Individual provider Active NPI

Nicole Dudaney, MD

  • Pediatrics Physician
  • Pleasanton, CA
National Provider Identifier
1316696743
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A197379 Issued in CA
Practice address
5575 W Las Positas Blvd Ste 340
Pleasanton, CA 94588-5804
Phone
(925) 847-9777
NPI assigned
Mar 22, 2022
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A197379 CA Primary

Addresses

Primary practice location

5575 W Las Positas Blvd Ste 340
Pleasanton, CA 94588-5804

Mailing address

5575 W Las Positas Blvd Ste 340
Pleasanton, CA 94588-5804
Phone (925) 847-9777

Other practice location 1

505 S Main St Ste 525
Orange, CA 92868-4553
Phone (714) 456-5631

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729003442 CA Practitioner - Pediatric Medicine 5890131478 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A197379CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Jul 15, 2025 Accepting new patients
University of California Irvine PastSince Mar 1, 2022 Accepting new patients
Bruce M. Gach, M.D., Inc. PastSince Jul 22, 2025 Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

5575 W Las Positas Blvd
Ste 340
Pleasanton, CA 94588
Phone (925) 847-9777

Organizations & group practices 3

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1316696743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD STE 340",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945885804",
            "telephone_number": "925-847-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD STE 340",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945885804",
            "telephone_number": "925-847-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St Ste 525",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684553",
            "country_code": "US",
            "telephone_number": "714-456-5631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDANEY",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A197379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.