Individual provider Active NPI

Sandra Mosich, LVN

  • Licensed Vocational Nurse
  • Inglewood, CA
National Provider Identifier
1982258067
Registry record updated Jul 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
259698 Issued in CA
Practice address
4450 W Century Blvd
Inglewood, CA 90304-1504
Phone
(310) 671-9294
NPI assigned
Jul 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2019

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 259698 CA Primary

Addresses

Primary practice location

4450 W Century Blvd
Inglewood, CA 90304-1504

Mailing address

1461 E Palm Ave
El Segundo, CA 90245-3327

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
259698CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564272000000",
    "number": "1982258067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 E PALM AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 W CENTURY BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903041504",
            "telephone_number": "310-671-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSICH",
        "first_name": "SANDRA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-28",
        "last_updated": "2019-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "259698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2019; 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.