Individual provider Active NPI

Jessica Wu, FNP-C

  • Family Nurse Practitioner
  • Monterey Park, CA
National Provider Identifier
1265972301
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005108 Issued in CA
Practice address
600 N Garfield Ave Ste 111
Monterey Park, CA 91754-1167
Phone
(626) 280-3651
Fax
(626) 280-3079
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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 95005108 CA Primary

Addresses

Primary practice location

600 N Garfield Ave Ste 111
Monterey Park, CA 91754-1167

Mailing address

600 N Garfield Ave Ste 111
Monterey Park, CA 91754-1167
Phone (626) 280-3651

Other practice location 1

14051 Ramona Pkwy
Baldwin Park, CA 91706-4114
Phone (626) 960-3753

Other identifiers 1

IdentifierTypeStateIssuer
10091562MedicaidCA

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
I20170803003664 CA Practitioner - Nurse Practitioner 9537430897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M D Medical Center IncGroup PAC ID 7618922113, 3 clinicians

Practice addresses (Care Compare)

600 N Garfield Ave
Suite 111
Monterey Park, CA 91754-1167
Phone (626) 280-3651

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95005108CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
M.D. Medical Center, Inc CurrentSince Apr 9, 2021 Accepting new patients
Baldwin Park Medical Clinic Inc CurrentSince Apr 9, 2021 Accepting new patients

Locations

14051 Ramona Pkwy
Baldwin Park, CA 91706
Phone (626) 338-7338

600 N Garfield Ave
Ste 111
Monterey Park, CA 91754
Phone (626) 280-3651

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1265972301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 111",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541167",
            "telephone_number": "626-280-3651",
            "fax_number": "626-280-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 111",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541167",
            "telephone_number": "626-280-3651",
            "fax_number": "626-280-3079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14051 Ramona Pkwy",
            "address_purpose": "LOCATION",
            "city": "Baldwin Park",
            "state": "CA",
            "postal_code": "917064114",
            "country_code": "US",
            "telephone_number": "626-960-3753",
            "fax_number": "626-962-9866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WU",
        "first_name": "JESSICA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10091562",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.