Philippa Van Der Wal, RN CNM

Primary specialty

Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X

License

42195 Issued in CA

Practice address

3260 Kerner Blvd
San Rafael, CA 94901-4861

Phone

(415) 499-4030

Fax

(415) 507-2634

NPI assigned

Oct 16, 2006

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife, Registered Nurse

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1659451409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014861",
            "telephone_number": "415-499-4030",
            "fax_number": "415-507-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014861",
            "telephone_number": "415-499-4030",
            "fax_number": "415-507-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER WAL",
        "first_name": "PHILIPPA",
        "credential": "RN CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "42195",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Alejandra Valenzuela
• Sydney Valett
• Andrew Valla, AU.D.
• Maureen A. Valley, D.M.D.
• Laurel Rose Van Der Toorn
• Alexandra N Van Dyke
• Bethany Laura Van Dyke, M.F.T.
• Marta Van Leuven, M.F.T.
• Lesley Ann Van Voorhees, M.S.W.
• Christine M Vandenbroucke-Bouckaert, PH.D.IN CLINICAL PSY

• Ambulatory Women's Health Care Registered Nurse in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Ambulatory Women's Health Care Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; 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.