Individual provider Active NPI

Alice Hwang, RN, FNP

  • Family Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1639577000
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95002136 Issued in CA
Practice address
4155 Moorpark Ave Ste 3
San Jose, CA 95117-1714
Phone
(408) 217-1905
NPI assigned
Dec 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 786137 CA
Nurse Practitioner 363L00000X 95002136 CA
Family Nurse Practitioner 363LF0000X 95002136 CA Primary

Addresses

Primary practice location

4155 Moorpark Ave Ste 3
San Jose, CA 95117-1714

Mailing address

4155 Moorpark Ave Ste 3
San Jose, CA 95117-1714
Phone (408) 217-1905

Other practice location 1

2516 Samaritan Dr
Suite M
San Jose, CA 95124-4108
Phone (408) 356-5900

Other practice location 2

2516 Samaritan Dr
Suite M
San Jose, CA 95124-4108
Phone (408) 356-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95002136CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639577000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171714",
            "telephone_number": "408-217-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171714",
            "telephone_number": "408-217-1905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2516 Samaritan Dr",
            "address_2": "Suite M",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951244108",
            "country_code": "US",
            "telephone_number": "408-356-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2516 Samaritan Dr",
            "address_2": "Suite M",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951244108",
            "country_code": "US",
            "telephone_number": "408-356-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HWANG",
        "first_name": "ALICE",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "786137",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95002136",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.