Active NPI
Kyle Albert Wilkerson, PHARM D
- Pharmacist
- Vacaville, CA
National Provider Identifier
1285424556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 90935
- Practice address
- 191 Depot St
Vacaville, CA 95688-3900 - Phone
- (707) 446-2401
- NPI assigned
- May 9, 2025
- Last updated
- May 9, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 90935 | CA | Primary |
Addresses
Primary practice location
191 Depot St
Vacaville, CA 95688-3900
Mailing address
191 Depot St
Vacaville, CA 95688-3900
Phone (707) 446-2401
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90935 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past | Accepting new patients | |
| Longs Drug Stores California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1285424556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 DEPOT ST",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956883900",
"telephone_number": "707-446-2401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 DEPOT ST",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956883900",
"telephone_number": "707-446-2401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "KYLE",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-09",
"last_updated": "2025-05-09",
"certification_date": "2025-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "90935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.