Active NPI
Raymond Richard Wasson, R.PH.
- Pharmacist
- Kings Beach, CA
National Provider Identifier
1609177872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 25826
- Practice address
- 7815 North Lake Blvd.
Kings Beach, CA 96143 - Phone
- (530) 546-0186
- Fax
- (530) 546-0277
- NPI assigned
- Nov 4, 2010
- Last updated
- Nov 4, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 25826 | CA | Primary |
Addresses
Primary practice location
7815 North Lake Blvd.
Kings Beach, CA 96143
Mailing address
PO Box 1056
Kings Beach, CA 96143-1056
Phone (530) 546-0186
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 25826 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1609177872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1056",
"city": "KINGS BEACH",
"state": "CA",
"postal_code": "961431056",
"telephone_number": "530-546-0186",
"fax_number": "530-546-0277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7815 NORTH LAKE BLVD.",
"city": "KINGS BEACH",
"state": "CA",
"postal_code": "96143",
"telephone_number": "530-546-0186",
"fax_number": "530-546-0277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSON",
"first_name": "RAYMOND",
"middle_name": "RICHARD",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-04",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 25826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kings Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.