John David Wildgust, RN, MSN, PHN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

NP95034156 Issued in CA

Practice address

480 Tesconi Cir Ste B
Santa Rosa, CA 95401-4691

Phone

(707) 206-7268

Fax

(707) 206-7254

NPI assigned

Jul 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siyan Clinical CorporationGroup PAC ID 0042470122, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Siyan Clinical Corporation

  • Psychiatry Physician
  • Santa Rosa, CA
  • NPI 1568732972
  Medicare reassignment Care Compare group NPD
• Stillwind Psychiatry, a Professional Nursing Corporation

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Santa Rosa, CA
  • NPI 1457281099
  NPD Authorized official

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1013698232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 HUNTER LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954048717",
            "telephone_number": "707-480-2030",
            "fax_number": "707-588-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 TESCONI CIR STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014691",
            "telephone_number": "707-206-7268",
            "fax_number": "707-206-7254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "935 Hunter Ln",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954048717",
            "country_code": "US",
            "telephone_number": "707-480-2030",
            "fax_number": "707-588-9032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDGUST",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "RN, MSN, PHN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "78261",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95034156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Bernard Wilder, D.C.
• Zoe Book Wilder, LCSW
• Wildflower Health, Inc.
• Wildflower Telehealth Network Inc.
• Wildflower Telehealth Services, Inc.
• Brittany Wiles, M.D.
• Sharon M. Wiles, DPM
• Adrienne Wiley-Thomas, ACSW
• Ayana Wiley, RRT
• Carlie Jeanette Wilkerson, P.A.

• Psychiatric/Mental Health Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.