Nicole Rachel Vaisman

Primary specialty

PharmacistTaxonomy code 183500000X

License

78429 Issued in CA

Practice address

602 N El Camino Real
San Clemente, CA 92672-4720

Phone

(949) 369-5281

NPI assigned

Dec 30, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Garfield Beach CVS LLC

  • Pharmacy
  • San Clemente, CA
  • NPI 1902841802
  NPD (past)
• Garfield Beach CVS, L.L.C.

  • Pharmacy
  • Jurupa Valley, CA
  • NPI 1780573113
  NPD (past)

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1245879865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ALTON PKWY APT 229",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062184",
            "telephone_number": "760-613-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N EL CAMINO REAL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724720",
            "telephone_number": "949-369-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAISMAN",
        "first_name": "NICOLE",
        "middle_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "78429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFIED REGISTERED PHARMACIST",
            "identifier": "78429",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Michelle Tye
• Tyler Davis Dental Corporation
• Tyson Synergy1 Solutions, Inc.
• US Express Transport, Inc.
• V.Mai DDS Inc
• Alfred Joseph Valenzuela, PHYSICAL THERAPY
• Theodore Richard Van Dam, M.D.
• William L Van Der Reis
• Jessica Marie Van Fleet
• Margaret Anne Vanblerk, MD

• Pharmacist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.