Lucille Amelia Whitaker, 11434

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

348574 Issued in CA

Practice address

575 Price St
Suite 313
Pismo Beach, CA 93449-2553

Phone

(805) 201-9135

Fax

(805) 201-9134

NPI assigned

Aug 9, 2011

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

State licenses

Practice roles

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.

• Coastal Prestige Medical Services, Inc

  • Primary Care Clinic/Center
  • Shell Beach, CA
  • NPI 1518101989
  NPD (past)

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1467731430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PRICE ST",
            "address_2": "SUITE 313",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492553",
            "telephone_number": "805-201-9135",
            "fax_number": "805-201-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PRICE ST",
            "address_2": "SUITE 313",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492553",
            "telephone_number": "805-201-9135",
            "fax_number": "805-201-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "LUCILLE",
        "middle_name": "AMELIA",
        "name_prefix": "Ms.",
        "credential": "11434",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "348574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Watt, PA-C
• Amy E. Webb, M.D.
• Marc W. Weise, M.D.
• Shonra Anne Weiss, NP
• Wendy Eve Weiss, DO
• Kathleen Wilde, RN
• Sarah Marie Willett, DPT
• Deirdre Betty Williams, DNP, FNP-BC
• Suzan Hillaire Williams, A.N.P.
• Cristina Ambos Wilson

• Family Nurse Practitioner in Pismo Beach, CA
• Providers in Pismo Beach, 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 Aug 9, 2011; 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.