Individual provider Active NPI

Elizabeth Socorro Guerra

  • Licensed Vocational Nurse
  • San Jose, CA
National Provider Identifier
1982230728
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
284784 Issued in CA
Practice address
2418 Hecate PL
San Jose, CA 95124-3311
Phone
(408) 655-4500
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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 284784 CA Primary

Addresses

Primary practice location

2418 Hecate PL
San Jose, CA 95124-3311

Mailing address

446 Century Oaks CT
San Jose, CA 95111-1810
Phone (408) 603-9432

Other identifiers 1

IdentifierTypeStateIssuer
284784OtherCALICENSE VOCATIONAL NURSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabethg1119@hotmail.com Direct

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
284784CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1982230728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 CENTURY OAKS CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111810",
            "telephone_number": "408-603-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 HECATE PL",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243311",
            "telephone_number": "408-655-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "ELIZABETH",
        "middle_name": "SOCORRO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "284784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE VOCATIONAL NURSE",
            "identifier": "284784",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabethg1119@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging",
            "address_1": "2418 Hecate Pl",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951243311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.