Lynette Woo-Sam, RN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020382 Issued in CA

Practice address

18541 San Antonio St
Fountain Valley, CA 92708-7103

Phone

(714) 362-7550

NPI assigned

Dec 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altea Medical California PCGroup PAC ID 1850740150, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations (25 of 29)

Interoperability endpoints

• Direct secure messaging: lwoosam767811@direct.memorialcare.org
• Direct secure messaging: lynette.woo-sam@104097756413956.direct.elationemr.com

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.

• Altea Medical California PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Eureka, CA
  • NPI 1174302954
  Medicare reassignment Care Compare group NPD
• Central Health Plan of California, Inc.

  • Health Maintenance Organization
  • Diamond Bar, CA
  • NPI 1386714772
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of California, Inc

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1184663965
  Medicare reassignment NPD
• Molina Healthcare of California

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment NPD
• Midwest Post-Acute Care of California PC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1326490871

  CA

  Medicare reassignment NPD
• Mpac SMH of California PC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1821660960

  CA

  Medicare reassignment NPD
• Nancy Bulbow Way, M.D.

  • Surgery Physician
  • Santa Ana, CA
  • NPI 1811053044
  Medicare reassignment
• Universal Care

  • Pediatrics Physician
  • Long Beach, CA
  • NPI 1376632877
  NPD

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

{
    "created_epoch": "1638576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1427716612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18541 SAN ANTONIO ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087103",
            "telephone_number": "714-362-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18541 SAN ANTONIO ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087103",
            "telephone_number": "714-362-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO-SAM",
        "first_name": "LYNETTE",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-04",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "756790",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Tomiko Wong, PTA
• Keith Michael Wong, OD
• Marilyn Wong
• Michael Henry Wong, D.O.
• Richard Man-Kim Wong, M.D.
• Kerry E Wood, NP
• Alyssa Nicole Woolley, BT
• Jazmine T Workman
• Alexis Worth, NP
• Geoffrey Richard Wrenn, M.A.

• Family Nurse Practitioner in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.