NPIMap

Individual provider Active NPI

Rebecca Elaine Wahlgren, NP

  • Nurse Practitioner
  • Pinole, CA
National Provider Identifier
1639504962
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23606 Issued in CA
Practice address
2160 Appian Way Ste 200
Pinole, CA 94564-2565
Phone
(510) 724-9110
NPI assigned
Sep 5, 2013
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23606 CA Primary

Addresses

Primary practice location

2160 Appian Way Ste 200
Pinole, CA 94564-2565

Mailing address

2160 Appian Way Ste 200
Pinole, CA 94564-2565
Phone (510) 724-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627002031 CA Practitioner - Nurse Practitioner 3375768740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

2160 Appian Way
Suite 200
Pinole, CA 94564-2565
Phone (510) 724-9110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23606CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance CurrentSince Apr 21, 2014 Accepting new patients

Locations

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

2160 Appian Way
Ste 200
Pinole, CA 94564
Phone (510) 724-9110

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

Interoperability endpoints

  • Direct secure messaging: rwahlgren86575@direct.stanfordhealthcare.org

Organizations & group practices 1

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 10

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": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1639504962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 APPIAN WAY STE 200",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642565",
            "telephone_number": "510-724-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 APPIAN WAY STE 200",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642565",
            "telephone_number": "510-724-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLGREN",
        "first_name": "REBECCA",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.