Carrie Lee Wickware, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

RNH321148 Issued in CA

Practice address

750 S Bascom Ave
Diabetes Ed
San Jose, CA 95128-2603

Phone

(408) 885-5000

NPI assigned

Jun 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992908008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 QUEENSBURY AVE",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245843",
            "telephone_number": "650-903-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S BASCOM AVE",
            "address_2": "DIABETES ED",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282603",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKWARE",
        "first_name": "CARRIE",
        "middle_name": "LEE",
        "credential": "CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "RNH321148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whole Health Medical Center Inc.
• Whole Kids Therapy Incorporated
• Bianca Neema Wibisono, PA-C
• Zoila Wichmann, LMFT
• Katherine Wickham
• Dennis Jordan Widman, DDS
• Bridget Mary Wieckowski, PSYD
• Tatum Catherine Wieder
• Caleb Hart Wiegman
• Kenneth Wiener, O.D.

• Diabetes Educator Registered Nurse in San Jose, CA
• Providers in San Jose, CA by specialty
• Diabetes Educator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.