Trisha Waldecker

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN271513 Issued in CA

Practice address

4750 Palm Ave
Riverside, CA 92501-4012

Phone

(951) 686-0021

NPI assigned

Dec 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1184139461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 ORANGE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925012538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 PALM AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014012",
            "telephone_number": "951-686-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2452 Wilshire St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925012144",
            "country_code": "US",
            "telephone_number": "951-686-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDECKER",
        "first_name": "TRISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN271513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Katali Wagner, PA-C
• Kenyada Marie Wagoner, LCSW
• Hakan Erik Wahlstrom, M.D.
• Alain A Waked, M.D.
• Lauren Angelique Wakoski
• Walden Environment
• Patricia Dianne Waldon, RN
• Amy R Waldron, MA
• Walgreen Co
• Walgreen Co

• Licensed Vocational Nurse in Riverside, CA
• Providers in Riverside, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.