Active NPI
Victoria Huckestein, DO
- Child Abuse Pediatrics Physician
- San Diego, CA
National Provider Identifier
1255899340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Abuse Pediatrics Physician
- Practice address
- 3020 Childrens Way
San Diego, CA 92123-4223 - Phone
- (858) 966-4011
- NPI assigned
- Mar 7, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0102206218 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 0102206218 | VA | |
| Child Abuse Pediatrics Physician | 2080C0008X | CA | Primary |
Addresses
Primary practice location
3020 Childrens Way
San Diego, CA 92123-4223
Mailing address
9255 Bent Arrow CV
Apopka, FL 32703-1965
Other practice location 1
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (866) 645-4584
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102206218 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1255899340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9255 BENT ARROW CV",
"city": "APOPKA",
"state": "FL",
"postal_code": "327031965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-966-4011"
}
],
"practiceLocations": [
{
"address_1": "620 John Paul Jones Cir",
"address_purpose": "LOCATION",
"city": "Portsmouth",
"state": "VA",
"postal_code": "237082111",
"country_code": "US",
"telephone_number": "866-645-4584",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUCKESTEIN",
"first_name": "VICTORIA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-07",
"last_updated": "2024-07-08",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0102206218",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0102206218",
"primary": false
},
{
"code": "2080C0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Child Abuse Pediatrics",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.