Dickey Wangmo Thukhotsong

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95015915 Issued in CA

Practice address

3230 Carlson Blvd
El Cerrito, CA 94530-3907

Phone

(510) 734-3560

NPI assigned

Nov 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• City & County of San Francisco

  • Clinical Medical Laboratory
  • San Francisco, CA
  • NPI 1982737524
  NPD

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1467055855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 HIGH SCHOOL AVE",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945201829",
            "telephone_number": "510-734-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 CARLSON BLVD",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945303907",
            "telephone_number": "510-734-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUKHOTSONG",
        "first_name": "DICKEY",
        "middle_name": "WANGMO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95080619",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95015915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Child Therapy Institute of Marin
• Third Optometric Care of California PC
• Tyler Scott Thompson, LMFT, LPCC
• Frederic Thouvenin, L.AC.
• Three Bridges Psychology & Mediation
• Gregory Michael Tilden, LMFT
• Helen Artis Tinsley-Jones, PH.D.
• Steve W Toby, LMFT
• Total Health Chiropractic
• Tom Trabin, PH.F.

• Family Nurse Practitioner in El Cerrito, CA
• Providers in El Cerrito, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.