Individual provider Active NPI

Nicole Marie Daisa, ARNP

  • Family Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1861924516
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95035040 Issued in CA
Practice address
575 Lennon LN
Walnut Creek, CA 94598-2443
Phone
(925) 433-8786
Fax
(925) 433-8788
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95415429 CA
Registered Nurse 163W00000X RN60666816 WA
Family Nurse Practitioner 363LF0000X AP60782216 WA
Family Nurse Practitioner 363LF0000X 95035040 CA Primary

Addresses

Primary practice location

575 Lennon LN
Walnut Creek, CA 94598-2443

Mailing address

575 Lennon LN
Walnut Creek, CA 94598-2443
Phone (925) 433-8786

Other practice location 1

3901 Hoyt Ave
Everett, WA 98201-4988
Phone (425) 259-0966

Other practice location 2

9709 3rd Ave NE
Seattle, WA 98115-2062
Phone (206) 860-2209

Other identifiers 1

IdentifierTypeStateIssuer
2106150MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180216001089 WA Practitioner - Nurse Practitioner 7911267786 Reassigns benefits to 3 organizations
I20250714000524 CA Practitioner - Nurse Practitioner 7911267786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

Practice addresses (Care Compare)

575 Lennon LN
Walnut Creek, CA 94598-2443
Phone (925) 378-4512

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Current Accepting new patients
Bass Medical Group Current Accepting new patients
Optum Care Washington PLLC CurrentSince Jul 17, 2023 Accepting new patients
Bass Medical Group CurrentSince Jun 16, 2025 Accepting new patients
Bass Medical Group CurrentSince Jun 16, 2025 Accepting new patients
The Polyclinic PLLC CurrentSince Jul 17, 2023 Accepting new patients
Optum Care Washington PLLC CurrentSince Jul 17, 2023 Accepting new patients
Bass Medical Group Past Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

575 Lennon Ln
Walnut Creek, CA 94598
Phone (925) 378-4512

1200 112th Ave NE
Ste C210
Bellevue, WA 98004
Phone (425) 412-4313

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1145 Broadway
Seattle, WA 98122

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: ndaisa186820@ehr.johnmuirhealth.com
  • Direct secure messaging: ndaisa78788@direct.tecmc.com

Organizations & group practices 10

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 2

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1861924516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LENNON LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982443",
            "telephone_number": "925-433-8786",
            "fax_number": "925-433-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 LENNON LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982443",
            "telephone_number": "925-433-8786",
            "fax_number": "925-433-8788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Hoyt Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014988",
            "country_code": "US",
            "telephone_number": "425-259-0966",
            "fax_number": "425-335-5154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9709 3rd Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981152062",
            "country_code": "US",
            "telephone_number": "206-860-2209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAISA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95415429",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60666816",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60782216",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95035040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2106150",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.