Individual provider Active NPI

Ktlenne Lehi Lazo

  • Family Nurse Practitioner
  • Ventura, CA
National Provider Identifier
1891341517
Registry record updated Aug 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R215966 Issued in MD
Practice address
800 S Victoria Ave
Ventura, CA 93009-0001
Phone
(805) 654-9511
NPI assigned
Aug 18, 2019
Last updated
Aug 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R215966 MD Primary

Addresses

Primary practice location

800 S Victoria Ave
Ventura, CA 93009-0001

Mailing address

PO Box 8132
Oxnard, CA 93031-8132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200211001564 CA Practitioner - Nurse Practitioner 8426484494 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R215966MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Jan 8, 2020 Accepting new patients
St. Johns Community Health CurrentSince Jan 8, 2020 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

Interoperability endpoints

  • Direct secure messaging: klazo686461@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566086400000",
    "number": "1891341517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8132",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930318132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S VICTORIA AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930090001",
            "telephone_number": "805-654-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZO",
        "first_name": "KTLENNE LEHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-18",
        "last_updated": "2019-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R215966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.