Active NPI
Patricia Champlin
- Pharmacist
- Fresno, CA
National Provider Identifier
1609275445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 57525
- Practice address
- 6074 N 1St St
Fresno, CA 93710-5405 - Phone
- (559) 362-3492
- NPI assigned
- Aug 18, 2014
- Sex
- Female
- 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 | 57525 | CA | Primary |
Addresses
Primary practice location
6074 N 1St St
Fresno, CA 93710-5405
Mailing address
2119 E Makenna Dr
Fresno, CA 93730-3415
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHY-42450 | Medicaid | CA |
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": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1609275445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 E MAKENNA DR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937303415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6074 N 1ST ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105405",
"telephone_number": "559-362-3492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPLIN",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "57525",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PHY-42450",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.