Jose Chavez, DNP RN ACCNS-AG CCRN

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

4549 Issued in CA

Practice address

4940 Laurel Canyon Blvd Apt 101
Valley Village, CA 91607-6007

Phone

(619) 944-5364

NPI assigned

Sep 17, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1992311757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 LAUREL CANYON BLVD APT 101",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916076007",
            "telephone_number": "619-944-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 LAUREL CANYON BLVD APT 101",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916076007",
            "telephone_number": "619-944-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DNP RN ACCNS-AG CCRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "4549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4549",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jchavez1@pointloma.edu",
            "affiliation": "N",
            "endpointDescription": "professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4940 Laurel Canyon Blvd Apt 101",
            "city": "Valley Village",
            "state": "CA",
            "country_code": "US",
            "postal_code": "916076007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Nurse Specialist in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.