Faye Waller, L.V.N

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

291954 Issued in CA

Practice address

300 E 15TH St
Merced, CA 95341-6217

Phone

(209) 381-6879

NPI assigned

Oct 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Faye Olzack Former name

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": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1245955210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953440087",
            "telephone_number": "209-381-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 15TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416217",
            "telephone_number": "209-381-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "FAYE",
        "name_prefix": "Ms.",
        "credential": "L.V.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "291954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAYE",
            "last_name": "OLZACK",
            "credential": "L.V.N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sophia Wallace-Boyd
• Jamie Wallace
• Kindle Wallace
• Richard Franklin Wallace, MFT
• Sarrah Wallace
• Walmart Inc.
• Walmart Stores, Inc.
• Robert T Walsh
• Nicole Marie Walter
• Carolyn Diane Walters, MFT

• Licensed Vocational Nurse in Merced, CA
• Providers in Merced, 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 Oct 11, 2022; 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.