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RAEVYN STALLWORTH
NPI 1891527370
Licensed Vocational Nurse in San Bernardino, CA

Active since August 14, 2024
1100 N D ST, SAN BERNARDINO, CA 92410(909) 381-3774 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Raevyn Stallworth NPPES

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

RAEVYN STALLWORTH (NPI 1891527370) is an individual licensed vocational nurse in San Bernardino, California, licensed in California (737988) and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1891527370
Entity TypeIndividualFemale
Primary Taxonomy164X00000X
Provider Legal NameRAEVYN STALLWORTH
Location Address1100 N D STSan Bernardino, CA 92410-3524
Mailing Address1100 N D StSan Bernardino, CA 92410-3524 · (909) 381-3774
Phone(909) 381-3774
Sole ProprietorNo
Enumeration DateAugust 14, 2024
NPPES CertifiedAugust 14, 2024
✔ NPI 1891527370 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 · 737988
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.
1100 N D ST, San Bernardino, CA 92410
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Other Providers at the Same Location NPPES 20

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

CHRISTOPHER DODD
Counselor (Addiction (Substance Use Disorder))
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 884-0840
JESSICA BAUTISTA DE MORA
Case Manager/Care Coordinator
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 884-0840
VETERANS ALCOHOL REHABILITATION PROGRAM
Substance Abuse Rehabilitation Facility
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 381-3774
KEITH STEPHENS
Counselor (Addiction (Substance Use Disorder))
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 884-0840
RICHARD VELIS
Counselor (Addiction (Substance Use Disorder))
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 381-3774
ADAM LAWRENCE BASTUBA
Counselor (Addiction (Substance Use Disorder))
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 381-3774
FREDDY SANCHEZ NAVAR CATC NO. 228278 I
Counselor (Addiction (Substance Use Disorder))
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 884-0840
MS. JENNIFER MARIE MENDOZA
Counselor (Addiction (Substance Use Disorder))
1100 N D ST
SAN BERNARDINO, CA 92410
San Bernardino County (909) 884-0840

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 Raevyn Stallworth's NPI number?

The NPI number for Raevyn Stallworth is 1891527370. It was assigned to this individual provider in the NPPES registry on August 14, 2024.

Where is Raevyn Stallworth located?

Raevyn Stallworth practices at 1100 N D St, San Bernardino, CA 92410. The listed phone number is (909) 381-3774.

What is Raevyn Stallworth's specialty?

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

When was this NPI record last updated?

The NPPES record for Raevyn Stallworth was last updated on August 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.