Individual provider Active NPI

Nicole Marie Elia

  • Pharmacy Technician
  • San Diego, CA
National Provider Identifier
1053984534
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
130431 Issued in CA
Practice address
4840 Niagara Ave
San Diego, CA 92107-3115
Phone
(619) 538-3846
Fax
(619) 222-4926
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 130431 CA Primary

Addresses

Primary practice location

4840 Niagara Ave
San Diego, CA 92107-3115

Mailing address

4840 Niagara Ave
San Diego, CA 92107-3115
Phone (619) 538-3846

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

LicenseStateTypeSpecialty
130431CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1053984534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 NIAGARA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073115",
            "telephone_number": "619-538-3846",
            "fax_number": "619-222-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 NIAGARA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073115",
            "telephone_number": "619-538-3846",
            "fax_number": "619-222-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "130431",
            "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 Jul 21, 2021; 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.