Caitlyn M Wild

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

26297 Issued in CA

Practice address

7090 Miratech Dr, San Diego,
San Diego, CA 92121-9212

Phone

(858) 304-6440

NPI assigned

Mar 22, 2021

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14973/brand/8/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cortica Healthcare Inc

  • Health Service Clinic/Center
  • San Diego, CA
  • NPI 1801288535
  NPD (past)

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1457937393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 W 138TH PL",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506435",
            "telephone_number": "310-418-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7090 MIRATECH DR, SAN DIEGO,",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921219212",
            "telephone_number": "858-304-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "CAITLYN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "26297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Anne Wilcox, DPM
• Sarah F Wilcox
• Wenonah Wilcox, L.AC.
• Michelle Almanza Wild Crea, LCSW
• Adam Clay Wild
• Helena Wild
• Christopher Paul Wilde, D.M.D.
• Joshua Zachary Wilde, D.O.
• Kanoni Wilder
• Michael L. Wilder, MD

• Pediatric Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.