Active NPI
Sheree R Waldon
- Driver
- Perris, CA
National Provider Identifier
1457083628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- B4686163
- Practice address
- 2058 Medical Center Dr
Perris, CA 92571-2644 - Phone
- (951) 238-9472
- Fax
- (909) 940-0966
- NPI assigned
- Jun 27, 2022
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | B4686163 | CA | Primary |
Addresses
Primary practice location
2058 Medical Center Dr
Perris, CA 92571-2644
Mailing address
2058 Medical Center Dr
Perris, CA 92571-2644
Phone (951) 238-9472
Other names 1
- Sheree R Waldon
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 |
|---|---|---|---|
| B4686163 | CA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1457083628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2058 MEDICAL CENTER DR",
"city": "PERRIS",
"state": "CA",
"postal_code": "925712644",
"telephone_number": "951-238-9472",
"fax_number": "909-940-0966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2058 MEDICAL CENTER DR",
"city": "PERRIS",
"state": "CA",
"postal_code": "925712644",
"telephone_number": "951-238-9472",
"fax_number": "909-940-0966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDON",
"first_name": "SHEREE",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-27",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "CA",
"license": "B4686163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHEREE",
"last_name": "WALDON",
"middle_name": "R",
"credential": "TRANSPORTATION",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.