Active NPI
Melissa Ann Wenzel, ND
- Naturopath
- Sebastopol, CA
National Provider Identifier
1194079111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- ND622
- Practice address
- 130 Petaluma Ave
Suite 2E
Sebastopol, CA 95472-4220 - Phone
- (707) 492-5356
- Fax
- (707) 492-5349
- NPI assigned
- Oct 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1915 | OR | |
| Naturopath | 175F00000X | ND622 | CA | Primary |
Addresses
Primary practice location
130 Petaluma Ave
Suite 2E
Sebastopol, CA 95472-4220
Mailing address
130 Petaluma Ave
Suite 2E
Sebastopol, CA 95472-4220
Phone (707) 492-5356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ND622 | Other | CA | NATUROPATHIC MEDICINE COMMITTEE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND622 | CA | MD | Naturopath |
| 1915 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspring Integrative Health & Acupuncture | Naturopath | Past | Accepting new patients |
Organizations & group practices 1
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": "1351468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478044800000",
"number": "1194079111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 PETALUMA AVE",
"address_2": "SUITE 2E",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954724220",
"telephone_number": "707-492-5356",
"fax_number": "707-492-5349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 PETALUMA AVE",
"address_2": "SUITE 2E",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954724220",
"telephone_number": "707-492-5356",
"fax_number": "707-492-5349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENZEL",
"first_name": "MELISSA",
"middle_name": "ANN",
"credential": "ND",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-29",
"last_updated": "2016-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "OR",
"license": "1915",
"primary": false
},
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "CA",
"license": "ND622",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATUROPATHIC MEDICINE COMMITTEE",
"identifier": "ND622",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.