Individual provider Active NPI

Monica Wilson, FNP

  • Family Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1861868275
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95002809 Issued in CA
Practice address
2960 Sacramento St
Berkeley, CA 94702-2510
Phone
(510) 549-3166
NPI assigned
Aug 19, 2015
Last updated
Aug 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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 NP95002809 CA Primary

Addresses

Primary practice location

2960 Sacramento St
Berkeley, CA 94702-2510

Mailing address

700 Adeline St
Oakland, CA 94607-2608

Other names 1

  • Monica Russell 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
I20151125001021 CA Practitioner - Nurse Practitioner 7517267404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

4050 Dublin Blvd
Dublin, CA 94568-3112
Phone (925) 875-6100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95002809CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Apr 30, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 30, 2018 Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

4050 Dublin Blvd
Dublin, CA 94568
Phone (925) 875-6100

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 780-0110

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: mwilson339506@hisp.ehr.sutterhealth.org

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, 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": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1861868275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ADELINE ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946072608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 SACRAMENTO ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947022510",
            "telephone_number": "510-549-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MONICA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95002809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONICA",
            "last_name": "RUSSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.