Beverly Ann Nuchols, ANP, PHD

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

257198 Issued in CA

Practice address

20103 Lake Chabot Rd
Eden Medical Center Employee Health Clinic
Castro Valley, CA 94546-5305

Phone

(510) 889-5067

Fax

(510) 537-1443

NPI assigned

Aug 16, 2010

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: bnuchols294253@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1922313824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "address_2": "EDEN MEDICAL CENTER EMPLOYEE HEALTH CLINIC",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-889-5067",
            "fax_number": "510-537-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "address_2": "EDEN MEDICAL CENTER EMPLOYEE HEALTH CLINIC",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-889-5067",
            "fax_number": "510-537-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCHOLS",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "ANP, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "257198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.