Active NPI
Walanika Lum, PHARMD, RPH, RN
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Perris, CA
National Provider Identifier
1053672212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 61691
- Practice address
- 17016 Birds Eye Dr
Perris, CA 92570-7376 - Phone
- (951) 888-0443
- NPI assigned
- Jun 5, 2012
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 61691 | CA | Primary |
Addresses
Primary practice location
17016 Birds Eye Dr
Perris, CA 92570-7376
Mailing address
17016 Birds Eye Dr
Perris, CA 92570-7376
Phone (951) 888-0443
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
- Credentials
- Doctor of Pharmacy, Registered Nurse, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61691 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1053672212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17016 BIRDS EYE DR",
"city": "PERRIS",
"state": "CA",
"postal_code": "925707376",
"telephone_number": "951-888-0443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17016 BIRDS EYE DR",
"city": "PERRIS",
"state": "CA",
"postal_code": "925707376",
"telephone_number": "951-888-0443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUM",
"first_name": "WALANIKA",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-05",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "61691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.