Maurine Bonkiyoy Forche, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95011523 Issued in CA

Practice address

40910 Fremont Blvd
Fremont, CA 94538-4375

Phone

(510) 770-8040

NPI assigned

Aug 26, 2019

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

Other names 1

• Ms. Maurine Bonkiyoy Wirkim Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations (25 of 32)

Interoperability endpoints

• Direct secure messaging: maurine.forchefnp.p3@direct.livingstoncommunity.nextgenshare.com
• Direct secure messaging: mndimah293295@direct.ochin.org

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.

• County of Santa Clara

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500
  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1629301346
  Medicare reassignment NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
  • NPI 1427110329
  Medicare reassignment NPD
• Providence Holistic Healing Advanced Nursing PC

  • Psychiatry Physician
  • Tracy, CA
  • NPI 1598688715

  Family

  NPD (past) Authorized official
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1043354020
  NPD
• County of Santa Clara

  • Clinic/Center
  • San Jose, CA
  • NPI 1154906634
  NPD
• County of Santa Clara

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1427717644
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
  • NPI 1487012779
  NPD

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1104473016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CASPIAN WAY",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950208505",
            "telephone_number": "952-260-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-770-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORCHE",
        "first_name": "MAURINE",
        "middle_name": "BONKIYOY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURINE",
            "last_name": "WIRKIM",
            "middle_name": "BONKIYOY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gloria E Follosco
• Deanna Yook Phon Fong
• Sarah Fong, DPT
• Steven Chee Fong, DDS
• TSZ Mei Fong, MD
• Ford Brewer MD, Inc
• Micheal Ford
• Michelle Ford
• Channah Foreman
• Sylvia Anna Forni, D.C.

• Family Nurse Practitioner in Fremont, CA
• Providers in Fremont, 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 Feb 17, 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.