NPI Code Detail JSON Logo

1861891376 NPI number — ADEMIRA PORCIC LVN

NPI Number: 1861891376
Health Care Provider/Practitioner: ADEMIRA PORCIC LVN

Information about “1861891376” NPI (ADEMIRA PORCIC LVN) exists in 1861891376 in HTML format HTML  |  1861891376 in plain Text format TXT  |  1861891376 in PDF (Portable Document Format) PDF  |  1861891376 in an XML format XML  formats.

NPI Number : 1861891376 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861891376",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PORCIC",
    "FirstName": "ADEMIRA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LVN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PORCIC",
    "OtherFirstName": "ADEMIRA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LVN",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "4205 ARCH DR APT 20",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STUDIO CITY",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91604-3260",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "701-306-5823",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4434 HARDING AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90066",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "701-306-5823",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/20/2014",
    "LastUpdateDate": "05/20/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "11/21/2018",
    "NPIReactivationDate": "01/30/2019",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "164X00000X",
        "TaxonomyName": "Licensed Vocational Nurse",
        "LicenseNumber": "696055",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.