EVELYN LAVERN THOMPSON NPI 1104003763

NPI Information

  • NPI: 1104003763
  • Provider Name: EVELYN LAVERN THOMPSON
  • Classification: Skilled Nursing Facility - 3140N1450X
  • Specialization: Nursing Care, Pediatric
  • Entity Type: Organization
  • Address: 12279 LASSELLE ST
    MORENO VALLEY, CA
    ZIP 92557
  • Phone: (951) 485-6847

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NPI Details

EVELYN LAVERN THOMPSON is a nursing care and pediatric skilled nursing facility in Moreno Valley, CA. The provider is a nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. EVELYN LAVERN THOMPSON NPI is 1104003763. The provider is registered as an organization entity type.

The provider's business location address is:

12279 LASSELLE ST
MORENO VALLEY, CA
ZIP 92557-705
Phone: (951) 485-6847

The provider's authorized official is Evelyn Lavern Thompson .
The authorized official title is L.v.n and has the following contact phone number (951) 485-6847.

The enumeration date for this NPI number is 1/25/2008 and was last updated on 1/25/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13140N1450XSkilled Nursing FacilityNursing Care, PediatricVN129832CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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