Mary Jane Aquino De Vera

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

723936 Issued in CA

Practice address

1885 Bay Rd
East Palo Alto, CA 94303-1312

Phone

(650) 330-7400

NPI assigned

Mar 5, 2024

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

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1912764911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2096 EVERGLADE ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945454737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 BAY RD",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031312",
            "telephone_number": "650-330-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VERA",
        "first_name": "MARY JANE",
        "middle_name": "AQUINO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "723936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Mackenzie Coyne, RN, FNP-C
• Brianne R. Crabbe
• Susan Marie Crosby
• Jaclyn Czaja, MD
• Jeremiah C. Davis, MD
• Tayischa Deldridge
• Diana Deras-Magana
• Davina Dick, L.AC., DAOM
• Sharon Jean Dipierro, MD
• Nyla Dowden

• Licensed Vocational Nurse in East Palo Alto, CA
• Providers in East Palo Alto, 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 Mar 5, 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.