Individual provider Active NPI

Desiree Chipman, PHARM.D

  • Pharmacist
  • Stockton, CA
National Provider Identifier
1114200367
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
58874 Issued in CA
Practice address
678 N Wilson Way
Stockton, CA 95205-4272
Phone
(209) 467-7861
Fax
(209) 467-0539
NPI assigned
Sep 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 58874 CA Primary

Addresses

Primary practice location

678 N Wilson Way
Stockton, CA 95205-4272

Mailing address

678 N Wilson Way
Stockton, CA 95205-4272
Phone (209) 467-7861

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

State licenses

LicenseStateTypeSpecialty
58874CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1114200367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 N WILSON WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054272",
            "telephone_number": "209-467-7861",
            "fax_number": "209-467-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 N WILSON WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054272",
            "telephone_number": "209-467-7861",
            "fax_number": "209-467-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPMAN",
        "first_name": "DESIREE",
        "name_prefix": "Mrs.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "58874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.