Active NPI
Azita Chehresa, MD
- Family Medicine Physician
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C134739
- Practice address
- 1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501 - Phone
- (925) 939-1220
- NPI assigned
- Jul 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01064679A | IN | |
| Family Medicine Physician | 207Q00000X | C134739 | CA | Primary |
Addresses
Primary practice location
1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501
Mailing address
Dept 34929
P.O. Box 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01157324 | Other | IN | RR MEDICARE PTAN |
| 200947090 | Medicaid | IN |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C134739 | CA | MD | Family Medicine Physician |
| 01064679A | IN | MD | Family Medicine Physician |
| 134739 | CA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Muir Physician Network | Current | Accepting new patients |
Locations
2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112
380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840
1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597
1220 Rossmoor Pkwy
Walnut Creek, CA 94595
Phone (925) 947-3393
Interoperability endpoints
- achehresa2594@ecommunitydirect.com
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 and National Provider Directory roles.
-
- General Practice Physician
- Walnut Creek, CA
- NPI 1841407665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454889600000",
"number": "1659534204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT 34929",
"address_2": "P.O. BOX 39000",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941390001",
"telephone_number": "925-952-2828",
"fax_number": "925-952-2850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 ROSSMOOR PKWY",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945952501",
"telephone_number": "925-939-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEHRESA",
"first_name": "AZITA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-03",
"last_updated": "2016-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01064679A",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C134739",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PTAN",
"identifier": "P01157324",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200947090",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.