Jason P Walsh

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95009795 Issued in CA

Practice address

3100 Telegraph Ave Ste 2102
Oakland, CA 94609-3210

Phone

(510) 286-8160

NPI assigned

Jan 20, 2019

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1547942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1629542923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE STE 2102",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093210",
            "telephone_number": "510-286-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE STE 2102",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093210",
            "telephone_number": "510-286-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JASON",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-20",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009795",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Wallin
• Chalise Renee Walls
• Stephen Walrod, PH.D.
• Elizabeth Jane Walser, MSW
• Cameron Walsh
• Katherine Claire Walsh
• Kathy Walsh, MA CCC-SLP
• Kevin Martin Walsh, M.D.
• Kyle Walsh
• Sally Walstrom, LCSW

• Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.