Active NPI
Cedar Wilkening, ATC, PAC
- Medical Physician Assistant
- Ventura, CA
National Provider Identifier
1194496067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 62543
- Practice address
- 2945 Loma Vista Rd
Ventura, CA 93003-2915 - Phone
- (805) 667-8003
- NPI assigned
- Sep 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Medical Physician Assistant | 363AM0700X | 62543 | CA | Primary |
Addresses
Primary practice location
2945 Loma Vista Rd
Ventura, CA 93003-2915
Mailing address
2945 Loma Vista Rd
Ventura, CA 93003-2915
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 |
|---|---|---|---|
| 62543 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1194496067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2945 LOMA VISTA RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930032915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2945 LOMA VISTA RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930032915",
"telephone_number": "805-667-8003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKENING",
"first_name": "CEDAR",
"credential": "ATC, PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-21",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "62543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.