Gila Wildfire

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A86112 Issued in CA

Practice address

2500 Alhambra Ave
Martinez, CA 94553-3156

Phone

(925) 370-5110

Fax

(925) 370-5142

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Contra Costa County

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  Medicare reassignment

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649348137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DOUGLAS DR",
            "address_2": "SUITE 391",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534098",
            "telephone_number": "925-957-5429",
            "fax_number": "925-957-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ALHAMBRA AVE",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945533156",
            "telephone_number": "925-370-5110",
            "fax_number": "925-370-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDFIRE",
        "first_name": "GILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A86112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Whitty, PHARM.D.
• Donald Widder
• John Widenmann, CTRS
• Jennifer Linton Wienecke-Friedman, IBCLC, CLEC
• Donna Michele Wigand, L.C.S.W.
• Mario Wiley
• Shante Wiley
• Lauren Wilke, DO
• Mark Wille
• Brittney Williams, CCC-SLP

• Family Medicine Physician in Martinez, CA
• Providers in Martinez, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.