Domevlo Umoja, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN 276219 Issued in CA

Practice address

2550 W Clinton Ave BLDG W
Fresno, CA 93705-4206

Phone

(559) 264-7521

Fax

(559) 860-0168

NPI assigned

May 28, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Systems, Inc.

  dba D.A.R.T. West

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1841813938
  NPD
• Mental Health Systems, Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1720745169
  NPD (past)

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1740692540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W CLINTON AVE UNIT 397",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054223",
            "telephone_number": "559-264-7521",
            "fax_number": "559-860-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 W CLINTON AVE BLDG W",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054206",
            "telephone_number": "559-264-7521",
            "fax_number": "559-860-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMOJA",
        "first_name": "DOMEVLO",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN 276219",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN276219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ultra Standards Inc
• Karam Um
• Teresita Umali, RN
• Bianca Destiny Umanzor
• Nisha A Umesh
• Sokhary Chea Un
• Unaiza Hayat, M.D. Inc. (avecinia wellness center)
• Angel Unay
• Alyshia Underwood
• Andrea Underwood, NNP

• Licensed Vocational Nurse in Fresno, CA
• Providers in Fresno, 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 17, 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.