Individual provider Active NPI

Marika Wijono, R.PH

  • Pharmacist
  • Mountain View, CA
National Provider Identifier
1720388804
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
56657 Issued in CA
Practice address
2580 California St
Mountain View, CA 94040-1302
Phone
(650) 949-2840
Fax
(650) 949-0736
NPI assigned
Oct 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 56657 CA Primary

Addresses

Primary practice location

2580 California St
Mountain View, CA 94040-1302

Mailing address

2580 California St
Mountain View, CA 94040-1302
Phone (650) 949-2840

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 Pharmacist

State licenses

LicenseStateTypeSpecialty
56657CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients

Organizations & group practices 1

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": "1287878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1720388804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 CALIFORNIA ST",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940401302",
            "telephone_number": "650-949-2840",
            "fax_number": "650-949-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 CALIFORNIA ST",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940401302",
            "telephone_number": "650-949-2840",
            "fax_number": "650-949-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJONO",
        "first_name": "MARIKA",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-24",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "56657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.