NPIMap

Organization Active NPI

Classic Healthcare, a Specialty Nursing Service, Inc.

  • Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1982337473
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
CLASSIC HEALTHCARE, A SPECIALTY NURSING SERVICE, INC.
Practice address
1300 Clay St Ste 600
Oakland, CA 94612-1427
Phone
(510) 846-8590
Fax
(510) 638-3400
NPI assigned
Jul 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2022

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

Authorized official

Name
Dr. Wanda H. Johnson, DNP, FNP-BC, CWOCNNPI 1043263452
Title
Owner
Phone
(510) 846-8590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1300 Clay St Ste 600
Oakland, CA 94612-1427

Mailing address

4475 Briar Cliff Rd
Oakland, CA 94605-4624
Phone (510) 846-8590

Other identifiers 1

IdentifierTypeStateIssuer
1043263452MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wjohnsonFNP@direct.practicefusion.com Direct

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: wjohnsonfnp@direct.practicefusion.com

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656720000000",
    "number": "1982337473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 BRIAR CLIFF RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054624",
            "telephone_number": "510-846-8590",
            "fax_number": "510-638-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CLAY ST STE 600",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121427",
            "telephone_number": "510-846-8590",
            "fax_number": "510-638-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC HEALTHCARE, A SPECIALTY NURSING SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-02",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-846-8590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-BC, CWOCN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043263452",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wjohnsonFNP@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1300 Clay St Ste 600",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946121427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

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