Individual provider Active NPI

Genesis Callejas-Mir, NP

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1013675370
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018148 Issued in CA
Practice address
1501 Mendocino Ave
Santa Rosa, CA 95401-4332
Phone
(707) 527-4445
NPI assigned
Dec 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95018148 CA Primary

Addresses

Primary practice location

1501 Mendocino Ave
Santa Rosa, CA 95401-4332

Mailing address

1501 Mendocino Ave
Santa Rosa, CA 95401-4395
Phone (707) 527-4445

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95018148CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoma County Junior College District Family CurrentSince Dec 5, 2021 Accepting new patients
Sonoma County Junior College District CurrentSince May 1, 2022 Accepting new patients

Locations

1501 Mendocino Ave
Santa Rosa, CA 95401
Phone (707) 527-4445

Organizations & group practices 2

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": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1013675370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MENDOCINO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014395",
            "telephone_number": "707-527-4445",
            "fax_number": "888-213-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MENDOCINO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014332",
            "telephone_number": "707-527-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEJAS-MIR",
        "first_name": "GENESIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.