Individual provider Active NPI

Deborah L Vitale, RPH

  • Pharmacist
  • Mission Viejo, CA
National Provider Identifier
1790070092
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
39603 Issued in CA
Practice address
24500 Alicia Pkwy
T0300
Mission Viejo, CA 92691-4508
Phone
(949) 583-1278
Fax
(949) 583-1278
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 39603 CA Primary
Pharmacist 183500000X 19661 MA

Addresses

Primary practice location

24500 Alicia Pkwy
T0300
Mission Viejo, CA 92691-4508

Mailing address

24500 Alicia Pkwy
T0300
Mission Viejo, CA 92691-4508
Phone (949) 583-1278

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
39603CAMDPharmacist
19661MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1790070092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24500 ALICIA PKWY",
            "address_2": "T0300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914508",
            "telephone_number": "949-583-1278",
            "fax_number": "949-583-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24500 ALICIA PKWY",
            "address_2": "T0300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914508",
            "telephone_number": "949-583-1278",
            "fax_number": "949-583-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "39603",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "19661",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.