Individual provider Active NPI

Dana M Welle, D.O.

  • Obstetrics & Gynecology Physician
  • Santa Cruz, CA
National Provider Identifier
1659423754
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A7123 Issued in CA
Practice address
1595 Soquel Dr
Ste 220
Santa Cruz, CA 95065-1719
Phone
(831) 476-4200
Fax
(831) 476-5052
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A7123 CA Primary

Addresses

Primary practice location

1595 Soquel Dr
Ste 220
Santa Cruz, CA 95065-1719

Mailing address

1595 Soquel Dr
Ste 220
Santa Cruz, CA 95065-1719
Phone (831) 476-4200

Other identifiers 2

IdentifierTypeStateIssuer
00AX71230MedicaidCA
20A7123OtherCASTATE LICENSE

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7123CAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1659423754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 SOQUEL DR",
            "address_2": "STE 220",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651719",
            "telephone_number": "831-476-4200",
            "fax_number": "831-476-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SOQUEL DR",
            "address_2": "STE 220",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651719",
            "telephone_number": "831-476-4200",
            "fax_number": "831-476-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLE",
        "first_name": "DANA",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A7123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX71230",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20A7123",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.