Julie Emma Swerdlow Wailes

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95009906 Issued in CA

Practice address

1906 Commercenter E Ste 100
San Bernardino, CA 92408-3423

Phone

(909) 891-1913

Fax

(909) 884-0810

NPI assigned

Aug 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mission Pediatrics, Inc.

  • Pediatrics Physician
  • Perris, CA
  • NPI 1679651921
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1740769157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 ESTHER WAY",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 COMMERCENTER E STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083423",
            "telephone_number": "909-891-1913",
            "fax_number": "909-884-0810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6926 Brockton Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925063804",
            "country_code": "US",
            "telephone_number": "951-779-1670",
            "fax_number": "951-779-1679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAILES",
        "first_name": "JULIE",
        "middle_name": "EMMA SWERDLOW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95009906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W&W Community Development Inc.
• Andrea Wade, FNP
• Adriana Wagner, RD
• Robert Jacob Wagner III, DDS
• Jacy Wahba
• Wal-Mart Stores, Inc.
• Walden Environment
• Walgreen Co
• Walgreen Co
• Walgreen Co

• Nurse Practitioner in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.