JESSIE WACKERMAN NPI 1053085076

NPI Information

NPI: 1053085076
Provider Name: JESSIE WACKERMAN
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
4101 MOUNT CANTARA CIR
CORONA, CA
ZIP 92882
Phone: (714) 267-9817
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Jessie Wackerman is an acute care nurse practitioner in Corona, CA. Jessie Wackerman NPI is 1053085076. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4101 MOUNT CANTARA CIR
CORONA, CA
ZIP 92882-942
Phone: (714) 267-9817

The NPI 1053085076 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/3/2021 and was last updated on 8/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	95017895	CALIFORNIA	Yes
2	363LA2200X	Nurse Practitioner	Adult Health	95017895	CALIFORNIA	No
3	363LG0600X	Nurse Practitioner	Gerontology	95017895	CALIFORNIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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