Active NPI
Angela Commodore, LVN
- Licensed Vocational Nurse
- Santa Fe Springs, CA
National Provider Identifier
1871827931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN199852
- Practice address
- 11741 Telegraph Rd
Ste G-H
Santa Fe Springs, CA 90670-3681 - Phone
- (626) 254-5000
- NPI assigned
- Sep 22, 2009
- 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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | VN199852 | CA | Primary |
Addresses
Primary practice location
11741 Telegraph Rd
Ste G-H
Santa Fe Springs, CA 90670-3681
Mailing address
9410 Olive St
Bellflower, CA 90706-4516
Phone (562) 326-2218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164X00000X | Other | CA | NONE |
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 |
|---|---|---|---|
| VN199852 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253577600000",
"number": "1871827931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9410 OLIVE ST",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907064516",
"telephone_number": "562-326-2218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11741 TELEGRAPH RD",
"address_2": "STE G-H",
"city": "SANTA FE SPRINGS",
"state": "CA",
"postal_code": "906703681",
"telephone_number": "626-254-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMMODORE",
"first_name": "ANGELA",
"name_prefix": "Mrs.",
"credential": "LVN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-22",
"last_updated": "2009-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN199852",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "164X00000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.