Individual provider Active NPI

Audrey Collard Wilke, NURSE PRACTITIONER

  • Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1770465247
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95035919 Issued in CA
Practice address
133 La Casa Via Ste 140
Walnut Creek, CA 94598-3005
Phone
(925) 947-3322
Fax
(925) 451-3172
NPI assigned
Jul 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95035919 CA Primary

Addresses

Primary practice location

133 La Casa Via Ste 140
Walnut Creek, CA 94598-3005

Mailing address

133 La Casa Via Ste 140
Walnut Creek, CA 94598-3005
Phone (925) 692-5610

Other names 1

  • Ms. Audrey Wilke Former name

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
I20251022004086 CA Order and Referring Only - Nurse Practitioner 5092203992

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95035919CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Health PastSince Jul 28, 2025 Accepting new patients
John Muir Physician Network PastSince Jul 28, 2025 Accepting new patients

Organizations & group practices 2

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": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1770465247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 LA CASA VIA STE 140",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983005",
            "telephone_number": "925-692-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 LA CASA VIA STE 140",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983005",
            "telephone_number": "925-947-3322",
            "fax_number": "925-451-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "AUDREY",
        "middle_name": "COLLARD",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95035919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "WILKE",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.