Individual provider Active NPI

Olivia Wu, PA-C

  • Physician Assistant
  • Carmichael, CA
National Provider Identifier
1932549649
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA23044 Issued in CA
Practice address
4156 Manzanita Ave
Carmichael, CA 95608-1496
Phone
(916) 488-6337
NPI assigned
Jun 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA23044 CA Primary

Addresses

Primary practice location

4156 Manzanita Ave
Carmichael, CA 95608-1496

Mailing address

PO Box 692
Sacramento, CA 95812-0692

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
I20141227000061 CA Practitioner - Physician Assistant 2860715802 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
23044CAMDDentist
PA23044CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Nov 1, 2014 Accepting new patients

Locations

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: owu232215@santaclaravalley.direct-ci.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1932549649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 692",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958120692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4156 MANZANITA AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956081496",
            "telephone_number": "916-488-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA23044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.