Individual provider Active NPI

Tina Laray Wilton

  • Community Health Worker
  • San Carlos, CA
National Provider Identifier
1497054886
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
957 Industrial Rd
Suite B
San Carlos, CA 94070-4151
Phone
(415) 265-7514
NPI assigned
Mar 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

957 Industrial Rd
Suite B
San Carlos, CA 94070-4151

Mailing address

957 Industrial Rd Ste B
San Carlos, CA 94070-4152
Phone (415) 265-7514

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

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1497054886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 INDUSTRIAL RD STE B",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940704152",
            "telephone_number": "415-265-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 INDUSTRIAL RD",
            "address_2": "SUITE B",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940704151",
            "telephone_number": "415-265-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTON",
        "first_name": "TINA",
        "middle_name": "LARAY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.