Active NPI
Renee Wilterding
- Physician Assistant
- Highland, CA
National Provider Identifier
1760669683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 19529
- Practice address
- 7772 Gold Buckle CT
Highland, CA 92346-5858 - Phone
- (909) 425-1932
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 19529 | CA | Primary |
| Surgical Physician Assistant | 363AS0400X | PA 19529 | CA |
Addresses
Primary practice location
7772 Gold Buckle CT
Highland, CA 92346-5858
Mailing address
7772 Gold Buckle CT
Highland, CA 92346-5858
Phone (909) 425-1932
Other names 1
- Renee Armistead
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 |
|---|---|---|---|
| PA 19529 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1760669683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7772 GOLD BUCKLE CT",
"city": "HIGHLAND",
"state": "CA",
"postal_code": "923465858",
"telephone_number": "909-425-1932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7772 GOLD BUCKLE CT",
"city": "HIGHLAND",
"state": "CA",
"postal_code": "923465858",
"telephone_number": "909-425-1932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILTERDING",
"first_name": "RENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 19529",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "PA 19529",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RENEE",
"last_name": "ARMISTEAD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Highland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.