Individual provider Active NPI

Nancy W Selix, CNM, FNP

  • Advanced Practice Midwife
  • Mill Valley, CA
National Provider Identifier
1063794584
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1423 Issued in CA
Practice address
957 W California Ave
Mill Valley, CA 94941-4449
Phone
(415) 497-3029
NPI assigned
Sep 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12072 CA
Advanced Practice Midwife 367A00000X 1423 CA Primary

Addresses

Primary practice location

957 W California Ave
Mill Valley, CA 94941-4449

Mailing address

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

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)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12072CAMDPediatric Occupational Therapist
1423CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LGTC Group PastSince May 20, 2025 Accepting new patients
WK Medical Group PastSince Apr 6, 2016 Accepting new patients
Los Gatos Therapy Center PastSince Apr 17, 2022 Accepting new patients

Organizations & group practices 3

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": "1315612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1063794584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 W CALIFORNIA AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949414449",
            "telephone_number": "415-497-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIX",
        "first_name": "NANCY",
        "middle_name": "W",
        "credential": "CNM, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-10",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "12072",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.