Active NPI
Vickie Marie Walden, RDA
- Dental Assistant
- Happy Camp, CA
National Provider Identifier
1619033602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- RDA59215
- Practice address
- 64236 Second Avenue
Happy Camp, CA 96039-1916 - Phone
- (530) 493-1600
- Fax
- (530) 493-5364
- NPI assigned
- Dec 28, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | RDA59215 | CA | Primary |
Addresses
Primary practice location
64236 Second Avenue
Happy Camp, CA 96039-1916
Mailing address
PO Box 1016
Happy Camp, CA 96039-1016
Phone (530) 493-1600
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RDA59215 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619033602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1016",
"city": "HAPPY CAMP",
"state": "CA",
"postal_code": "960391016",
"telephone_number": "530-493-1600",
"fax_number": "530-493-5364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64236 SECOND AVENUE",
"city": "HAPPY CAMP",
"state": "CA",
"postal_code": "960391916",
"telephone_number": "530-493-1600",
"fax_number": "530-493-5364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDEN",
"first_name": "VICKIE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "RDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "RDA59215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Happy Camp, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.