Individual provider Active NPI

Alexis Silao Van Sickle, FNP

  • Family Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1104336700
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006331 Issued in CA
Practice address
2470 Alvin Ave Ste 60
San Jose, CA 95121-1664
Phone
(408) 271-7100
Fax
(408) 274-8763
NPI assigned
Oct 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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 95006331 CA Primary

Addresses

Primary practice location

2470 Alvin Ave Ste 60
San Jose, CA 95121-1664

Mailing address

1691 The Alameda
San Jose, CA 95126-2203
Phone (408) 795-3619

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
I20190307001568 CA Practitioner - Nurse Practitioner 9234478314 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95006331CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Mar Monte, Inc CurrentSince Jun 11, 2019 Accepting new patients
Planned Parenthood Mar Monte, Inc. CurrentSince Jun 11, 2019 Accepting new patients
Planned Parenthood Mar Monte, Inc Current Accepting new patients
Planned Parenthood Mar Monte, Inc Current Accepting new patients
Planned Parenthood Mar Monte Inc. Current Accepting new patients
Planned Parenthood Mar Monte, Inc Current Accepting new patients
Planned Parenthood Mar Monte, Inc Current Accepting new patients
Planned Parenthood Mar Monte, Inc PastSince Nov 21, 2018 Accepting new patients

Locations

650 N Fulton St
Fresno, CA 93728
Phone (559) 488-4900

1032 A St
Hayward, CA 94541
Phone (510) 300-3800

2907 El Camino Real
Redwood City, CA 94061
Phone (650) 235-7940

1694 Tully Rd
Ste 40
San Jose, CA 95122
Phone (408) 795-3600

1691 The Alameda
San Jose, CA 95126
Phone (408) 287-7526

Interoperability endpoints

  • Direct secure messaging: alexis.vansicklenp.p1@direct.ppmarmonte.nextgenshare.com

Organizations & group practices 8

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": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1104336700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262203",
            "telephone_number": "408-795-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 ALVIN AVE STE 60",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211664",
            "telephone_number": "408-271-7100",
            "fax_number": "408-274-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SICKLE",
        "first_name": "ALEXIS",
        "middle_name": "SILAO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.