Individual provider Active NPI

Lisa Stephanie Wilkie, HHP

  • Massage Therapist
  • San Diego, CA
National Provider Identifier
1164723177
Registry record updated Nov 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
4047 Issued in CA
Practice address
1901 1St Ave
Ste 221
San Diego, CA 92101-2356
Phone
(858) 205-9003
NPI assigned
Nov 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 4047 CA Primary

Addresses

Primary practice location

1901 1St Ave
Ste 221
San Diego, CA 92101-2356

Mailing address

PO Box 22063
San Diego, CA 92192-2063
Phone (858) 205-9003

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
4047CAMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1289088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289088000000",
    "number": "1164723177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22063",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921922063",
            "telephone_number": "858-205-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "address_2": "STE 221",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012356",
            "telephone_number": "858-205-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIE",
        "first_name": "LISA",
        "middle_name": "STEPHANIE",
        "name_prefix": "Miss",
        "credential": "HHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-07",
        "last_updated": "2010-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "4047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2010; 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.