Individual provider Active NPI

Christine Hermosillo-Exza, LVN

  • Licensed Vocational Nurse
  • Winnetka, CA
National Provider Identifier
1780882415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN147503 Issued in CA
Practice address
20800 Sherman Way
Winnetka, CA 91306-2707
Phone
(818) 883-2273
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 VN147503 CA Primary

Addresses

Primary practice location

20800 Sherman Way
Winnetka, CA 91306-2707

Mailing address

8902 Woodman Ave
Arleta, CA 91331-6401
Phone (818) 830-7133

Other identifiers 1

IdentifierTypeStateIssuer
EAP70468FOtherCAEAPC GRANT

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
VN147503CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780882415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8902 WOODMAN AVE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913316401",
            "telephone_number": "818-830-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20800 SHERMAN WAY",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062707",
            "telephone_number": "818-883-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMOSILLO-EXZA",
        "first_name": "CHRISTINE",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN147503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC GRANT",
            "identifier": "EAP70468F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnetka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.