Individual provider Active NPI

Marcos J Lombera, RN

  • Psychiatric/Mental Health Registered Nurse
  • Fresno, CA
National Provider Identifier
1902270259
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
95171606 Issued in CA
Practice address
4411 E Cesar Chavez Blvd
Fresno, CA 93702-3604
Phone
(559) 453-1008
NPI assigned
Nov 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95171606 CA
Licensed Vocational Nurse 164X00000X VN 280643 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X 95171606 CA Primary

Addresses

Primary practice location

4411 E Cesar Chavez Blvd
Fresno, CA 93702-3604

Mailing address

4411 E Cesar Chavez Blvd
Fresno, CA 93702-3604
Phone (559) 548-0105

Other practice location 1

3133B N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 453-1008

Other practice location 2

3147 N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 453-1008

Other practice location 3

3127 N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 453-1008

Other practice location 4

3520 E Shields Ave Ste 102
Fresno, CA 93726-6923
Phone (559) 538-1230

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

LicenseStateTypeSpecialty
95171606CAMDPsychiatric/Mental Health Registered Nurse
VN 280643CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1902270259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-548-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-453-1008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3133B N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3147 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3127 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3520 E Shields Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937266923",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOMBERA",
        "first_name": "MARCOS",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-24",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95171606",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN 280643",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95171606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.