Bonnie Jo Gallegos, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

510448 Issued in CA

Practice address

975 Sereno Dr
Kaiser Permanente Vallejo Medical Center
Vallejo, CA 94589-2441

Phone

(707) 651-1031

NPI assigned

Oct 12, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1063502110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 SERENO DRIVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892485",
            "telephone_number": "707-651-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "address_2": "KAISER PERMANENTE VALLEJO MEDICAL CENTER",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "707-651-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "BONNIE",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "510448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Craig S Gainza, D.D.S., M.S.D.
• Bianca Ymara Gaitan-Ochoa
• Nicole Galay
• Maureen Elizabeth Gallagher, RN,FNP
• Maria Gallego, NP
• Galvan Dental LLC
• Gretel L Galvan-Padilla, RADT-1
• Josef Gammad
• Kristen Patrice Gandek, MPT
• Michelle Gandley, RPH

• Family Nurse Practitioner in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.