Individual provider Active NPI

Kelly Roma Maneja, LVN

  • Licensed Vocational Nurse
  • Fullerton, CA
National Provider Identifier
1851244768
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
740258 Issued in CA
Practice address
218 E Commonwealth Ave
Fullerton, CA 92832-1911
Phone
(626) 516-4646
NPI assigned
Feb 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 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 740258 CA Primary

Addresses

Primary practice location

218 E Commonwealth Ave
Fullerton, CA 92832-1911

Mailing address

1054 Forestdale Ave
Glendora, CA 91740-4945
Phone (626) 516-4646

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
740258CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1771459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1851244768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 FORESTDALE AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404945",
            "telephone_number": "626-516-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321911",
            "telephone_number": "626-516-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEJA",
        "first_name": "KELLY",
        "middle_name": "ROMA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-19",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "740258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.