Active NPI
Nicole Marie Daisa, ARNP
- Family Nurse Practitioner
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95035040
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2106150 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Polyclinic PLLC | Current | Accepting new patients | |
| Bass Medical Group | Current | Accepting new patients | |
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Bass Medical Group | Current | Accepting new patients | |
| Bass Medical Group | Current | Accepting new patients | |
| The Polyclinic PLLC | Current | Accepting new patients | |
| Optum Care Washington PLLC | Current | 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
- ndaisa186820@ehr.johnmuirhealth.com
- 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.
-
- Obstetrics & Gynecology Physician
- Walnut Creek, CA
- NPI 1174253405
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1831186766
-
- Audiologist
- Seattle, WA
- NPI 1174594634
-
- Orthopaedic Surgery Physician
- Bellevue, WA
- NPI 1174036826
-
- Orthopaedic Surgery Physician
- Castro Valley, CA
- NPI 1093181646
-
- Orthopaedic Surgery Physician
- San Ramon, CA
- NPI 1467329904
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
-
- Durable Medical Equipment & Medical Supplies
- Tacoma, WA
- NPI 1831411487
-
- Specialist
- Walnut Creek, CA
- NPI 1154401941
-
- Pain Medicine Physician
- Visalia, CA
- NPI 1326409343
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Walnut Creek, CA
- NPI 1740215219
-
- General Acute Care Hospital
- Concord, CA
- NPI 1801821376
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.