Active NPI
Brigitte Karin Wolverton, PA-C
- Physician Assistant
- Vernon, CA
National Provider Identifier
1154474716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA15094
- Practice address
- 3851 S Soto St
Vernon, CA 90058-1718 - Phone
- (323) 585-7162
- Fax
- (323) 585-0167
- NPI assigned
- Jan 18, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA15094 | CA | Primary |
Addresses
Primary practice location
3851 S Soto St
Vernon, CA 90058-1718
Mailing address
5620 Vista del Mar
Yorba Linda, CA 92887-3266
Phone (714) 334-4696
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15094 | CA | MD | Professional Counselor |
| PA15094 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466467200000",
"number": "1154474716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5620 VISTA DEL MAR",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928873266",
"telephone_number": "714-334-4696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3851 S SOTO ST",
"city": "VERNON",
"state": "CA",
"postal_code": "900581718",
"telephone_number": "323-585-7162",
"fax_number": "323-585-0167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLVERTON",
"first_name": "BRIGITTE",
"middle_name": "KARIN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2016-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA15094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.