Joycelyn Antonio, 164X00000X

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

267875 Issued in CA

Practice address

1450 Bessie Ave Ste B
Tracy, CA 95376-3456

Phone

(209) 597-3090

NPI assigned

Jun 22, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Tracy, CA
  • NPI 1083224141
  NPD

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1881370203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 BESSIE AVE STE B",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763456",
            "telephone_number": "209-597-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BESSIE AVE STE B",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763456",
            "telephone_number": "209-597-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "JOYCELYN",
        "name_prefix": "Ms.",
        "credential": "164X00000X",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "267875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Angeles
• Jesse Antal
• Anthony R. Hoffman, DPM, Inc.
• Gabriela Antimo
• Brianna Antognazzi
• Anukaran Samra DDS Inc
• Shannon P Apodaca
• Dale Marie Applewhite
• Applied Chiropractic Solotions
• Feleshia L Apps

• Licensed Vocational Nurse in Tracy, CA
• Providers in Tracy, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.