Individual provider Active NPI

Jennifer Wylde

  • Occupational Therapist
  • Aliso Viejo, CA
National Provider Identifier
1083072417
Registry record updated Jan 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7918 Issued in CA
Practice address
27071 Aliso Creek Rd
Aliso Viejo, CA 92656-5327
Phone
(888) 468-4372
NPI assigned
Jan 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 7918 CA Primary

Addresses

Primary practice location

27071 Aliso Creek Rd
Aliso Viejo, CA 92656-5327

Mailing address

27071 Aliso Creek Rd
Aliso Viejo, CA 92656-5327
Phone (888) 468-4372

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
7918CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1454112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454112000000",
    "number": "1083072417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27071 ALISO CREEK RD",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565327",
            "telephone_number": "888-468-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27071 ALISO CREEK RD",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565327",
            "telephone_number": "888-468-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLDE",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-30",
        "last_updated": "2016-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "7918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2016; 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.