Individual provider Active NPI

Rachelle Liana Fredericks, LVN

  • Licensed Vocational Nurse
  • El Cajon, CA
National Provider Identifier
1841152642
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
730872 Issued in CA
Practice address
234 N Magnolia Ave
El Cajon, CA 92020-3906
Phone
(619) 579-8373
Fax
(619) 579-8155
NPI assigned
Dec 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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 730872 CA Primary

Addresses

Primary practice location

234 N Magnolia Ave
El Cajon, CA 92020-3906

Mailing address

234 N Magnolia Ave
El Cajon, CA 92020-3906
Phone (619) 579-8373

Other names 1

  • Rachelle Liana Delva Former name

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
730872CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1841152642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 N MAGNOLIA AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203906",
            "telephone_number": "619-579-8373",
            "fax_number": "619-579-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 N MAGNOLIA AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203906",
            "telephone_number": "619-579-8373",
            "fax_number": "619-579-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "RACHELLE",
        "middle_name": "LIANA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "730872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "DELVA",
            "middle_name": "LIANA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.