Active NPI
Wilsa M.S. Charles Malveaux, M.D.
- Psychiatry Physician
- Northridge, CA
National Provider Identifier
1346500360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A128767
- Practice address
- 19849 Nordhoff St
Northridge, CA 91324-3331 - Phone
- (885) 223-7926
- NPI assigned
- May 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | A128767 | CA | |
| Sports Medicine (Psychiatry & Neurology) Physician | 2084S0010X | A128767 | CA | |
| Psychiatry Physician | 2084P0800X | A128767 | CA | Primary |
Addresses
Primary practice location
19849 Nordhoff St
Northridge, CA 91324-3331
Mailing address
19849 Nordhoff St
Northridge, CA 91324-3331
Phone (885) 223-7926
Other names 1
- Wilsa M.S. Charles
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A128767 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704585600000",
"number": "1346500360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19849 NORDHOFF ST",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913243331",
"telephone_number": "885-223-7926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19849 NORDHOFF ST",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913243331",
"telephone_number": "885-223-7926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES MALVEAUX",
"first_name": "WILSA",
"middle_name": "M.S.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-23",
"last_updated": "2024-01-07",
"certification_date": "2024-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A128767",
"primary": false
},
{
"code": "2084S0010X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Sports Medicine",
"state": "CA",
"license": "A128767",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A128767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "WILSA",
"last_name": "CHARLES",
"middle_name": "M.S.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
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- Prathima Smruthi Charugundla, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.