KELVIN CLARENCE AQUILIZAN DERRADA (NPI# 1295242899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295242899 |
| Entity Type | Individual |
| Full Name | KELVIN CLARENCE AQUILIZAN DERRADA |
| Practice Address |
13405 Brookwood Way Lathrop CA 95330-8920 |
| Practice Telephone | 2099829368 |
| Mailing Telephone | 2099829368 |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2018-01-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164X00000X | Licensed Vocational Nurse | 280438 | CA | Nursing Service Providers |
| Street Address |
13405 BROOKWOOD WAY |
| City | LATHROP |
| State | CA |
| Zip Code | 95330-8920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861919938 | Lathrop Pharmacy, LLC. | Pharmacy | 201 E. Louise Ave, Lathrop, CA 95330 | 2017-08-29 |
| 1063936052 | Japneet S Dhillon Dds Inc | Dentist | 15366 S Harlan Rd, Lathrop, CA 95330 | 2017-08-01 |
| 1992966253 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 16858 Golden Valley Pkwy, Lathrop, CA 95330 | 2008-06-19 |
| 1508023235 | Marysol B. Realon Dds A Prof. Dental Corp | Dentist | 259 E. Louise Ave, Lathrop, CA 95330 | 2008-05-20 |
| 1104048107 | Myduyen Tran | Dentist | 15136 Harlan Rd., Lathrop, CA 95330 | 2007-05-02 |
| 1043689193 | Joy Viscia Victoria Bareng | Pharmacist | 16858 Golden Valley Pkwy, Lathrop, CA 95330 | 2015-09-18 |
| 1851645287 | Amarpreet Kaur Sidhu | Pharmacist | 16858 Golden Valley Parkway, Lathrop, CA 95330 | 2012-11-07 |
| 1275801946 | Han Nguyen | Pharmacist | 16858 Golden Valley Pkwy, T2347, Lathrop, CA 95330 | 2011-12-08 |
| 1184910820 | Jennifer Leung | Pharmacist | 16858 Golden Valley Parkway, T-2347, Lathrop, CA 95330-7296 | 2011-06-21 |
| 1154959666 | Edgar D Lardizabal | Registered Nurse | 1705 Cranbrook Ct, Lathrop, CA 95330-8244 | 2020-03-30 |
| Find all providers in zip 95330 | ||||
| Taxonomy Code | 164X00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Vocational Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619449360 | Crisloren Barba-mendoza | Licensed Vocational Nurse | 166 Camelback St, Lathrop, CA 95330-9643 | 2018-12-19 |
| 1710102082 | Ana Maria Yerena | Licensed Vocational Nurse | 404 Thomsen Rd, Lathrop, CA 95330-9132 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931846 | Deanna Barfield | Licensed Vocational Nurse | 9633 Laurel St, Bellflower, CA 90706-5318 | 2020-10-31 |
| 1710587639 | Steven Wheeler Knight Thomspon | Licensed Vocational Nurse | 10960 Poppy Field Cir, Moreno Valley, CA 92557-3912 | 2020-10-29 |
| 1942800982 | Michelle Marie Toman | Licensed Vocational Nurse | 900 Weber Cir Apt 105, Ventura, CA 93003-8248 | 2020-10-29 |
| 1326647876 | Valeria Brinkers | Licensed Vocational Nurse | 1225 Calle Fantasia, San Marcos, CA 92069-7353 | 2020-10-25 |
| 1417556374 | Rainville Love Dela Salde | Licensed Vocational Nurse | 1300 Adams Ave Apt 12a, Costa Mesa, CA 92626-8315 | 2020-10-21 |
| 1396344222 | Mary Lynn Anderson | Licensed Vocational Nurse | 311 Oceanside Blvd Spc 49, Oceanside, CA 92054-5130 | 2020-10-21 |
| 1689273674 | To Yen Ruby Ngo | Licensed Vocational Nurse | 10501 Valley Blvd Ste 1200, El Monte, CA 91731-3617 | 2020-10-21 |
| 1699374991 | Patricia Ann Perkins | Licensed Vocational Nurse | 3210 Madera Pl, Oxnard, CA 93033-5756 | 2020-10-19 |
| 1003415308 | Veronica Esparza | Licensed Vocational Nurse | 315 E Ventura St Apt 6, Santa Paula, CA 93060-3824 | 2020-10-19 |
| 1649878166 | Crystal Shin | Licensed Vocational Nurse | 3785 Wilshire Blvd Apt 1804, Los Angeles, CA 90010-2893 | 2020-10-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.