Active NPI
Vicki Marie Clavin, RN
- Registered Nurse
- Winchester, CA
National Provider Identifier
1871705988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 563630
- Practice address
- 36280 Hague St
Winchester, CA 92596-9273 - Phone
- (951) 926-8491
- Fax
- (951) 926-0889
- NPI assigned
- May 3, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 563630 | CA | Primary |
Addresses
Primary practice location
36280 Hague St
Winchester, CA 92596-9273
Mailing address
36280 Hague St
Winchester, CA 92596-9273
Phone (951) 926-8491
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EPS011920 | Other | CA | MEDI-CAL PROVIDER NUMBER |
| RVN001490 | Other | CA | MEDI-CAL FAMILY TRAINING |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 563630 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871705988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36280 HAGUE ST",
"city": "WINCHESTER",
"state": "CA",
"postal_code": "925969273",
"telephone_number": "951-926-8491",
"fax_number": "951-926-0889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36280 HAGUE ST",
"city": "WINCHESTER",
"state": "CA",
"postal_code": "925969273",
"telephone_number": "951-926-8491",
"fax_number": "951-926-0889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAVIN",
"first_name": "VICKI",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "563630",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL PROVIDER NUMBER",
"identifier": "EPS011920",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL FAMILY TRAINING",
"identifier": "RVN001490",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, CA
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- Clarity Collections LLC
- Claudia Q. Baliscao, a Licensed Clinical Social Worker Corporation (HOOLA Counseling and Consultation)
- Sharon Denise Clay Matemavi, NURSE PRACTITIONER
- Cohen Sedgh, Manavi & Pakravan Dental Corp (West Coast Dental Adult and Childrens Dentistry)
- Cameron Leigh Cordle
- Tracy Crockett
- Stephanie Culpepper
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.