Active NPI
Shiela Wolford
- Specialist
- San Gabriel, CA
National Provider Identifier
1871962530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OT415
- Practice address
- 6819 N Muscatel Ave
San Gabriel, CA 91775-1225 - Phone
- (626) 614-0851
- NPI assigned
- Sep 23, 2015
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | OT415 | CA | Primary |
Addresses
Primary practice location
6819 N Muscatel Ave
San Gabriel, CA 91775-1225
Mailing address
PO Box 1785
Arcadia, CA 91077-1785
Phone (626) 614-0851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT415 | Other | CA | OT LICENSE |
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 |
|---|---|---|---|
| OT415 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442966400000",
"number": "1871962530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1785",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910771785",
"telephone_number": "626-614-0851",
"fax_number": "323-283-4365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6819 N MUSCATEL AVE",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917751225",
"telephone_number": "626-614-0851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFORD",
"first_name": "SHIELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-23",
"last_updated": "2015-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "OT415",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OT LICENSE",
"identifier": "OT415",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.