Individual provider · Type 1 NPI

Jakob Vander Wal

Licensed Vocational Nurse · Santa Monica, CA

NPI number 1205744224 Active

Practice location

907 Pico Blvd
Santa Monica, CA 90405-1326

Call (310) 314-6200 Map

Mailing address

909 Pico Blvd
Santa Monica, CA 90405-1326

Specialties and licenses

Taxonomy	Code	License
Licensed Vocational Nurse Primary	164X00000X	VN761120 (CA)

Licensed Vocational Nurse: An individual 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 re…

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About NPI 1205744224

Jakob Vander Wal's National Provider Identifier is 1205744224, issued on Aug 31, 2026. The primary taxonomy on file is Licensed Vocational Nurse (164X00000X), and the practice location is in Santa Monica, CA. The record was last updated on Aug 31, 2026.