Active NPI
Corinne Jean Wolak
- School Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1124751672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Nurse Practitioner
- License
- 22582
- Practice address
- 3580 Wilshire Blvd
Los Angeles, CA 90010-2501 - Phone
- (888) 897-2547
- NPI assigned
- Jul 1, 2022
- 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 |
|---|---|---|---|---|
| School Nurse Practitioner | 363LS0200X | 22582 | CA | Primary |
Addresses
Primary practice location
3580 Wilshire Blvd
Los Angeles, CA 90010-2501
Mailing address
14002 Palawan Way Apt 210
Marina del Rey, CA 90292-6226
Phone (310) 686-6471
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22582 | CA | MD | School Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1124751672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14002 PALAWAN WAY APT 210",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926226",
"telephone_number": "310-686-6471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3580 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102501",
"telephone_number": "888-897-2547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLAK",
"first_name": "CORINNE",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-01",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LS0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, School",
"state": "CA",
"license": "22582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.