Active NPI
Jennifer Wang
- Pharmacist
- San Diego, CA
National Provider Identifier
1003455262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 69143
- Practice address
- 12037 Mil Pitrero Rd
San Diego, CA 92128-5281 - Phone
- (858) 733-1181
- NPI assigned
- Jan 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 69143 | CA | Primary |
Addresses
Primary practice location
12037 Mil Pitrero Rd
San Diego, CA 92128-5281
Mailing address
420 34TH St
Bakersfield, CA 93301-2237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69143 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578096000000",
"number": "1003455262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 34TH ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933012237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12037 MIL PITRERO RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921285281",
"telephone_number": "858-733-1181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-04",
"last_updated": "2020-01-04",
"certification_date": "2020-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "69143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.