Diana Marie Thelen, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

53646 Issued in CA

Practice address

4440 Alamo St
CVS Pharmacy #9790
Simi Valley, CA 93063-1733

Phone

(805) 522-3120

Fax

(805) 522-3120

NPI assigned

Jun 15, 2011

Last updated

Jun 22, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1033404389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 ALAMO STREET",
            "address_2": "CVS PHARMACY #9790",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "93063",
            "telephone_number": "805-522-3120",
            "fax_number": "805-522-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 ALAMO ST",
            "address_2": "CVS PHARMACY #9790",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930631733",
            "telephone_number": "805-522-3120",
            "fax_number": "805-522-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELEN",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "53646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.