Active NPI
/Prince Pela
- Licensed Vocational Nurse
- Sacramento, CA
National Provider Identifier
1962641175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN201981
- Practice address
- 6630 Riverside Blvd
Sacramento, CA 95831-1938 - Phone
- (916) 236-8876
- NPI assigned
- Feb 11, 2009
- Sex
- Male
- 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 | VN201981 | CA | Primary |
Addresses
Primary practice location
6630 Riverside Blvd
Sacramento, CA 95831-1938
Mailing address
6630 Riverside Blvd
Sacramento, CA 95831-1938
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 |
|---|---|---|---|
| VN201981 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234310400000",
"number": "1962641175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6630 RIVERSIDE BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958311938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6630 RIVERSIDE BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958311938",
"telephone_number": "916-236-8876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELA",
"first_name": "/PRINCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-11",
"last_updated": "2009-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN201981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.