Individual provider Active NPI

Ullrike Johanna Childs

  • Registered Nurse
  • Santa Rosa, CA
National Provider Identifier
1932546744
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
792695 Issued in CA
Practice address
2350 Professional Dr
Santa Rosa, CA 95403-3018
Phone
(707) 565-4963
NPI assigned
Jun 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 792695 CA Primary

Addresses

Primary practice location

2350 Professional Dr
Santa Rosa, CA 95403-3018

Mailing address

PO Box 698
Calistoga, CA 94515-0698

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

LicenseStateTypeSpecialty
792695CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1932546744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "CALISTOGA",
            "state": "CA",
            "postal_code": "945150698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 PROFESSIONAL DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033018",
            "telephone_number": "707-565-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "ULLRIKE",
        "middle_name": "JOHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "792695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.