Active NPI
Gerri Wallace
- Rehabilitation Practitioner
- Ontario, CA
National Provider Identifier
1801339130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1448 E Deerfield St
Ontario, CA 91761-7134 - Phone
- (310) 948-0013
- NPI assigned
- Nov 17, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1448 E Deerfield St
Ontario, CA 91761-7134
Mailing address
1448 E Deerfield St
Ontario, CA 91761-7134
Phone (310) 948-0013
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486339200000",
"number": "1801339130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1448 E DEERFIELD ST",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917617134",
"telephone_number": "310-948-0013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1448 E DEERFIELD ST",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917617134",
"telephone_number": "310-948-0013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "GERRI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-17",
"last_updated": "2017-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.