Active NPI
Annette Willey
- Private Vehicle
- Long Beach, CA
National Provider Identifier
1730814674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- 7KRT590
- Practice address
- 6312 Marina Pacifica Dr S
Key 16
Long Beach, CA 90803 - Phone
- (562) 685-2481
- NPI assigned
- Jul 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | TRUJOY | CA | |
| Private Vehicle | 347C00000X | 7KRT590 | CA | Primary |
Addresses
Primary practice location
6312 Marina Pacifica Dr S
Key 16
Long Beach, CA 90803
Mailing address
6312 Marina Pacifica Dr S
Key 16
Long Beach, CA 90803
Phone (562) 685-2481
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7KRT590 | CA | MD | Private Vehicle |
| TRUJOY | CA | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1730814674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6312 MARINA PACIFICA DR S",
"address_2": "KEY 16",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90803",
"telephone_number": "562-685-2481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6312 MARINA PACIFICA DR S",
"address_2": "KEY 16",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90803",
"telephone_number": "562-685-2481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLEY",
"first_name": "ANNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-22",
"last_updated": "2022-07-22",
"certification_date": "2022-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "CA",
"license": "TRUJOY",
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "CA",
"license": "7KRT590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.