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "LVN273175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.