Individual provider Active NPI

Pamela Marie Wachholz, D.C.

  • Chiropractor
  • Hemet, CA
National Provider Identifier
1245342252
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC21158 Issued in CA
Practice address
1284 E. Latham Ave
Hemet, CA 92543
Phone
(951) 652-4357
Fax
(951) 658-6657
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC21158 CA Primary

Addresses

Primary practice location

1284 E. Latham Ave
Hemet, CA 92543

Mailing address

1284 E. Latham Ave
Hemet, CA 92543
Phone (951) 652-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080107000605 CA Practitioner - Chiropractic 6507946332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC21158CAMDChiropractor

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245342252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1284 E. LATHAM AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "951-652-4357",
            "fax_number": "951-658-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 E. LATHAM AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "951-652-4357",
            "fax_number": "951-658-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHHOLZ",
        "first_name": "PAMELA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC21158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.