NPIMap

Individual provider Active NPI

Valerie Helen Takes, RN ACNP

  • Acute Care Nurse Practitioner
  • Sebastopol, CA
National Provider Identifier
1831443878
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP 22514 Issued in CA
Practice address
501 Petaluma Ave
Sebastopol, CA 95472-4215
Phone
(707) 271-2265
NPI assigned
Oct 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP 22514 CA Primary

Addresses

Primary practice location

501 Petaluma Ave
Sebastopol, CA 95472-4215

Mailing address

PO Box 314
Dillon Beach, CA 94929-0314
Phone (707) 217-2265

Other practice location 1

400 N McDowell Blvd
Petaluma, CA 94954-2339
Phone (707) 778-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150228000029 CA Practitioner - Nurse Practitioner 0749506293 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

400 N McDowell Blvd
Petaluma, CA 94954-2339
Phone (707) 778-2631

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP 22514CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ukiah Adventist Hospital CurrentSince May 15, 2015 Accepting new patients
Willits Hospital Inc. CurrentSince May 15, 2015 Accepting new patients
Providence Medical Foundation CurrentSince Oct 2, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Oct 2, 2017 Accepting new patients
Providence Medical Foundation Current Accepting new patients
SRM Alliance Hospital Services Past Accepting new patients

Locations

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

501 Petaluma Ave
Sebastopol, CA 95472
Phone (707) 823-8511

1 Madrone St
Willits, CA 95490
Phone (707) 456-3041

1 Marcela Dr
Willits, CA 95490
Phone (707) 456-3001

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831443878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 314",
            "city": "DILLON BEACH",
            "state": "CA",
            "postal_code": "949290314",
            "telephone_number": "707-217-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724215",
            "telephone_number": "707-271-2265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N McDowell Blvd",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949542339",
            "country_code": "US",
            "telephone_number": "707-778-1111",
            "fax_number": "707-778-2769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAKES",
        "first_name": "VALERIE",
        "middle_name": "HELEN",
        "credential": "RN ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP 22514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

Verify at the official NPI Registry.