Angela Wallace, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021029 Issued in CA

Practice address

21 Metro LN
Sacramento, CA 95816-4396

Phone

(405) 210-0778

NPI assigned

Aug 2, 2022

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of California, Inc Home health agency, Redding, CA, CCN 557273
• Mission Home Health of Redding Home health agency, Redding, CA, CCN 059579
• Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.wallacenp.p1@direct.schc.nextgenshare.com

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.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1114533171
  Medicare reassignment NPD
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1356815542
  NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Accentcare Home Health of California, Inc.

  • Home Health Agency
  • Redding, CA
  • NPI 1992751382
  Care Compare affiliation
• Healthy Living at Home - Redding LLC

  • Home Health Agency
  • Redding, CA
  • NPI 1063853398
  Care Compare affiliation
• Prime Healthcare Services - Shasta LLC

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1205089026
  Care Compare affiliation

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1972230738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 METRO LN",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 METRO LN",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164396",
            "telephone_number": "405-210-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ANGELA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamu Joy Walker, LVN
• Timothy Walker
• Jenna Walkingstick
• Stephen Lee Wall, M.D.
• Amanda Patricia Wallace
• David Wallace, M.S. CCC-SLP
• David Wallace, MD MSC FRCSC
• Julian Wallace
• Meagan Wallace
• Nadia Giselle Wallace

• Family Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.

Verify at the official NPI Registry.