Individual provider Active NPI

Rebecca Maher, NP

  • Pediatric Nurse Practitioner
  • Oakley, CA
National Provider Identifier
1306521406
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
9895 Issued in CA
Practice address
2021 Main St
Oakley, CA 94561-3302
Phone
(925) 776-8200
NPI assigned
Jun 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 9895 CA Primary

Addresses

Primary practice location

2021 Main St
Oakley, CA 94561-3302

Mailing address

PO Box 22210
Oakland, CA 94623-2210
Phone (510) 535-4000

Other practice location 1

2240 Gladstone Dr Ste 4
Pittsburg, CA 94565-5126
Phone (925) 363-2000

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
I20230711002294 CA Practitioner - Nurse Practitioner 5092174821 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9895CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza, Inc. CurrentSince Jun 26, 2023 Accepting new patients
La Clinica de la Raza Inc CurrentSince Jun 26, 2023 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients

Locations

2021 Main St
Oakley, CA 94561
Phone (925) 776-8200

2240 Gladstone Dr
Ste 4
Pittsburg, CA 94565
Phone (925) 431-1230

Organizations & group practices 4

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": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1306521406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 MAIN ST",
            "city": "OAKLEY",
            "state": "CA",
            "postal_code": "945613302",
            "telephone_number": "925-776-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2240 Gladstone Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "CA",
            "postal_code": "945655126",
            "country_code": "US",
            "telephone_number": "925-363-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHER",
        "first_name": "REBECCA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "9895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakley, CA

Sources for this page

Verify at the official NPI Registry.