Individual provider Active NPI

Cosbi Katrina Defensor Villesis

  • Licensed Vocational Nurse
  • Camarillo, CA
National Provider Identifier
1871107078
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
692907 Issued in CA
Practice address
1750 S Lewis Rd
Camarillo, CA 93012-8520
Phone
(805) 702-2930
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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 692907 CA Primary

Addresses

Primary practice location

1750 S Lewis Rd
Camarillo, CA 93012-8520

Mailing address

939 Perry Dr Apt D
Port Hueneme, CA 93041-4176
Phone (619) 807-7280

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
692907CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1871107078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 PERRY DR APT D",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930414176",
            "telephone_number": "619-807-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S LEWIS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128520",
            "telephone_number": "805-702-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLESIS",
        "first_name": "COSBI KATRINA",
        "middle_name": "DEFENSOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "692907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.