Wisal Fare, PA-C is a
Clinical Nurse Specialist - Adult Health based in San Leandro, California. Wisal Fare is licensed to practice in California (license number PA13725) and her current practice location is
13851 E 14th St, Ste 305, San Leandro, California. She can be reached at her office (for appointments etc.) via phone at
(510) 351-1193.
NPI number for Wisal Fare is 1578525598 and her current mailing address is 4721 Dallas Ranch Rd, Antioch, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1578525598.
Provider's Profile
Full Name | Wisal Fare |
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Gender | Female |
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Speciality | Clinical Nurse Specialist - Adult Health |
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Location | 13851 E 14th St, San Leandro, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1578525598
- Provider Enumeration Date: 04/05/2006
- Last Update Date: 09/23/2014
Medical Identifiers
Medical identifiers for Wisal Fare such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578525598 | NPI | - | NPPES |
110006522 | Other | CA | PTAN |
ZZZ15328Z | Other | CA | PTAN |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
364SA2200X | Clinical Nurse Specialist - Adult Health | PA13725 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wisal Fare is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Wisal Fare, PA-C 4721 Dallas Ranch Rd, Antioch, CA 94531-8811 Ph: (925) 778-0679 | Wisal Fare, PA-C 13851 E 14th St, Ste 305, San Leandro, CA 94578-2631 Ph: (510) 351-1193 |
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