KATIE VICKLUN
NPI 1962185405
Nurse Practitioner - Family in Long Beach, CA

Q: What is Katie Vicklun's NPI number?

The NPI number for Katie Vicklun is 1962185405. It was assigned to this individual provider in the NPPES registry on August 10, 2023.

Q: What is Katie Vicklun's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Katie Vicklun was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 10, 2023PECOS Enrolled

200 OCEANGATE STE 100, LONG BEACH, CA 90802(562) 499-6191 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 15, 2025, Aug 10, 2023 (2 updates tracked since 2023).

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About Katie Vicklun NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATIE VICKLUN (NPI 1962185405) is an individual family provider in Long Beach, California, licensed in California (95026753) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962185405

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKATIE VICKLUN

Location Address200 OCEANGATE STE 100Long Beach, CA 90802-4317

Mailing Address5038 Chaparral WaySan Diego, CA 92115-2238 · (619) 602-7773

Phone(562) 499-6191

Sole ProprietorYes

Enumeration DateAugust 10, 2023

Last NPPES UpdateSeptember 15, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 15, 2025

✔ NPI 1962185405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95026753

200 OCEANGATE STE 100, Long Beach, CA 90802

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katie Vicklun is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90802 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOLINA MEDICAL GROUP OF NEW MEXICO, PC

Family Medicine