Individual provider Active NPI

Jeffrey B Velasco

  • Registered Nurse
  • Winchester, CA
National Provider Identifier
1801176565
Registry record updated Jun 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95263229 Issued in CA
Practice address
31422 Kailua Dr
Winchester, CA 92596-8511
Phone
(626) 877-3019
NPI assigned
Aug 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95263229 CA Primary
Licensed Vocational Nurse 164X00000X 255359 CA

Addresses

Primary practice location

31422 Kailua Dr
Winchester, CA 92596-8511

Mailing address

31422 Kailua Dr
Winchester, CA 92596-8511
Phone (626) 877-3019

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
255359CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782604800000",
    "number": "1801176565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31422 KAILUA DR",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968511",
            "telephone_number": "626-877-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31422 KAILUA DR",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968511",
            "telephone_number": "626-877-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2026-06-28",
        "certification_date": "2026-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95263229",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "255359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2026; 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.