Alexandra Taylor Wade, FNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95026359 Issued in CA

Practice address

250 Northgate Dr Ste 102
Manteca, CA 95336-3161

Phone

(209) 239-5299

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1922249077
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1902648207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 58TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171724",
            "telephone_number": "209-201-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NORTHGATE DR STE 102",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953363161",
            "telephone_number": "209-239-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "ALEXANDRA",
        "middle_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95026359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaliyah Raquel Vories
• Angelique Vories
• Vrushali Damle Dental Corporation
• Christopher Tri Vu
• Phu Tien Vu, MD
• Ismail Wadiwala, MD
• Alexandria Natasha Waid
• Walgreen Co
• Blake J Walker
• Walmart Inc.

• Acute Care Nurse Practitioner in Manteca, CA
• Providers in Manteca, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.