Individual provider Active NPI

Lauri Wynn, WYNN DRIVING SERVICE

  • Driver
  • Menifee, CA
National Provider Identifier
1730766130
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
A3123559 Issued in CA
Practice address
28609 N Port LN
Menifee, CA 92584-8169
Phone
(909) 921-3193
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X A3123559 CA Primary

Addresses

Primary practice location

28609 N Port LN
Menifee, CA 92584-8169

Mailing address

28609 N Port LN
Menifee, CA 92584-8169
Phone (909) 921-3193

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

LicenseStateTypeSpecialty
A3123559CAMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1730766130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28609 N PORT LN",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848169",
            "telephone_number": "909-921-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28609 N PORT LN",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848169",
            "telephone_number": "909-921-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "LAURI",
        "credential": "WYNN DRIVING SERVICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "A3123559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.