Individual provider Active NPI

Vicki Debbra Tea, PHARMD

  • Pharmacy
  • Los Angeles, CA
National Provider Identifier
1629746565
Registry record updated Sep 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RPH84870 Issued in CA
Practice address
1625 W Sunset Blvd
Los Angeles, CA 90026-4226
Phone
(213) 482-9286
NPI assigned
Sep 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RPH84870 CA Primary

Addresses

Primary practice location

1625 W Sunset Blvd
Los Angeles, CA 90026-4226

Mailing address

1000 N Olive Ave
Alhambra, CA 91801-1347
Phone (626) 688-8854

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH84870CAMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Pharmacy PastSince Sep 12, 2021 Accepting new patients
Walgreen Co Pharmacy PastSince Sep 12, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630713600000",
    "number": "1629746565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OLIVE AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011347",
            "telephone_number": "626-688-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264226",
            "telephone_number": "213-482-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEA",
        "first_name": "VICKI",
        "middle_name": "DEBBRA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-04",
        "last_updated": "2021-09-04",
        "certification_date": "2021-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "RPH84870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2021; 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.