Active NPI
Domel Briones Evangelista
- Licensed Vocational Nurse
- Santa Ana, CA
National Provider Identifier
1861669459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN 226734
- Practice address
- 1209 Hemlock Way
Santa Ana, CA 92707-3609 - Phone
- (714) 546-1966
- NPI assigned
- May 13, 2008
- Sex
- Male
- Sole proprietor
- No
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 | VN 226734 | CA | Primary |
Addresses
Primary practice location
1209 Hemlock Way
Santa Ana, CA 92707-3609
Mailing address
1607 Calle del Sol
Apartment H
Anaheim, CA 92802
Phone (714) 563-0198
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 |
|---|---|---|---|
| VN 226734 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1861669459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 CALLE DEL SOL",
"address_2": "APARTMENT H",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "92802",
"telephone_number": "714-563-0198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1209 HEMLOCK WAY",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927073609",
"telephone_number": "714-546-1966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANGELISTA",
"first_name": "DOMEL",
"middle_name": "BRIONES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-13",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN 226734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.