Active NPI
Lindella Wilson
- Student in an Organized Health Care Education/Training Program
- Lodi, CA
National Provider Identifier
1417403668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- ASW71454
- Practice address
- 12755 N Highway 88
Lodi, CA 95253 - Phone
- (209) 642-1740
- NPI assigned
- Aug 28, 2016
- Last updated
- Nov 7, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | ASW71454 | CA | Primary |
Addresses
Primary practice location
12755 N Highway 88
Lodi, CA 95253
Mailing address
12755 N Highway 88
Lodi, CA 95253
Phone (209) 642-1740
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW71454 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478476800000",
"number": "1417403668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12755 N HIGHWAY 88",
"city": "LODI",
"state": "CA",
"postal_code": "95253",
"telephone_number": "209-642-1740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12755 N HIGHWAY 88",
"city": "LODI",
"state": "CA",
"postal_code": "95253",
"telephone_number": "209-642-1740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LINDELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-28",
"last_updated": "2016-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "ASW71454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.