Active NPI
Savannah Watts
- Licensed Vocational Nurse
- Modesto, CA
National Provider Identifier
1831857002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 720293
- Practice address
- 1609 Radcliffe Ave
Modesto, CA 95358-1041 - Phone
- (209) 300-8800
- NPI assigned
- Dec 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 720293 | CA | Primary |
Addresses
Primary practice location
1609 Radcliffe Ave
Modesto, CA 95358-1041
Mailing address
1609 Radcliffe Ave
Modesto, CA 95358-1041
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
| License | State | Type | Specialty |
|---|---|---|---|
| 720293 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1831857002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 RADCLIFFE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953581041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 RADCLIFFE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953581041",
"telephone_number": "209-300-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "SAVANNAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-03",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "720293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.