Individual provider Active NPI

Krystyna Dubetz

  • Licensed Vocational Nurse
  • Desert Hot Springs, CA
National Provider Identifier
1962870071
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
290625 Issued in CA
Practice address
66400 7TH St
Desert Hot Springs, CA 92240-3138
Phone
(740) 424-7009
NPI assigned
Sep 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 290625 CA Primary

Addresses

Primary practice location

66400 7TH St
Desert Hot Springs, CA 92240-3138

Mailing address

66400 7TH St
Desert Hot Springs, CA 92240-3138
Phone (740) 424-7009

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

LicenseStateTypeSpecialty
290625CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1962870071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66400 7TH ST",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403138",
            "telephone_number": "740-424-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66400 7TH ST",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403138",
            "telephone_number": "740-424-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBETZ",
        "first_name": "KRYSTYNA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "290625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desert Hot Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.