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JAN RAYMOND VICENCIO N.P.
NPI 1295109304
Nurse Practitioner - Adult Health in Newport Beach, CA

Active since December 01, 2015
2901 W COAST HWY, SUITE 200, NEWPORT BEACH, CA 92663(562) 229-4813 Get Directions Write a Review

NPPES record last updated: February 2, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 2, 2016, Dec 1, 2015 (2 updates tracked since 2015).

About Jan Raymond Vicencio N.p. NPPES

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

JAN RAYMOND VICENCIO N.P. (NPI 1295109304) is an individual adult health provider in Newport Beach, California, licensed in California (95003057) and active in the NPI registry since December 2015.

NPPES Registry Identity

NPI1295109304
Entity TypeIndividualMale
Primary Taxonomy363LA2200X
Provider Legal NameJAN RAYMOND VICENCIOCredential: N.P.
Location Address2901 W COAST HWY, SUITE 200Newport Beach, CA 92663-4023
Mailing Address14733 Woodruff PlBellflower, CA 90706-3270 · (562) 229-4813
Phone(562) 229-4813
Sole ProprietorYes
Enumeration DateDecember 1, 2015
Last NPPES UpdateFebruary 2, 20162 updates tracked since enumeration
✔ NPI 1295109304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in CA · 95003057
2901 W COAST HWY, Newport Beach, CA 92663
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Other Names 1

Former Name (1)Jan Raymond Vicencio Vicencio

Other Providers at the Same Location NPPES 3

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

JEFF EVANS
Counselor (Addiction (Substance Use Disorder))
2901 W COAST HWY
NEWPORT BEACH, CA 92663
Orange County (949) 997-0080
JOSBAT MEDICAL CA
Clinic/Center
2901 W COAST HWY
NEWPORT BEACH, CA 92663
Orange County (949) 271-2013
CRESCENT MOON RECOVERY NEWPORT BEACH
Clinic/Center (Rehabilitation, Substance Use Disorder)
2901 W COAST HWY
NEWPORT BEACH, CA 92663
Orange County (949) 997-0080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jan Vicencio's NPI number?

The NPI number for Jan Vicencio is 1295109304. It was assigned to this individual provider in the NPPES registry on December 1, 2015. The provider is also known as Jan Raymond Vicencio Vicencio.

Where is Jan Vicencio located?

Jan Vicencio practices at 2901 W Coast Hwy Suite 200, Newport Beach, CA 92663. The listed phone number is (562) 229-4813.

What is Jan Vicencio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Jan Vicencio was last updated on February 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.