WISAL FARE PA-C NPI 1578525598

NPI Information

NPI: 1578525598
Provider Name: WISAL FARE, PA-C
Classification: Clinical Nurse Specialist - 364SA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
13851 E 14TH ST
STE 305
SAN LEANDRO, CA
ZIP 94578
Phone: (510) 351-1193
Get Directions

Wisal Fare, PA-C is an adult health clinical nurse specialist in San Leandro, CA. Wisal Fare, PA-C NPI is 1578525598. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

13851 E 14TH ST
STE 305
SAN LEANDRO, CA
ZIP 94578-631
Phone: (510) 351-1193
Fax: (510) 351-6456

The NPI 1578525598 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 9/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SA2200X	Clinical Nurse Specialist	Adult Health	PA13725	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110006522	OTHER	CALIFORNIA	PTAN
2	0PA137250	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
3	ZZZ15328Z	OTHER	CALIFORNIA	PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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