Individual provider Active NPI

Jesse Woisard Wennik, NP, CNS

  • Psychiatric/Mental Health Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1073651154
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
16967 Issued in CA
Practice address
230 Golden Gate Ave
San Francisco, CA 94102-3706
Phone
(628) 754-7800
Fax
(628) 217-7505
NPI assigned
Feb 2, 2007
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 16967 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 16967 CA Primary

Addresses

Primary practice location

230 Golden Gate Ave
San Francisco, CA 94102-3706

Mailing address

230 Golden Gate Ave
San Francisco, CA 94102-3706
Phone (628) 754-7800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081029000803 CA Practitioner - Nurse Practitioner 6002975497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City and County of San FranciscoGroup PAC ID 1658280748, 368 clinicians

Practice addresses (Care Compare)

2403 Keith St
San Francisco, CA 94124-3231
Phone (628) 217-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
61.12
Promoting interoperability
99
Improvement activities
40
Cost
83.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16967CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco CurrentSince Jul 8, 2024 Accepting new patients
City and County of San Francisco CurrentSince Jul 8, 2024 Accepting new patients
City & County of San Francisco Current Accepting new patients

Locations

1001 Potrero Ave
Bldg 20
San Francisco, CA 94110
Phone (415) 206-8524

2401 Keith St
San Francisco, CA 94124
Phone (415) 671-7000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1073651154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 GOLDEN GATE AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023706",
            "telephone_number": "628-754-7800",
            "fax_number": "628-217-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 GOLDEN GATE AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023706",
            "telephone_number": "628-754-7800",
            "fax_number": "628-217-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNIK",
        "first_name": "JESSE",
        "middle_name": "WOISARD",
        "name_prefix": "Mr.",
        "credential": "NP, CNS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "16967",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "16967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.