Individual provider Active NPI

Karla Bailey

  • Family Nurse Practitioner
  • Vallejo, CA
National Provider Identifier
1700433604
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19676 Issued in CA
Practice address
365 Tuolumne St
Vallejo, CA 94590-5700
Phone
(707) 553-5509
Fax
(707) 553-5307
NPI assigned
Aug 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19676 CA Primary

Addresses

Primary practice location

365 Tuolumne St
Vallejo, CA 94590-5700

Mailing address

3825 Chapparal Dr
Fairfield, CA 94534-7930
Phone (707) 718-8531

Other practice location 1

243 Georgia St
Vallejo, CA 94590-5905
Phone (707) 556-8100

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191015002569 CA Practitioner - Nurse Practitioner 2769713288 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19676CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc Current Accepting new patients
California Pacific Medical Group, Inc. PastSince Sep 1, 2019 Accepting new patients
La Clinica de la Raza, Inc. PastSince Sep 1, 2019 Accepting new patients

Locations

220 Hospital Dr
Vallejo, CA 94589
Phone (707) 641-1900

Interoperability endpoints

  • Direct secure messaging: kbailey716946@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1566691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1700433604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 CHAPPARAL DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347930",
            "telephone_number": "707-718-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 TUOLUMNE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905700",
            "telephone_number": "707-553-5509",
            "fax_number": "707-553-5307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "243 Georgia St",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945905905",
            "country_code": "US",
            "telephone_number": "707-556-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KARLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-25",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.