Nicole Marie Whittaker

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

30957 Issued in CA

Practice address

Area 27, Building H200T
Oceanside, CA 92055

Phone

(760) 725-0063

NPI assigned

Aug 14, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1659103232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 LUKUP LN APT 101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266709",
            "telephone_number": "714-483-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AREA 27, BUILDING H200T",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-0063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mercy Cir.",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920555191",
            "country_code": "US",
            "telephone_number": "760-725-0063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "6727",
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "30957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Vanderveen White, BA
• Sara Whitehouse, RN, IBCLC
• Sequieta Whitfield
• Brenda Arlene Whitt
• Amanda Whittaker Davis, LEP
• Devonna Wicks
• Elizabeth Poulsen Wiegand, PH.D.
• Maren Elizabeth Wiegers, PT
• Sarah Rose Wiestling
• Rudolph Wietfeldt, PSYD

• Licensed Psychiatric Technician in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.

Verify at the official NPI Registry.