STASHA LEIGH BLACKWELL LVN
NPI 1114783818
Licensed Vocational Nurse in Perris, CA

Q: What is Stasha Blackwell's NPI number?

The NPI number for Stasha Blackwell is 1114783818. It was assigned to this individual provider in the NPPES registry on February 21, 2024. The provider is also known as Stasha Leigh Bravo Lvn.

Q: What is Stasha Blackwell's specialty?

The primary specialty registered for this NPI is Licensed Vocational Nurse with taxonomy code 164X00000X.

Q: When was this NPI record last updated?

The NPPES record for Stasha Blackwell was last updated on February 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 21, 2024

2560 N PERRIS BLVD STE N1, PERRIS, CA 92571(951) 940-6755 Get Directions Write a Review

NPPES record last updated: February 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Stasha Leigh Blackwell Lvn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STASHA LEIGH BLACKWELL LVN (NPI 1114783818) is an individual licensed vocational nurse in Perris, California, licensed in California (288447) and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1114783818

Entity TypeIndividualFemale

Primary Taxonomy164X00000X

Provider Legal NameSTASHA LEIGH BLACKWELLCredential: LVN

Location Address2560 N PERRIS BLVD STE N1Perris, CA 92571-3251

Mailing Address2560 N Perris Blvd Ste N1Perris, CA 92571-3251 · (951) 940-6755

Phone(951) 940-6755

Sole ProprietorYes

Enumeration DateFebruary 21, 2024

NPPES CertifiedFebruary 21, 2024

✔ NPI 1114783818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Vocational NurseNursing Service Providers

Taxonomy Code164X00000X

License✔ Licensed in CA · 288447

Definition

A licensed vocational nurse 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.

2560 N PERRIS BLVD STE N1, Perris, CA 92571

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Other Names 1

Former Name (1)Stasha Leigh Bravo Lvn

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAIME P MCDERMOTT

Peer Specialist