Allie Rae Nowak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11649 Issued in MN

Practice address

4100 Redwood Rd # 20a-616
Oakland, CA 94619-2363

Phone

(510) 849-6500

Fax

(510) 849-6501

NPI assigned

Jul 2, 2014

Last updated

Dec 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Allie Rae Jagielo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1144636838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 NORWOOD LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422069",
            "telephone_number": "715-630-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 REDWOOD RD # 20A-616",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946192363",
            "telephone_number": "510-849-6500",
            "fax_number": "510-849-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "ALLIE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59272",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLIE",
            "last_name": "JAGIELO",
            "middle_name": "RAE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jean Jacques Noubiap Nzeale, MD, PHD
• Nova Midwifery Services
• Sloan Jade Nova
• Novacare Rehabilitation
• Raphaelle Lamoureux Novotny
• Monica Z. Nowakowski-Carlson, LCSW
• Kristen Nowakowski
• Lynn Tabb Noyce, NURSE PRACTITIONER
• Ntiedo Johnson Inyang
• Ntu Wellness Center

• Physician Assistant in Oakland, CA
• Providers in Oakland, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.