| Bay Area Pain & Wellness Center | |
|
15047 Los Gatos Boulvard Suite 200 Los Gatos CA 95032 | |
| (408) 364-6799 | |
| (408) 375-4510 |
| Full Name | Bay Area Pain & Wellness Center |
|---|---|
| Speciality | Pain Medicine |
| Location | 15047 Los Gatos Boulvard, Los Gatos, California |
| Authorized Official Name and Position | John Edward Massey (OWNER) |
| Authorized Official Contact | 4083646799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Area Pain & Wellness Center 15047 Los Gatos Boulvard Suite 200 Los Gatos CA 95032 Ph: (408) 364-6799 | Bay Area Pain & Wellness Center 15047 Los Gatos Boulvard Suite 200 Los Gatos CA 95032 Ph: (408) 364-6799 |
| NPI Number | 1487758074 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 12/02/2014 |
| Medicare PECOS PAC ID | 0648165043 |
|---|---|
| Medicare Enrollment ID | O20040216000803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487758074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Primary |
| Provider Name | Linda Lee Wolbers |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1093753899 PECOS PAC ID: 6204877962 Enrollment ID: I20050512000922 |
| Provider Name | Peter A Abaci |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1447200761 PECOS PAC ID: 2365470531 Enrollment ID: I20050728001190 |
| Provider Name | Amy L Maher |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1205945995 PECOS PAC ID: 7618972829 Enrollment ID: I20060921000517 |
| Provider Name | Michele Jehenson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649445826 PECOS PAC ID: 3274690458 Enrollment ID: I20090316000680 |
| Provider Name | Konrad Ng |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1700074549 PECOS PAC ID: 5092863738 Enrollment ID: I20090506000313 |
| Provider Name | Michael Sullivan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609156702 PECOS PAC ID: 1951568211 Enrollment ID: I20120130000403 |
| Provider Name | John Mckellar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184893778 PECOS PAC ID: 0547484248 Enrollment ID: I20140707002080 |
| Provider Name | Jessica Goza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649710476 PECOS PAC ID: 8022388867 Enrollment ID: I20170726003803 |
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