Individual provider Active NPI

Angela Mallari Vega, NP

  • Acute Care Nurse Practitioner
  • Menlo Park, CA
National Provider Identifier
1538400361
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
21740 Issued in CA
Practice address
1275 Crane St
Menlo Park, CA 94025-4212
Phone
(650) 206-8342
NPI assigned
Mar 4, 2013
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 21740 CA Primary

Addresses

Primary practice location

1275 Crane St
Menlo Park, CA 94025-4212

Mailing address

1275 Crane St
Menlo Park, CA 94025-4212
Phone (650) 206-8342

Other identifiers 1

IdentifierTypeStateIssuer
00A407355MedicaidCA

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
I20140106000864 CA Practitioner - Nurse Practitioner 8022246669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatrics Care Solution IncGroup PAC ID 7618416512, 7 clinicians

Practice addresses (Care Compare)

318 Main St
Unit 5J
San Francisco, CA 94105-2159
Phone (617) 510-7972

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21740CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis & Rheumatology Medical Associates, Inc CurrentSince Jul 1, 2013 Accepting new patients
Quality Care Solution Inc. CurrentSince Jan 15, 2024 Accepting new patients
Geriatrics Care Solution Inc CurrentSince Jul 16, 2024 Accepting new patients

Locations

1275 Crane St
Menlo Park, CA 94025
Phone (510) 481-3206

1477 Grove St
San Francisco, CA 94117
Phone (415) 563-0565

2043 19th Ave
San Francisco, CA 94116
Phone (415) 661-8787

1355 Clayton Rd
San Jose, CA 95127
Phone (408) 251-3070

120 La Casa Via
Ste 204
Walnut Creek, CA 94598
Phone (925) 210-1050

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1538400361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 CRANE ST",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254212",
            "telephone_number": "650-206-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 CRANE ST",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254212",
            "telephone_number": "650-206-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "ANGELA",
        "middle_name": "MALLARI",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "21740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A407355",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.