Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

AMMONE RADDAVONG- JAIME
NPI 1972411239
Licensed Vocational Nurse in Santa Rosa, CA

Q: What is Ammone Raddavong- Jaime's NPI number?

The NPI number for Ammone Raddavong- Jaime is 1972411239. It was assigned to this individual provider in the NPPES registry on August 28, 2026.

Q: What is Ammone Raddavong- Jaime's specialty?

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

Active since August 28, 2026

3639 MONTGOMERY DR, SANTA ROSA, CA 95405(707) 395-5116 Get Directions Write a Review

NPPES record added: August 28, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

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About Ammone Raddavong- Jaime NPPES

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

AMMONE RADDAVONG- JAIME (NPI 1972411239) is an individual licensed vocational nurse in Santa Rosa, California, licensed in California (VN183543) and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1972411239

Entity TypeIndividualFemale

Primary Taxonomy164X00000X

Provider Legal NameAMMONE RADDAVONG- JAIME

Location Address3639 MONTGOMERY DRSanta Rosa, CA 95405-5212

Mailing Address3639 Montgomery DrSanta Rosa, CA 95405-5212 · (707) 395-5116

Phone(707) 395-5116

Sole ProprietorYes

Enumeration DateAugust 28, 2026

NPPES CertifiedAugust 28, 2026

✔ NPI 1972411239 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 · VN183543

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.

3639 MONTGOMERY DR, Santa Rosa, CA 95405

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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 Ammone Raddavong- Jaime's NPI number?

The NPI number for Ammone Raddavong- Jaime is 1972411239. It was assigned to this individual provider in the NPPES registry on August 28, 2026.

Where is Ammone Raddavong- Jaime located?

Ammone Raddavong- Jaime practices at 3639 Montgomery Dr, Santa Rosa, CA 95405. The listed phone number is (707) 395-5116.

What is Ammone Raddavong- Jaime'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 Ammone Raddavong- Jaime was last updated on August 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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.