Individual provider Active NPI

Taha Abdelwahhab, APRN-CNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hayward, CA
National Provider Identifier
1760670616
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
22045 Issued in CA
Practice address
22248 Main St
Hayward, CA 94541-4005
Phone
(650) 899-0762
Fax
(510) 256-0248
NPI assigned
Oct 4, 2007
Last updated
May 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 68088 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 22045 CA Primary
Registered Nurse 163W00000X 641128 CA

Addresses

Primary practice location

22248 Main St
Hayward, CA 94541-4005

Mailing address

22248 Main St
Hayward, CA 94541-4005

Other practice location 1

1720 El Camino Real Ste 140
Burlingame, CA 94010-3231
Phone (925) 282-1778

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
I20260609003491 CA Practitioner - Nurse Practitioner 4486125556

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

490 Post St
San Francisco, CA 94102-1301

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
641128CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central County Mental Health Services Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1760670616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22248 MAIN ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22248 MAIN ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414005",
            "telephone_number": "650-899-0762",
            "fax_number": "510-256-0248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 El Camino Real Ste 140",
            "address_purpose": "LOCATION",
            "city": "Burlingame",
            "state": "CA",
            "postal_code": "940103231",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDELWAHHAB",
        "first_name": "TAHA",
        "credential": "APRN-CNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "68088",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "22045",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "641128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.