Individual provider Active NPI

Kendal Wesley Gaines

  • Licensed Vocational Nurse
  • Rialto, CA
National Provider Identifier
1851201651
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
762030 Issued in CA
Practice address
1414 N Riverside Ave Apt 239
Rialto, CA 92376-8080
Phone
(840) 220-1111
NPI assigned
Sep 11, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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 762030 CA Primary

Addresses

Primary practice location

1414 N Riverside Ave Apt 239
Rialto, CA 92376-8080

Mailing address

1414 N Riverside Ave Apt 239
Rialto, CA 92376-8080
Phone (840) 220-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1851201651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 N RIVERSIDE AVE APT 239",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768080",
            "telephone_number": "840-220-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 N RIVERSIDE AVE APT 239",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768080",
            "telephone_number": "840-220-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "KENDAL",
        "middle_name": "WESLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "762030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.