Kathleen Wilde, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

365707 Issued in CA

Practice address

468 Bello St
Pismo Beach, CA 93449-2702

Phone

(805) 452-3225

Fax

(805) 773-6154

NPI assigned

Oct 3, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1437552403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 BELLO ST",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492702",
            "telephone_number": "805-452-3225",
            "fax_number": "805-773-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 BELLO ST",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492702",
            "telephone_number": "805-452-3225",
            "fax_number": "805-773-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "KATHLEEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "365707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E. Webb, M.D.
• Marc W. Weise, M.D.
• Shonra Anne Weiss, NP
• Wendy Eve Weiss, DO
• Lucille Amelia Whitaker, 11434
• Sarah Marie Willett, DPT
• Deirdre Betty Williams, DNP, FNP-BC
• Suzan Hillaire Williams, A.N.P.
• Cristina Ambos Wilson
• Jaclyn Woods, LMFT

• Registered Nurse in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.