Individual provider Active NPI

Clyette S Smith-Wilcher, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1043966658
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020525 Issued in CA
Practice address
1300 North Vermont Hollywood
Los Angeles, CA 90027-9002
Phone
(323) 522-6857
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 682 CA
Family Nurse Practitioner 363LF0000X 95020525 CA Primary

Addresses

Primary practice location

1300 North Vermont Hollywood
Los Angeles, CA 90027-9002

Mailing address

2309 W Avenue O
Palmdale, CA 93551-3348
Phone (661) 317-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715002179 CA Practitioner - Nurse Practitioner 3971984352 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Izuchukwu Okpara MD IncGroup PAC ID 1052698966, 45 clinicians
Tarzana Treatment Centers IncGroup PAC ID 5991897845, 55 clinicians

Practice addresses (Care Compare)

28212 Kelly Johnson Pkwy
Suite 200
Valencia, CA 91355-5090
Phone (213) 228-3538

907 W Lancaster Blvd
Lancaster, CA 93534-2305
Phone (800) 996-1051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95020525CAMDFamily Nurse Practitioner
682CAMDStudent in an Organized Health Care Education/Training Program

Practice roles (8 of 9)

OrganizationSpecialtyStatusNew patients
Community Care Mobile Doctors Single Specialty CurrentSince Feb 3, 2024 Accepting new patients
Jem Hospice Corporation CurrentSince Feb 3, 2024 Accepting new patients
Makini Clinic PLLC Single Specialty CurrentSince Feb 6, 2024 Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Mar 27, 2024 Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Mar 27, 2024 Accepting new patients
Always Better Care Home Health Services LLC CurrentSince Feb 6, 2024 Accepting new patients
Tarzana Treatment Centers, Inc. Single Specialty Current Accepting new patients
Tarzana Treatment Centers, Inc. Past Accepting new patients

Locations

9604 Artesia Blvd
Ste 105
Bellflower, CA 90706
Phone (562) 804-3200

907 W Lancaster Blvd
Lancaster, CA 93534
Phone (661) 723-4829

275 W Hospitality Ln
Ste 314
Sn Bernrdno, CA 92408
Phone (956) 245-2275

18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cwilcher700296@direct.ochin.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1043966658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 W AVENUE O",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513348",
            "telephone_number": "661-317-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 NORTH VERMONT HOLLYWOOD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900279002",
            "telephone_number": "323-522-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-WILCHER",
        "first_name": "CLYETTE",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "682",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.