Active NPI
Carrie Gorham
- Technician
- Temecula, CA
National Provider Identifier
1932938628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- License
- L8424
- Practice address
- 26439 Ynez Rd Ste B
Temecula, CA 92591-5621 - Phone
- (909) 816-3645
- NPI assigned
- Jul 30, 2024
- 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 |
|---|---|---|---|---|
| Technician | 374700000X | L8424 | CA | Primary |
Addresses
Primary practice location
26439 Ynez Rd Ste B
Temecula, CA 92591-5621
Mailing address
27625 Stanford Dr
Temecula, CA 92591-2849
Phone (909) 816-3645
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 |
|---|---|---|---|
| L8424 | CA | MD | Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1932938628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27625 STANFORD DR",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925912849",
"telephone_number": "909-816-3645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26439 YNEZ RD STE B",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925915621",
"telephone_number": "909-816-3645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORHAM",
"first_name": "CARRIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-30",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "CA",
"license": "L8424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.