Individual provider Active NPI

Glenda Faith Wellington, RN

  • Registered Nurse
  • Moreno Valley, CA
National Provider Identifier
1972271302
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
W417067 Issued in CA
Practice address
25400 Alessandro Blvd Ste 102
Moreno Valley, CA 92553-4319
Phone
(951) 522-4918
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 W417067 CA Primary

Addresses

Primary practice location

25400 Alessandro Blvd Ste 102
Moreno Valley, CA 92553-4319

Mailing address

27882 De la Valle Dr
Moreno Valley, CA 92555-5917
Phone (951) 522-4918

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
W417067CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Shortstayrentals LLC CurrentSince Jul 10, 2022 Accepting new patients

Locations

25400 Alessandro Blvd
Ste 102
Moreno Valley, CA 92553
Phone (951) 247-4292

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1972271302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27882 DE LA VALLE DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925555917",
            "telephone_number": "951-522-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25400 ALESSANDRO BLVD STE 102",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534319",
            "telephone_number": "951-522-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLINGTON",
        "first_name": "GLENDA",
        "middle_name": "FAITH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "W417067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.