Individual provider Active NPI

Beau Campa

  • Audiologist
  • Walnut Creek, CA
National Provider Identifier
1306454319
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3550 Issued in CA
Practice address
2623 Shadelands Dr Ste 1
Walnut Creek, CA 94598-2512
Phone
(925) 242-0647
NPI assigned
Jul 15, 2020
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3550 CA Primary
Audiologist-Hearing Aid Fitter 237600000X NU

Addresses

Primary practice location

2623 Shadelands Dr Ste 1
Walnut Creek, CA 94598-2512

Mailing address

2623 Shadelands Dr Ste 1
Walnut Creek, CA 94598-2512
Phone (925) 933-8462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201111001853 CA Practitioner - Qualified Audiologist 4880004308 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2400 Del Paso Rd
Suite 145
Sacramento, CA 95834-9629
Phone (916) 928-3940

2800 L St
Sacramento, CA 95816-5616

500 University Ave
Suite 220
Sacramento, CA 95825-6525
Phone (916) 734-2011

550 W Ranch View Dr
Rocklin, CA 95765-5396
Phone (916) 295-5766

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3550CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Single Specialty Current Accepting new patients
Regents of the Univ of Ca Single Specialty CurrentSince Apr 15, 2024 Accepting new patients
Regents of the University of California Single Specialty CurrentSince Apr 15, 2024 Accepting new patients
Sutter Valley Medical Foundation Single Specialty CurrentSince Feb 1, 2026 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2026 Accepting new patients
Regents of the Univ of Ca Single Specialty CurrentSince Apr 15, 2024 Accepting new patients
Regents of the University of California Single Specialty CurrentSince Apr 15, 2024 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

550 W Ranch View Dr
Rocklin, CA 95765
Phone (916) 295-5700

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2521 Stockton Blvd
Ste 5200
Sacramento, CA 95817
Phone (916) 734-2801

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

250 W Main St
Woodland, CA 95695
Phone (916) 668-6100

Organizations & group practices 9

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": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1306454319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 SHADELANDS DR STE 1",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-933-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 SHADELANDS DR STE 1",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-242-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPA",
        "first_name": "BEAU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "3550",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.