Individual provider Active NPI

Jennifer Grace Wharram, PA

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1063168094
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61018 Issued in CA
Practice address
3965 Fifth Ave Ste 230
San Diego, CA 92103-3107
Phone
(619) 872-0953
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61018 CA Primary

Addresses

Primary practice location

3965 Fifth Ave Ste 230
San Diego, CA 92103-3107

Mailing address

3965 5TH Ave Ste 230
San Diego, CA 92103-3107
Phone (619) 872-0953

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
I20220825004013 CA Practitioner - Physician Assistant 5890179790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oncology Institute Ca, a Professional CorporationGroup PAC ID 5698872398, 114 clinicians

Practice addresses (Care Compare)

2067 W Vista Way
Suite 295
Vista, CA 92083-6002
Phone (526) 735-3226

450 4TH Ave
Suite 311
Chula Vista, CA 91910-4429
Phone (526) 735-3226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61018CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Oncology Ca, a Professional Corporation CurrentSince Oct 25, 2024 Accepting new patients
The Oncology Institute Ca, a Professional Corporation CurrentSince Oct 25, 2024 Accepting new patients
Svmhs Clinics CurrentSince Sep 1, 2022 Accepting new patients
Lancelot O Alexander MD a Medical Corporation Past Accepting new patients

Locations

18000 Studebaker Rd
Ste 800
Cerritos, CA 90703

900 S Main St
Ste 204
Corona, CA 92882
Phone (951) 372-2400

11100 Warner Ave
Ste 214
Fountain Vly, CA 92708
Phone (714) 594-7820

6121 N Thesta St
Ste 204
Fresno, CA 93710
Phone (559) 438-7390

3300 E South St
Ste 304
Lakewood, CA 90805
Phone (562) 232-0550

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

505 E Romie Ln
Ste A
Salinas, CA 93901
Phone (831) 755-1701

1033 Los Palos Dr
Salinas, CA 93901
Phone (831) 424-2866

3965 5th Ave
Ste 230
San Diego, CA 92103
Phone (619) 872-0953

399 E Highland Ave
Ste 501
Sn Bernrdno, CA 92404
Phone (909) 982-4252

425 Haaland Dr
Ste 103
Thousand Oaks, CA 91361
Phone (805) 345-2020

2067 W Vista Way
Ste 295
Vista, CA 92083
Phone (526) 735-3226

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jennifer.wharram@theoncologyinstitute.ikm.direct-ci.com

Organizations & group practices 4

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": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1063168094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 5TH AVE STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033107",
            "telephone_number": "619-872-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 FIFTH AVE STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033107",
            "telephone_number": "619-872-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHARRAM",
        "first_name": "JENNIFER",
        "middle_name": "GRACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.