Active NPI
Gillian Werolin, RN, PHN
- Registered Nurse
- San Diego, CA
National Provider Identifier
1629816491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95294341
- Practice address
- 4077 Fifth Ave
San Diego, CA 92103-2105 - Phone
- (858) 832-2478
- NPI assigned
- Jul 17, 2024
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95294341 | CA | Primary |
Addresses
Primary practice location
4077 Fifth Ave
San Diego, CA 92103-2105
Mailing address
4559 1/2 Alabama St
San Diego, CA 92116-2725
Phone (916) 805-9182
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 Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95294341 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1629816491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4559 1/2 ALABAMA ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921162725",
"telephone_number": "916-805-9182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4077 FIFTH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032105",
"telephone_number": "858-832-2478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEROLIN",
"first_name": "GILLIAN",
"credential": "RN, PHN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-17",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95294341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.