Active NPI
Wanda Meyer, FNP
- Family Nurse Practitioner
- Rialto, CA
National Provider Identifier
1962776104
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jun 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 21649
- Practice address
- 1850 N Riverside Ave Ste 240
Rialto, CA 92376-8082 - Phone
- (909) 421-2700
- NPI assigned
- Mar 6, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 21649 | CA | Primary |
Addresses
Primary practice location
1850 N Riverside Ave Ste 240
Rialto, CA 92376-8082
Mailing address
900 Montclair Dr
Santa Paula, CA 93060-1610
Phone (805) 444-2137
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21649 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330992000000",
"number": "1962776104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 MONTCLAIR DR",
"city": "SANTA PAULA",
"state": "CA",
"postal_code": "930601610",
"telephone_number": "805-444-2137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 N RIVERSIDE AVE STE 240",
"city": "RIALTO",
"state": "CA",
"postal_code": "923768082",
"telephone_number": "909-421-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYER",
"first_name": "WANDA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-06",
"last_updated": "2012-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "21649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.