Active NPI
Vicki Diane Casella-Gordon, MS, CNS, RN
- Critical Care Medicine Registered Nurse
- Walnut Creek, CA
National Provider Identifier
1376696617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 296530
- Practice address
- 1425 S Main St
Walnut Creek, CA 94596-5318 - Phone
- (925) 295-4692
- NPI assigned
- Jan 19, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 296530 | CA | Primary |
Addresses
Primary practice location
1425 S Main St
Walnut Creek, CA 94596-5318
Mailing address
1425 S Main St
Walnut Creek, CA 94596-5318
Phone (925) 295-4692
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
- Credentials
- Certified Nurse Specialist, Master of Science, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 296530 | CA | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376696617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 S MAIN ST",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965318",
"telephone_number": "925-295-4692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 S MAIN ST",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965318",
"telephone_number": "925-295-4692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASELLA-GORDON",
"first_name": "VICKI",
"middle_name": "DIANE",
"credential": "MS, CNS, RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "CA",
"license": "296530",
"primary": true
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.