Carolyn Joyce Wadsworth, NURSE PRACTITONER

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

245433 Issued in CA

Practice address

351 S Hudson Ave
Pasadena, CA 91101-3507

Phone

(626) 795-6981

Fax

(626) 584-1540

NPI assigned

Feb 20, 2007

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 identifiers 1

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366587206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4082 DENVER AVE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928861944",
            "telephone_number": "714-524-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 S HUDSON AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013507",
            "telephone_number": "626-795-6981",
            "fax_number": "626-584-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "CAROLYN",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "245433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SS1964881",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levi Carl Wade
• Vanessa Mary Wade, LVN
• Tina Godwin Wadiwala, D.O.
• Corinne Rebecca Wadley
• Alexis Katherine Wadsworth
• Linda Mans Wagener, PH.D.
• Christy Ann Wagner, LVN
• Vickie Joan Wagner
• Whitney Wagner, LMFT
• Veronica H. Wahba, PSY.D.

• Pediatric Nurse Practitioner in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.