Individual provider Active NPI

Alexandria Renae Devaughn, RN, WHNP-BC

  • Women's Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1578846127
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
95032003 Issued in CA
Practice address
1809 National Ave
San Diego, CA 92113-2113
Phone
(619) 515-2300
NPI assigned
Sep 20, 2011
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 732773 TX
Women's Health Nurse Practitioner 363LW0102X 95032003 CA Primary

Addresses

Primary practice location

1809 National Ave
San Diego, CA 92113-2113

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

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
I20241202003797 CA Practitioner - Nurse Practitioner 5294029278 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
Bay Area Community HealthGroup PAC ID 1658349824, 106 clinicians

Practice addresses (Care Compare)

1066 S White Rd
Suite 170
San Jose, CA 95127-3812
Phone (408) 729-9700

1650 S White Rd
San Jose, CA 95127-4758
Phone (408) 928-5250

2880 Story Rd
Suite a
San Jose, CA 95127-3942
Phone (408) 729-9700

5504 Monterey Hwy
San Jose, CA 95138-1529
Phone (408) 729-9700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95032003CAMDWomen's Health Nurse Practitioner
732773TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Nov 4, 2024 Accepting new patients
Bay Area Community Health CurrentSince Mar 31, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Nov 4, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Bay Area Community Health CurrentSince Mar 31, 2025 Accepting new patients
Allara Medical Group PA Past Accepting new patients
Bay Area Community Health Past Accepting new patients

Locations

40910 Fremont Blvd
Fremont, CA 94538
Phone (510) 770-8133

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

1066 S White Rd
Ste 170
San Jose, CA 95127

1650 S White Rd
San Jose, CA 95127
Phone (408) 928-5250

Interoperability endpoints

  • Direct secure messaging: adevaughn779768@direct.ochin.org

Organizations & group practices 7

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1578846127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132113",
            "telephone_number": "619-515-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVAUGHN",
        "first_name": "ALEXANDRIA",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "RN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "732773",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95032003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.