Individual provider Active NPI

Rebecca Tina Moronez, LVN

  • Licensed Vocational Nurse
  • Pasadena, CA
National Provider Identifier
1790953479
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN231412 Issued in CA
Practice address
940 Avenue 64
Pasadena, CA 91105-2711
Phone
(323) 543-2800
NPI assigned
Feb 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 VN231412 CA Primary

Addresses

Primary practice location

940 Avenue 64
Pasadena, CA 91105-2711

Mailing address

940 Avenue 64
Pasadena, CA 91105-2711
Phone (323) 543-2800

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
VN231412CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Haynes Family of Programs PastSince Apr 1, 2020 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1790953479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 AVENUE 64",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052711",
            "telephone_number": "323-543-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 AVENUE 64",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052711",
            "telephone_number": "323-543-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONEZ",
        "first_name": "REBECCA",
        "middle_name": "TINA",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN231412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.