Individual provider Active NPI

Cynthia Valdez Wilson

  • Licensed Vocational Nurse
  • El Cajon, CA
National Provider Identifier
1407355613
Registry record updated Feb 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
687392 Issued in CA
Practice address
654 S Anza St
El Cajon, CA 92020-6602
Phone
(161) 944-0500
NPI assigned
Feb 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 687392 CA Primary

Addresses

Primary practice location

654 S Anza St
El Cajon, CA 92020-6602

Mailing address

404 S Anza St
El Cajon, CA 92020-5516
Phone (619) 631-9050

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

State licenses

LicenseStateTypeSpecialty
687392CAMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517616000000",
    "number": "1407355613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S ANZA ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920205516",
            "telephone_number": "619-631-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 S ANZA ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920206602",
            "telephone_number": "161-944-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CYNTHIA",
        "middle_name": "VALDEZ",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-03",
        "last_updated": "2018-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "687392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2018; 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.