Table: enrolled_medi_cal_fee_for_service_ffs_providers , legal_name like W*

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  *

objectid	provider_source	provider_number	npi	owner_number	service_location_number	legal_name	enroll_status_eff_dt	provider_taxonomy	nemt_nmt_provider_type	anc_provider_type	fi_provider_type_cd	fi_provider_type	provider_license	fi_provider_specialty_cd	fi_provider_specialty	out_of_state_indicator	in_out_state	address_attention	address	address2	city	state	zip	zip_4	dhcs_county_cd	fips_county_cd	latitude	longitude	countyname
32	Fee-for-Service	1184177065	1184177065	1	1	WILCOX, RUSSELL T CRNA	11/14/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
48	Fee-for-Service	1225006109	1225006109	1	1	WINTER, THOMAS C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N MEDICAL DR	None	SLC	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
73	Fee-for-Service	1952534265	1952534265	1	1	WOOD, MICHAEL L PHD	12/11/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
84	Fee-for-Service	1932126265	1932126265	1	1	WAL-MART STORES, INC	4/29/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102094	1800 UNIVERSITY DR	None	VISTA	CA	92083	7700	37	06073	33.172614	-117.2166885	San Diego County
107	Fee-for-Service	1194065813	1194065813	1	1	WILLIAMS, DIANA A LCSW	9/24/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4004 BEYER BLVD	None	SAN DIEGO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
119	Fee-for-Service	1487971644	1487971644	1	1	WHITLOW, HEATHER N MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120735	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
136	Fee-for-Service	1013968999	1013968999	1	1	WILE, JAMES P MD INC	7/31/1987	207L00000X	NA	Other	026	PHYSICIANS	42137	05	Anesthesiology	0	In state provider	None	1900 POINT WEST WAY	STE 222	SACRAMENTO	CA	95815	4704	34	06067	38.599677	-121.431447	Sacramento County
158	Fee-for-Service	1891929741	1891929741	1	1	WRAY, ADRIAN L MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121717	08	Family Practice	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
179	Fee-for-Service	1023589694	1023589694	1	1	WATSON, JOYCELYN O RCP	1/11/2019	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
193	Fee-for-Service	1942268255	1942268255	1	1	WELTGE, ARLO MD	10/15/2020	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	6410 FANNIN STREET	SUITE 1500	HOUSTON	TX	77030	5306	00	None	29.71419639	-95.39755562	Harris County
224	Fee-for-Service	1801052410	1801052410	1	1	WOLFORD, CONNIE S NP	11/8/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
243	Fee-for-Service	1316183700	1316183700	1	1	WESTCARE CALIFORNIA, INC	12/11/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	410 EAST 7TH STREET	5,7,9	HANFORD	CA	93230	4606	16	06031	36.32745558	-119.6404941	Kings County
244	Fee-for-Service	1508914458	1508914458	1	1	WANG, RAYMOND Y MD	2/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80602	40	Pediatrics	0	In state provider	None	455 S MAIN STREET	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
258	Fee-for-Service	1992712954	1992712954	1	1	WALGREEN CO	6/17/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	495 E HOLT AVE	None	POMONA	CA	91767	5539	19	06037	34.06259846	-117.7425045	Los Angeles County
272	Fee-for-Service	1023168721	1023168721	1	1	WILLIAMSON, TIMOTHY L MD	1/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	32937	66	Emergency Medicine (Urgent Care)	0	In state provider	None	207 CHURCH RD	None	OJAI	CA	93023	3119	56	06111	34.44425314	-119.2668713	Ventura County
277	Fee-for-Service	1427054279	1427054279	1	1	WASSERMAN, PAUL F	10/1/1999	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	31149	40	Pediatrics	0	In state provider	None	1430 ESPLANADE	STE 5	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
287	Fee-for-Service	1679077580	1679077580	1	1	WRIGHT, TANECHA LMFT	11/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
327	Fee-for-Service	1134211725	1134211725	1	1	WONG, TOM K OD	3/1/2000	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	477 E COLORADO BLVD	None	PASADENA	CA	91101	2024	19	06037	34.14587948	-118.140561	Los Angeles County
408	Fee-for-Service	1285787556	1285787556	1	1	WALTON, DIANA L	6/2/1998	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	118 E OCEAN AVE	None	LOMPOC	CA	93436	6823	42	06083	34.63894992	-120.4569361	Santa Barbara County
504	Fee-for-Service	1992710271	1992710271	1	1	WALGREEN CO.	6/12/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	210 MOUNT HERMON RD	None	SCOTTS VALLEY	CA	95066	4009	44	06087	37.045183	-122.0269209	Santa Cruz County
522	Fee-for-Service	1578323564	1578323564	1	1	WATSON, CAITLIN PHD	5/15/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7257 FRESNO	FIRST FLOOR	FRESNO	CA	93720	2950	10	06019	36.84225164	-119.7833937	Fresno County
560	Fee-for-Service	1023168721	1023168721	1	1	WILLIAMSON, TIMOTHY L MD	1/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	32937	40	Pediatrics	0	In state provider	None	207 CHURCH RD	None	OJAI	CA	93023	3119	56	06111	34.44425314	-119.2668713	Ventura County
576	Fee-for-Service	1043362049	1043362049	1	1	WILLDEN, GERALD J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	65 E 100 N	None	GUNNISON	UT	84634	0000	00	None	39.15671009	-111.8163438	Sanpete County
589	Fee-for-Service	1477649119	1477649119	1	1	WATTS HEALTHCARE	4/1/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	19	06037	33.94274917	-118.2461916	Los Angeles County
638	Fee-for-Service	1609822816	1609822816	1	1	WHEELER,TIMOTHY M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	613 23RD ST SUITE 130	None	ASHLAND	KY	41105	0000	00	None	38.47105355	-82.6330827	Boyd County
724	Fee-for-Service	1598755787	1598755787	1	1	WHEELER, PAUL K MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	71309	41	Internal Medicine	0	In state provider	None	200 PORTER DR	STE 300	SAN RAMON	CA	94583	1524	07	06013	37.77372204	-121.9911155	Contra Costa County
740	Fee-for-Service	1952763773	1952763773	1	1	WANG, TIMOTHY MD	10/14/2022	207R00000X	NA	Other	026	PHYSICIANS	151494	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
770	Fee-for-Service	1255740874	1255740874	1	1	WAL-MART STORE INC	6/12/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 GOLF COURSE DR	None	ROHNERT PARK	CA	94928	1800	49	06097	38.3625018	-122.6934778	Sonoma County
773	Fee-for-Service	1639149511	1639149511	1	1	WILLIAMS, TIMOTHY MD	3/3/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	42175	05	Anesthesiology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
824	Fee-for-Service	1255633442	1255633442	1	1	WILLES, LAWRENCE B MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103827	22	Pathology (M.D. only)	0	In state provider	None	1509 WILSON TERRACE	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
840	Fee-for-Service	1083025183	1083025183	1	1	WALKER, COREY T MD	8/3/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	166677	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
842	Fee-for-Service	1821003153	1821003153	1	1	WALGREEN CO	9/22/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6012 WARNER AVE	None	HUNTINGTON BEACH	CA	92647	5568	30	06059	33.71536944	-118.023518	Orange County
853	Fee-for-Service	1023168721	1023168721	1	1	WILLIAMSON, TIMOTHY L MD	7/1/2007	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	207 CHURCH RD	None	OJAI	CA	93023	3119	56	06111	34.44425314	-119.2668713	Ventura County
880	Fee-for-Service	1477649119	1477649119	1	1	WATTS HEALTHCARE	4/1/2003	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	19	06037	33.94274917	-118.2461916	Los Angeles County
908	Fee-for-Service	1508274416	1508274416	1	1	WONG, VICTOR J OD	5/21/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7601 STONERIDGE DRIVE	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
937	Fee-for-Service	1124392147	1124392147	1	1	WALGREENS CO	5/14/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1905 W EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2216	43	06085	37.39277273	-122.0962874	Santa Clara County
975	Fee-for-Service	1871364596	1871364596	1	1	WHITE, LA RONCI MICHELE	2/7/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	316 E TAMARACK AVE	APT 6	INGLEWOOD	CA	90301	6272	19	06037	33.95783404	-118.3488243	Los Angeles County
1016	Fee-for-Service	1851786636	1851786636	1	1	WEBER, ANDREW T MD	3/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145452	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
1038	Fee-for-Service	1780857334	1780857334	1	1	WERNETTE, KATHLEEN S	4/11/2008	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
1055	Fee-for-Service	1821091174	1821091174	1	1	WOOD, YELENA MD	12/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70807	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
1073	Fee-for-Service	1104232602	1104232602	1	1	WOLFE, LORRAINE C PHD	1/2/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8950 VILLA LA JOLLA DR	STE B-208	LA JOLLA	CA	92037	1730	37	06073	32.870934	-117.2338765	San Diego County
1148	Fee-for-Service	1679705255	1679705255	1	1	WHITESIDE, WENDY LMFT	2/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	777 DAVIS ST	None	SAN LEANDRO	CA	94577	6923	01	06001	37.72317409	-122.162925	Alameda County
1165	Fee-for-Service	1477649119	1477649119	1	1	WATTS HEALTHCARE	8/18/2003	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	19	06037	33.94274917	-118.2461916	Los Angeles County
1184	Fee-for-Service	1003920372	1003920372	1	1	WU, WILSON C MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	67007	18	Ophthalmology	0	In state provider	None	200 N LA CUMBRE RD	STE C	SANTA BARBARA	CA	93110	2590	42	06083	34.44255908	-119.7510269	Santa Barbara County
1201	Fee-for-Service	1508933979	1508933979	1	1	WOLF, BARRY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2799 W GRAND BLVD	None	DETROIT	MI	48202	2608	00	None	42.36645079	-83.08385497	Wayne County
1207	Fee-for-Service	1174865281	1174865281	1	1	WANG, JEFFREY C DO	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14155	01	General Practice	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.2206967	-118.5342638	Los Angeles County
1214	Fee-for-Service	1518590165	1518590165	1	1	WEIGEL, CHRISTY LPCC	10/8/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
1222	Fee-for-Service	1629069042	1629069042	1	1	WESELY, STEPHEN A MD	9/22/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75251	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2519 E WHITMORE AVE	None	CERES	CA	95307	2634	50	06099	37.59479844	-120.9491078	Stanislaus County
1228	Fee-for-Service	1023196508	1023196508	1	1	WEI, JEFFREY T MD	1/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	75464	10	Gastroenterology (M.D. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
1248	Fee-for-Service	1306109863	1306109863	1	1	WILLIAMS, SANITHIA L MD	6/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143090	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
1261	Fee-for-Service	1871364596	1871364596	1	1	WHITE, LA RONCI MICHELE	2/7/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	316 E TAMARACK AVE	APT 6	INGLEWOOD	CA	90301	6272	19	06037	33.95783404	-118.3488243	Los Angeles County
1270	Fee-for-Service	1558484717	1558484717	1	1	WONG, HUMBERTO MD	9/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84419	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
1320	Fee-for-Service	1659696987	1659696987	1	1	WOO, RANDY E MD	3/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120400	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
1437	Fee-for-Service	1649271040	1649271040	1	1	WENGER, SPENCER H MD	1/1/1982	207R00000X	NA	Other	026	PHYSICIANS	33619	41	Internal Medicine	0	In state provider	None	4314 W SLAUSON AVE	None	LOS ANGELES	CA	90043	2854	19	06037	33.98885257	-118.3509655	Los Angeles County
1453	Fee-for-Service	1477649119	1477649119	1	1	WATTS HEALTHCARE	8/25/2003	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	19	06037	33.94274917	-118.2461916	Los Angeles County
1504	Fee-for-Service	1871641811	1871641811	1	1	WASIM, DAVID U MD	1/23/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	92461	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
1506	Fee-for-Service	1831235605	1831235605	1	1	WESTSIDE MEDICAL GROUP	6/26/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1107 O ST	None	FIREBAUGH	CA	93622	2224	10	06019	36.85875277	-120.4562709	Fresno County
1617	Fee-for-Service	1194777839	1194777839	1	1	WINTER, ANTHONY SCOTT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	855 MONTGOMERY ST	None	FORT WORTH	TX	76107	2553	00	None	32.750541	-97.3698605	Tarrant County
1624	Fee-for-Service	1285210211	1285210211	1	1	WONG, TAI C MD	8/21/2024	207P00000X	NA	Other	026	PHYSICIANS	187476	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
1657	Fee-for-Service	1093291106	1093291106	1	1	WEK, JACLYN N OD	10/14/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
1717	Fee-for-Service	1104808849	1104808849	1	2	WELBORN, JEANNA L MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	41810	68	Hematology	0	In state provider	None	2525 STOCKTON BLVD	SUITE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
1783	Fee-for-Service	1891009247	1891009247	1	1	WALTON, ZACHARY D MD	12/30/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
1785	Fee-for-Service	1164667002	1164667002	1	1	WAI, SANDRA G MD	6/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106062	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
1795	Fee-for-Service	1831235605	1831235605	1	1	WESTSIDE MEDICAL GROUP	6/26/2000	261QR1300X	NA	Rural Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1107 O ST	None	FIREBAUGH	CA	93622	2224	10	06019	36.85875277	-120.4562709	Fresno County
1826	Fee-for-Service	1548286255	1548286255	1	1	WITMER, BRUCE J MD	9/1/1984	174400000X	NA	Other	026	PHYSICIANS	47289	20	Orthopedic Surgery	0	In state provider	None	6121 N THESTA ST	STE 106	FRESNO	CA	93710	5294	10	06019	36.82493955	-119.783139	Fresno County
1867	Fee-for-Service	1689249427	1689249427	1	1	WALTERS, IAN N MD	9/3/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
1890	Fee-for-Service	1316524960	1316524960	1	1	WALTON, ALEXANDRA MD	7/12/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
1941	Fee-for-Service	1750571360	1750571360	1	1	WELTY, CHRISTOPHER MD	10/22/2020	208800000X	NA	Other	026	PHYSICIANS	126313	None	None	0	In state provider	None	2700 GRANT ST	STE 316	CONCORD	CA	94520	2272	07	06013	37.98417931	-122.0361585	Contra Costa County
1955	Fee-for-Service	1073691978	1073691978	1	1	WHITELEY, STEVEN P MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	41833	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
2000	Fee-for-Service	1336294875	1336294875	1	1	WONG, GREGORY S MD	2/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96833	41	Internal Medicine	0	In state provider	None	1700 CESAR CHAVEZ AVE	STE 3900	LOS ANGELES	CA	90033	0000	19	06037	34.05101259	-118.217259	Los Angeles County
2049	Fee-for-Service	1568778074	1568778074	1	1	WILHELM-LEEN, EMILEE R MD	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113294	45	Nephrology (Renal-Kidney)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2614	43	06085	37.313433	-121.9318385	Santa Clara County
2056	Fee-for-Service	1295758241	1295758241	1	1	WADHWANI, DAVID L MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74762	41	Internal Medicine	0	In state provider	None	11600 INDIAN HILLS RD	None	MISSION HILLS	CA	91345	1225	19	06037	34.2811228	-118.4588429	Los Angeles County
2104	Fee-for-Service	1184776304	1184776304	1	1	WICKS, CARLA V MD	11/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87161	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
2262	Fee-for-Service	1972338390	1972338390	1	1	WELLS, DEKALEIGHA A BIRTH DO	3/14/2025	390200000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
2337	Fee-for-Service	1568778074	1568778074	1	1	WILHELM-LEEN, EMILEE R MD	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113294	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2614	43	06085	37.313433	-121.9318385	Santa Clara County
2359	Fee-for-Service	1215995998	1215995998	1	1	WITTIG, KRISTINA MD	7/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125813	34	Urology and Urological Surgery	0	In state provider	None	1500 E DURATE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
2378	Fee-for-Service	1053808303	1053808303	1	1	WANG, DAVID	10/11/2024	208C00000X	NA	General Surgery	026	PHYSICIANS	187172	02	General Surgery	0	In state provider	None	26357 MCBEAN PARKWAY	STE 255	VALENCIA	CA	91355	5504	19	06037	34.41257644	-118.5597683	Los Angeles County
2444	Fee-for-Service	1689618415	1689618415	1	1	WADHWA, SONALI MD	7/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73002	30	Radiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
2475	Fee-for-Service	1992776041	1992776041	1	1	WATERTOWN REGIONAL MEDICAL	4/3/2015	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER INC	125 HOSPITAL DR	None	WATERTOWN	WI	53098	3303	00	None	43.20015336	-88.69897782	Dodge County
2493	Fee-for-Service	1831131192	1831131192	1	1	WILMES-REITZ, JOYCE E PHD	6/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23945 CALABASAS RD	#202	CALABASAS	CA	91302	1552	19	06037	34.15340482	-118.6490978	Los Angeles County
2516	Fee-for-Service	1700934502	1700934502	1	1	WAYNE, ERIN P MD	9/1/1998	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	65144	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
2534	Fee-for-Service	1588734099	1588734099	1	1	WALLACE, ROBERT L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	SOUTHWEST EMERGENCY SVCS	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
2586	Fee-for-Service	1396847711	1396847711	1	1	WANG, LEI MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70595	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
2605	Fee-for-Service	1164867412	1164867412	1	1	WADE, ALEXANDER J MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156071	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
2625	Fee-for-Service	1861012106	1861012106	1	1	WOODRUFF, BIANCA C MD	10/1/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
2630	Fee-for-Service	1427107796	1427107796	1	1	WU, NEETIKA K	4/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89029	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
2649	Fee-for-Service	1528381704	1528381704	1	1	WESTSIDE ANESTHESIA SERVICES	5/7/2010	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	5925 SAN VICENTE BLVD	None	LOS ANGELES	CA	90019	6630	19	06037	34.05682871	-118.360716	Los Angeles County
2655	Fee-for-Service	1194730424	1194730424	1	1	WALGREEN PHARMACY #04474	1/30/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2501 W MAGNOLIA BLVD	None	BURBANK	CA	91505	3030	19	06037	34.17187593	-118.3351483	Los Angeles County
2673	Fee-for-Service	1215593462	1215593462	1	1	WILLIS-SMITH, ARIANE A LCSW	6/21/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
2675	Fee-for-Service	1609142561	1609142561	1	1	WALKER, JENNIFER R LMFT	6/23/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
2677	Fee-for-Service	1104843457	1104843457	1	1	WAL-MART STORES, INC	7/13/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101826	1819 E NOBLE AVE	None	VISALIA	CA	93292	1519	54	06107	36.324621	-119.2730535	Tulare County
2741	Fee-for-Service	1700099728	1700099728	1	1	WANG, GARRICK K MD	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	88477	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	None	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
2764	Fee-for-Service	1992776041	1992776041	1	1	WATERTOWN REGIONAL MEDICAL	4/3/2015	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER INC	125 HOSPITAL DR	None	WATERTOWN	WI	53098	3303	00	None	43.20015336	-88.69897782	Dodge County
2791	Fee-for-Service	1912941469	1912941469	1	1	WILLIAMS, VIRGIL L MD	4/4/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62613	30	Radiology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
2796	Fee-for-Service	1235298860	1235298860	1	1	WOODWARD, THAD H MD	6/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	54083	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
2851	Fee-for-Service	1033306469	1033306469	1	1	WILLHITE, POLLIE M CRNA	3/29/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
2947	Fee-for-Service	1497914006	1497914006	1	1	WOO, WENDY W MD	4/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110769	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
3072	Fee-for-Service	1548525066	1548525066	1	1	WIDURI, SRIE MD	10/7/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
3102	Fee-for-Service	1730133976	1730133976	1	1	WANG, ANGELA C MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	62974	41	Internal Medicine	0	In state provider	SFGH MEDICAL GROUP	1001 POTRERO AVE	RM 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
3163	Fee-for-Service	1831387760	1831387760	1	1	WILLIAM, ANGELA H CRNA	7/5/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
3199	Fee-for-Service	1821083965	1821083965	1	1	WIEMANN, LINDY ANN	5/2/2004	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	OMNI MEDICAL	9272 JERONIMO RD	STE 120	IRVINE	CA	92618	1914	30	06059	33.6518409	-117.7208414	Orange County
3292	Fee-for-Service	1740623008	1740623008	1	1	WATERMAN, BENJAMIN A MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136262	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
3331	Fee-for-Service	1437513066	1437513066	1	1	WILTSHIRE, CHRISTINA H MD	8/2/2023	207P00000X	NA	Other	026	PHYSICIANS	184884	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
3424	Fee-for-Service	1619179033	1619179033	1	1	WOLPE, ALLAN MD	8/4/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	45800	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
3455	Fee-for-Service	1942521232	1942521232	1	1	WONG, DEVIN S MD	12/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127431	40	Pediatrics	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
3463	Fee-for-Service	1619981743	1619981743	1	1	WASHKE, DEBBIE L MD	6/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86811	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
3479	Fee-for-Service	1629152202	1629152202	1	1	WHITEMAN, CHARLES MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 STADIUM DR	None	MORGANTOWN	WV	26506	7911	00	None	39.65345878	-79.95562791	Monongalia County
3503	Fee-for-Service	1699430678	1699430678	1	1	WILSON, ABIGAIL L CRNA	3/28/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
3532	Fee-for-Service	1164437406	1164437406	1	1	WALGREENS MAIL SERVICE LLC	8/13/2020	3336M0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	3397	8350 S RIVER PKWY	None	TEMPE	AZ	85284	2615	00	None	33.34068	-111.8990835	Maricopa County
3556	Fee-for-Service	1699807792	1699807792	1	1	WALL, JACQUELYN L V MD	11/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	65045	41	Internal Medicine	0	In state provider	None	3460 KATELLA AVENUE	None	LOS ALAMITOS	CA	90720	2334	30	06059	33.8029707	-118.073517	Orange County
3581	Fee-for-Service	1104832807	1104832807	1	1	WALGREEN CO	8/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17051 BEAR VALLEY RD	None	HESPERIA	CA	92345	1845	36	06071	34.47090265	-117.2915472	San Bernardino County
3588	Fee-for-Service	1558737981	1558737981	1	1	WAHEED ABDUL	8/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3269 N STOCKTON HILL RD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
3665	Fee-for-Service	1336371665	1336371665	1	1	WU, STEFANIE S MD	3/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108947	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
3708	Fee-for-Service	1629043609	1629043609	1	1	WILSON, KEITH A LCSW	6/1/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
3792	Fee-for-Service	1396884789	1396884789	1	1	WOLF-BLOOM, MICHELLE S PHD	10/16/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
3801	Fee-for-Service	1568950533	1568950533	1	1	WOLLSTEIN, ADI MD	9/30/2024	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
3804	Fee-for-Service	1700841707	1700841707	1	1	WHITLEY, CAREEN R MD	4/12/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53303	08	Family Practice	0	In state provider	None	3100 TELEGRAPH AVE	FL 4	OAKLAND	CA	94609	3210	01	06001	37.82037533	-122.2667839	Alameda County
3813	Fee-for-Service	1336219831	1336219831	1	1	WOOD, PATRICK C CRNA	3/1/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	481 PLUMAS BLVD	SUITE 104	YUBA CITY	CA	95991	5075	51	06101	39.13306148	-121.6140103	Sutter County
3903	Fee-for-Service	1275822041	1275822041	1	1	WEBB, CAISEY M NP	1/24/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3451 W CENTURY BLVD	STE B-3	INGLEWOOD	CA	90303	1218	19	06037	33.948198	-118.3321575	Los Angeles County
4002	Fee-for-Service	1063049195	1063049195	1	1	WANG, ALEXANDER T MD	7/11/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	1450 SAN PABLO ST	STE 2505	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
4092	Fee-for-Service	1780771162	1780771162	1	1	WONG, MICHAEL A MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62105	07	Dermatology	0	In state provider	14-C	24953 PASEO DE VALENCIA	None	LAGUNA HILLS	CA	92653	4342	30	06059	33.60028568	-117.7010887	Orange County
4133	Fee-for-Service	1093123663	1093123663	1	1	WEI, KATHY S T LCSW	10/10/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
4145	Fee-for-Service	1457845539	1457845539	1	1	WINKLER, MEGAN J LPCC	12/6/2023	106H00000X	NA	Mental Health Outpatient Services	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
4147	Fee-for-Service	1578604237	1578604237	1	1	WOLLASTON, SHARON M MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64194	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
4191	Fee-for-Service	1316014392	1316014392	1	1	WONG, KONG D MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31644	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	15203 11TH ST	STE B	VICTORVILLE	CA	92395	3737	36	06071	34.52758919	-117.2925085	San Bernardino County
4209	Fee-for-Service	1588644355	1588644355	1	1	WILLIAM B. LUJAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	WESTERN NEUROSURGERY	350 N WILMOT DRIVE	None	TUCSON	AZ	85711	0000	00	None	32.227209	-110.8556595	Pima County
4228	Fee-for-Service	1356157614	1356157614	2	1	WINGERT, KATHARINE BIRTH DO	2/6/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
4277	Fee-for-Service	1437415957	1437415957	1	1	WOO, VICTORIA G MD	1/28/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	128309	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	611 S MILPITAS BLVD	None	MILPITAS	CA	95035	5473	43	06085	37.4246225	-121.8944566	Santa Clara County
4281	Fee-for-Service	1811909732	1811909732	1	1	WALI, DEVDAS MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78108	02	General Surgery	0	In state provider	None	1510 SAN PABLO ST	STE 514	LOS ANGELES	CA	90033	5324	19	06037	34.06287152	-118.2029433	Los Angeles County
4289	Fee-for-Service	1063419018	1063419018	1	1	WALTER KNOX MEMORIAL	8/28/2006	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1202 E LOCUST ST	None	EMMETT	ID	83617	2715	00	None	43.87907751	-116.4848985	Gem County
4319	Fee-for-Service	1235305889	1235305889	1	1	WALLACE, CYNTHIA K MD	8/13/2021	207R00000X	NA	Other	026	PHYSICIANS	139714	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
4357	Fee-for-Service	1962840363	1962840363	1	1	WINTER, MEREDITH C MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143636	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
4371	Fee-for-Service	1386913754	1386913754	1	1	WATONSI, EMILIENNE Y NP	7/14/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
4388	Fee-for-Service	1720048291	1720048291	1	1	WANG, JOHN W MD	6/5/2018	207R00000X	NA	Other	026	PHYSICIANS	73379	41	Internal Medicine	0	In state provider	None	10110 ADAMS AVE	None	HUNTINGTON BEACH	CA	92646	4907	30	06059	33.670539	-117.9521865	Orange County
4394	Fee-for-Service	1508575200	1508575200	1	1	WINER, JULIANNA BIRTH DOULA	3/6/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
4407	Fee-for-Service	1780770602	1780770602	1	1	WONG, STEVEN L DC	1/1/1985	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1821 W MEADOW AVE	STE A2	VISALIA	CA	93277	2247	54	06107	36.321624	-119.312991	Tulare County
4413	Fee-for-Service	1033411020	1033411020	1	1	WILKERSON, JESSICA D LMFT	6/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 HUMBOLDT RD	SUITE 3	CHICO	CA	95928	9196	04	06007	39.73660489	-121.8115227	Butte County
4417	Fee-for-Service	1316441934	1316441934	1	1	WINTERSTEIN, NICOLE OT	3/23/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5870 EL CAMINO REAL	100	CARLSBAD	CA	92008	8816	37	06073	33.13309467	-117.2697522	San Diego County
4422	Fee-for-Service	1972968758	1972968758	1	1	WANG, RYAN	9/25/2024	207L00000X	NA	Other	026	PHYSICIANS	178435	05	Anesthesiology	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
4468	Fee-for-Service	1245457712	1245457712	1	1	WU, MARK W MD	2/22/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	90198	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
4479	Fee-for-Service	1588697296	1588697296	1	1	WEST BOCA MED CTR INC	2/20/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	21644 STATE ROAD 7	None	WEST BOCA RATON	FL	33428	1842	00	None	26.35605	-80.199297	Palm Beach County
4523	Fee-for-Service	1700945292	1700945292	1	1	WALSH, CYNTHIA C	3/18/2013	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
4527	Fee-for-Service	1033605084	1033605084	1	1	WAGONER, MARJORIE E PT	7/5/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1350 41ST AVE STE 100	None	CAPITOLA	CA	95010	3934	44	06087	36.970515	-121.9648325	Santa Cruz County
4546	Fee-for-Service	1639567605	1639567605	1	1	WELLNESSRX PHARMACY	5/22/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	5971 UNIVERSITY AVE	STE 304	SAN DIEGO	CA	92115	6348	37	06073	32.75140282	-117.068199	San Diego County
4556	Fee-for-Service	1255692455	1255692455	1	2	WESTSIDE INFANT-FAMILY NETWO	2/18/2025	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	RK	5601 W SLAUSON AVENUE	SUITE 220	CULVER CITY	CA	90230	6648	19	06037	33.98900447	-118.37979	Los Angeles County
4575	Fee-for-Service	1063419018	1063419018	1	1	WALTER KNOX MEMORIAL	8/10/2008	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1202 E LOCUST ST	None	EMMETT	ID	83617	2715	00	None	43.87907751	-116.4848985	Gem County
4594	Fee-for-Service	1710210737	1710210737	1	1	WALGREEN CO	5/18/2010	332B00000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3001 FOOTHILL BLVD	None	LA CRESCENTA	CA	91214	2714	19	06037	34.22747229	-118.2452305	Los Angeles County
4606	Fee-for-Service	1164449393	1164449393	1	1	WAL-MART STORES INC	10/6/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 105457	777 STORY RD	None	SAN JOSE	CA	95122	2628	43	06085	37.330992	-121.8604545	Santa Clara County
4631	Fee-for-Service	1306396361	1306396361	1	1	WILMARTH, MELISSA L CNM	5/23/2022	207V00000X	NA	Obstetrics & Gynecology	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
4632	Fee-for-Service	1679916480	1679916480	1	1	WENGER, LINDSAY M MD	9/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	537 SW UNION AVE	None	GRANTS PASS	OR	97527	5543	00	None	42.42237366	-123.3423317	Josephine County
4639	Fee-for-Service	1164459533	1164459533	1	1	WARREN, JAMES P MD	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	31265	30	Radiology	0	In state provider	None	1770 N ORANGE GROVE AVE	None	POMONA	CA	91767	3027	19	06037	34.07637624	-117.7492622	Los Angeles County
4642	Fee-for-Service	1174020689	1174020689	1	1	WARD, MICHAEL F DO	7/11/2022	261QS0132X	NA	Other	026	PHYSICIANS	19894	None	None	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
4656	Fee-for-Service	1639360076	1639360076	1	1	WU, SARAH T	7/8/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
4691	Fee-for-Service	1851513469	1851513469	1	5	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	10544 SPENCEVILLE ROAD	None	PENN VALLEY	CA	95946	9623	29	06057	39.19618415	-121.1776527	Nevada County
4716	Fee-for-Service	1255435483	1255435483	1	1	WONG, DAVID C MD	2/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	71313	41	Internal Medicine	0	In state provider	None	625 LINCOLN AVENUE	None	SAN JOSE	CA	95126	3705	43	06085	37.31809479	-121.9082315	Santa Clara County
4752	Fee-for-Service	1811989973	1811989973	1	1	WINGATE, KURT T PT	5/15/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1201 23RD ST	None	BAKERSFIELD	CA	93301	2306	15	06029	35.38001554	-119.015649	Kern County
4758	Fee-for-Service	1992043905	1992043905	1	1	WILLEMSEN, COLIN M	3/26/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	SUITE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
4763	Fee-for-Service	1588697296	1588697296	1	1	WEST BOCA MED CTR INC	2/20/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	21644 STATE ROAD 7	None	WEST BOCA RATON	FL	33428	1842	00	None	26.35605	-80.199297	Palm Beach County
4770	Fee-for-Service	1649677402	1649677402	1	1	WINANS, SARI NP	1/14/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1315 S MILLER ST	STE 101	SANTA MARIA	CA	93454	6910	42	06083	34.93799144	-120.4316337	Santa Barbara County
4779	Fee-for-Service	1033287529	1033287529	1	1	WIDDER, DONALD J MD	3/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55185	30	Radiology	0	In state provider	None	401 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4227	42	06083	34.42940104	-119.7230763	Santa Barbara County
4842	Fee-for-Service	1124105085	1124105085	1	1	WULFF, KENNETH R MD	6/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	32683	36	Psychiatry	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
4852	Fee-for-Service	1124157680	1124157680	1	1	WEATHERBY, PAULA LCSW	12/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
4906	Fee-for-Service	1104316413	1104316413	1	1	WEST SACRAMENTO NURSING AND	7/17/2020	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION CENTER	751 ELM STREET	None	WEST SACRAMENTO	CA	95605	1623	57	06113	38.59049543	-121.5426545	Yolo County
4953	Fee-for-Service	1659703171	1659703171	1	1	WALLACH, ERICA	4/2/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PARKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
4978	Fee-for-Service	1104989573	1104989573	1	1	WELLING, NANCY L CRNA	3/18/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
4981	Fee-for-Service	1851513469	1851513469	1	5	WESTERN SIERRA MED CLINIC	9/26/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	10544 SPENCEVILLE ROAD	None	PENN VALLEY	CA	95946	9623	29	06057	39.19618415	-121.1776527	Nevada County
5011	Fee-for-Service	1902926850	1902926850	1	1	WALDRON, JAMES S MD	8/20/2009	207T00000X	NA	General Surgery	026	PHYSICIANS	87383	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
5031	Fee-for-Service	1851513469	1851513469	1	4	WESTERN SIERRA MED CLINIC	9/26/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3111 PROFESSIONAL DRIVE	None	AUBURN	CA	95603	2456	31	06061	38.940327	-121.1007585	Placer County
5076	Fee-for-Service	1669479614	1669479614	1	1	WANG, SIJIAN MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69749	22	Pathology (M.D. only)	0	In state provider	None	200 NORTH ROBERTSON	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
5078	Fee-for-Service	1861443731	1861443731	1	1	WOLTERS, PAUL J MD	6/1/1998	207RP1001X	NA	Pulmonology	026	PHYSICIANS	81179	41	Internal Medicine	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
5117	Fee-for-Service	1275577504	1275577504	1	1	WEDEEN, GLENN P MD	11/16/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	75574	None	None	0	In state provider	None	330 LEWIS ST	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
5140	Fee-for-Service	1881809218	1881809218	1	1	WOMACK BATZDORF, STACY L	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76108	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
5207	Fee-for-Service	1932538394	1932538394	1	1	WOODSOME, MICHAEL E NP	5/30/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
5242	Fee-for-Service	1639307895	1639307895	1	1	WILLIAMS, SHANICKA N DO MD	11/8/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	144347	01	General Practice	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	19	06037	34.28200485	-118.4030797	Los Angeles County
5260	Fee-for-Service	1770085318	1770085318	1	1	WU, TIFFANY PT	2/28/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12865 POINTE DEL MAR WAY	190	DEL MAR	CA	92014	3860	37	06073	32.93310886	-117.2428542	San Diego County
5264	Fee-for-Service	1043506413	1043506413	1	1	WALKER, JAMES E MD	7/31/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	168097	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
5271	Fee-for-Service	1851513469	1851513469	1	5	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	10544 SPENCEVILLE ROAD	None	PENN VALLEY	CA	95946	9623	29	06057	39.19618415	-121.1776527	Nevada County
5321	Fee-for-Service	1851513469	1851513469	1	4	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3111 PROFESSIONAL DRIVE	None	AUBURN	CA	95603	2456	31	06061	38.940327	-121.1007585	Placer County
5324	Fee-for-Service	1437205085	1437205085	1	1	WHITESIDE, MEREDITH M OD	10/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
5356	Fee-for-Service	1760672919	1760672919	1	1	WILSON B ALTMEYER, MD	6/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4493	00	None	29.508012	-98.578683	Bexar County
5406	Fee-for-Service	1922115609	1922115609	1	1	WILLIAMS, KORWYN L MD	10/1/2021	2084N0402X	NA	Neurology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
5414	Fee-for-Service	1972205144	1972205144	1	1	WONG, FUN W NP	4/10/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1760 TERMINO AVE	100	LONG BEACH	CA	90804	2182	19	06037	33.78889871	-118.1458784	Los Angeles County
5475	Fee-for-Service	1407873821	1407873821	1	1	WAL-MART STORES, INC	12/7/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102401	1600 MOUNTAIN AVE	None	DUARTE	CA	91010	2757	19	06037	34.134165	-117.98397	Los Angeles County
5505	Fee-for-Service	1063761740	1063761740	1	1	WIN, ZIN M MD	9/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134590	41	Internal Medicine	0	In state provider	None	43112 15 ST W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
5563	Fee-for-Service	1184676595	1184676595	1	2	WELLSCRIPT, INC.	1/17/2024	3336S0011X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2025 COURT ST	STE D	REDDING	CA	96001	1805	45	06089	40.57812322	-122.3935669	Shasta County
5598	Fee-for-Service	1164197000	1164197000	1	1	WHOLESOME ELDERLY CARE HOMES	9/16/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6024 KIFISIA WAY	None	FAIR OAKS	CA	95628	2520	34	06067	38.675907	-121.2571665	Sacramento County
5609	Fee-for-Service	1851513469	1851513469	1	4	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3111 PROFESSIONAL DRIVE	None	AUBURN	CA	95603	2456	31	06061	38.940327	-121.1007585	Placer County
5670	Fee-for-Service	1609069830	1609069830	1	1	WOESNER, RANDALL E MD	7/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	44111	18	Ophthalmology	0	In state provider	INC	248 HOSPITAL DR	STE A	UKIAH	CA	95482	4555	23	06045	39.15280713	-123.2037723	Mendocino County
5676	Fee-for-Service	1093886178	1093886178	1	1	WILSON, CHRISOPHER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	21601 76TH AVE W	None	EDMONDS	WA	98026	7507	00	None	47.803239	-122.335652	Snohomish County
5706	Fee-for-Service	1205367794	1205367794	1	1	WEINGARDEN, ALEXA R MD	6/12/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	156996	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
5716	Fee-for-Service	1881985612	1881985612	1	1	WONG, CHRISTOPHER C D DO	8/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	12470	45	Nephrology (Renal-Kidney)	0	In state provider	None	1335 CYPRESS ST	STE 205	SAN DIMAS	CA	91773	3538	19	06037	34.09583252	-117.834134	Los Angeles County
5767	Fee-for-Service	1417681040	1417681040	1	1	WHITE, MADELINE R CCC-SLP	10/14/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	25467 MEDICAL CENTER DR	100	MURRIETA	CA	92562	1501	33	06065	33.55711632	-117.1860368	Riverside County
5782	Fee-for-Service	1457500738	1457500738	1	1	WONG, JUDITH M MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130110	14	Neurological Surgery	0	In state provider	None	2888 LONG BEACH BLVD	STE 240	LONG BEACH	CA	90806	1570	19	06037	33.809706	-118.189343	Los Angeles County
5819	Fee-for-Service	1851499727	1851499727	2	1	WHEELER, GUY L MD	4/17/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	102150	30	Radiology	0	In state provider	None	1101 VAN NESS AVE	3RD FLOOR	SAN FRANCISCO	CA	94109	6919	38	06075	37.78610439	-122.421569	San Francisco County
5821	Fee-for-Service	1811175110	1811175110	1	1	WESTERN HEALTH RESOURCES	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	100 SAN HEDRIN CIRCLE	None	WILLITS	CA	95490	8753	23	06045	39.390957	-123.3361455	Mendocino County
5895	Fee-for-Service	1124244223	1124244223	1	1	WHITE, KAREN B MD	12/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103949	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	877 W FREMONT AVE	BLDG N	SUNNYVALE	CA	94087	2319	43	06085	37.35226149	-122.049297	Santa Clara County
5983	Fee-for-Service	1942300504	1942300504	1	1	WILEY, MARY C PSYD	5/18/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
6045	Fee-for-Service	1386608230	1386608230	1	1	WINOKUR, ROBERT H MD	4/30/1982	207P00000X	NA	Other	026	PHYSICIANS	48741	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3100 S SUSANA RD	None	COMPTON	CA	90221	5418	19	06037	33.87386619	-118.2070981	Los Angeles County
6073	Fee-for-Service	1538504295	1538504295	1	1	WAYNE, RICHARD D LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	SUITE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
6110	Fee-for-Service	1811175110	1811175110	1	1	WESTERN HEALTH RESOURCES	1/1/2008	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	100 SAN HEDRIN CIRCLE	None	WILLITS	CA	95490	8753	23	06045	39.390957	-123.3361455	Mendocino County
6129	Fee-for-Service	1497718415	1497718415	1	1	WEINSTEIN, LAWRENCE S MD	8/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98278	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
6133	Fee-for-Service	1265437644	1265437644	2	1	WEST JEFFERSON HOLDINGS, LLC	8/18/2023	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	R	1101 MEDICAL CENTER BLVD	None	MARRERO	LA	70072	3147	00	None	29.89168678	-90.09584835	Jefferson Parish
6157	Fee-for-Service	1861642183	1861642183	1	1	WHITE, WANDA S LCSW	5/26/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
6165	Fee-for-Service	1033473913	1033473913	1	1	WESTAFER, MICHAEL D MD	2/24/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	-	None	None	1	Border provider	None	3475 GS RICHARDS BLVD ST	None	CARSON CITY	NV	89703	8462	00	None	39.190617	-119.776275	Consolidated Municipality of Carson City
6291	Fee-for-Service	1598746950	1598746950	1	1	WINGET, LEI H MD	11/18/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	90467	08	Family Practice	0	In state provider	None	2885 HARRIS ST	None	EUREKA	CA	95503	4808	12	06023	40.78053262	-124.1353699	Humboldt County
6328	Fee-for-Service	1750542338	1750542338	1	1	WU, FRANK MC DO	12/9/2009	207R00000X	NA	Other	026	PHYSICIANS	10464	41	Internal Medicine	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	8589	30	06059	33.62421676	-117.9309656	Orange County
6349	Fee-for-Service	1255419982	1255419982	1	1	WINTERS, TODD J MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74205	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
6359	Fee-for-Service	1083046247	1083046247	1	1	WELLBOUND OF MOUNTAIN VIEW	6/19/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	247 WEST EL CAMINO REAL	SUITE 200	MOUNTAIN VIEW	CA	94040	2605	43	06085	37.3830969	-122.0787871	Santa Clara County
6372	Fee-for-Service	1770128373	1770128373	1	1	WEST, LAURA E NP	1/1/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
6405	Fee-for-Service	1245887660	1245887660	1	1	WAHGA, VIMALJIT K NP	12/13/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	481 PLUMAS BLVD	SUITE 104	YUBA CITY	CA	95991	5075	51	06101	39.13306148	-121.6140103	Sutter County
6422	Fee-for-Service	1265437644	1265437644	2	1	WEST JEFFERSON HOLDINGS, LLC	8/18/2023	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	R	1101 MEDICAL CENTER BLVD	None	MARRERO	LA	70072	3147	00	None	29.89168678	-90.09584835	Jefferson Parish
6460	Fee-for-Service	1588780373	1588780373	1	1	WILLARD, GARY MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34995	08	Family Practice	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
6480	Fee-for-Service	1942229604	1942229604	1	1	WELLS, WINFIELD J MD	1/1/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	31277	33	Thoracic Surgery	0	In state provider	None	4650 SUNSET BLVD	MS 66	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
6515	Fee-for-Service	1295269264	1295269264	1	1	WALTON, NICOLAS A DO	6/1/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16928	08	Family Practice	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
6533	Fee-for-Service	1417032640	1417032640	1	1	WATKINS, JEAN M PSYD	5/15/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
6566	Fee-for-Service	1992047369	1992047369	1	1	WILCOCK, JACIE M LMFT	6/1/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
6593	Fee-for-Service	1710046313	1710046313	1	1	WELLES, CAROL A MD	1/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	65700	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
6628	Fee-for-Service	1346218625	1346218625	1	1	WIRGA, MARIUSZ MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74487	36	Psychiatry	0	In state provider	None	4510 E PACIFIC COAST HWY	STE 120	LONG BEACH	CA	90804	6939	19	06037	33.78815204	-118.1400821	Los Angeles County
6653	Fee-for-Service	1659870939	1659870939	1	1	WALL, TIMOTHY	6/20/2023	207R00000X	NA	Other	026	PHYSICIANS	182748	None	None	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
6695	Fee-for-Service	1386716033	1386716033	1	1	WOLL, LISA A MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	60472	41	Internal Medicine	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
6711	Fee-for-Service	1851513469	1851513469	1	10	WESTERN SIERRA MED CLINIC	10/31/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	11720 EDUCATION ST	STE 3	AUBURN	CA	95602	2419	31	06061	38.94437237	-121.1019188	Placer County
6751	Fee-for-Service	1265156756	1265156756	1	1	WARD, ALEXANDRIA LPCC	10/9/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4221 WILSHIRE BLVD	STE 230	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
6768	Fee-for-Service	1942229604	1942229604	1	1	WELLS, WINFIELD J MD	1/1/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	31277	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4650 SUNSET BLVD	MS 66	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
6777	Fee-for-Service	1194986125	1194986125	1	1	WU, KIMBERLY C	10/18/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3772 HOWE ST	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
6778	Fee-for-Service	1053637520	1053637520	1	1	WELSH, SARA L LMFT	5/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
6790	Fee-for-Service	1780627257	1780627257	1	1	WILLIAM,CONWAY F MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	171 ASHLEY AVENUE	None	CHARLESTON	SC	29425	0001	00	None	32.78556	-79.9467075	Charleston County
6849	Fee-for-Service	1356344758	1356344758	1	2	WEST COUNTY HEALTH CENTERS	5/3/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	14630 ARMSTRONG WOODS RD	None	GUERNEVILLE	CA	95446	9576	49	06097	38.51092405	-122.9954993	Sonoma County
6903	Fee-for-Service	1710067061	1710067061	1	1	WIGDER, MATTHEW W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6621 FANNIN ST	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
6905	Fee-for-Service	1265505291	1265505291	1	1	WEBER, ROBERT W MD	9/30/1992	207RH0003X	NA	Oncology	026	PHYSICIANS	72551	41	Internal Medicine	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
6925	Fee-for-Service	1477613644	1477613644	1	1	WANG, EDWARD C C MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	59717	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
6932	Fee-for-Service	1891952545	1891952545	1	1	WOLFE, VALERIE M MD	4/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134897	20	Orthopedic Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
6937	Fee-for-Service	1114279304	1114279304	1	1	WEBB, KATHLEEN A	6/22/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
6942	Fee-for-Service	1811072861	1811072861	1	1	WONG, GORDON A MD	10/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	22027	77	Infectious Disease	0	In state provider	None	3941 J ST	STE 354	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
6967	Fee-for-Service	1578597506	1578597506	1	1	WARSHAWSKY, ARTHUR B MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32686	34	Urology and Urological Surgery	0	In state provider	None	3231 WARING CT	STE B	OCEANSIDE	CA	92056	4520	37	06073	33.18776771	-117.2893136	San Diego County
6996	Fee-for-Service	1851513469	1851513469	1	10	WESTERN SIERRA MED CLINIC	10/31/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	11720 EDUCATION ST	STE 3	AUBURN	CA	95602	2419	31	06061	38.94437237	-121.1019188	Placer County
7032	Fee-for-Service	1366718587	1366718587	1	1	WALGREEN CO	7/16/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11000 VENTURA BLVD	None	STUDIO CITY	CA	91604	3546	19	06037	34.14047342	-118.3703398	Los Angeles County
7053	Fee-for-Service	1851513469	1851513469	1	2	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8665 SALMON AVENUE	None	KINGS BEACH	CA	96143	9800	31	06061	39.23616552	-120.021381	Placer County
7057	Fee-for-Service	1538104385	1538104385	1	1	WILDE, ASHLEY P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79378	05	Anesthesiology	0	In state provider	None	9542 ARTESIA BLVD	None	BELLFLOWER	CA	90706	6511	19	06037	33.87472553	-118.1294775	Los Angeles County
7117	Fee-for-Service	1013265081	1013265081	1	1	WAL-MART STORES, INC	12/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	575 SATURN BLVD	None	SAN DIEGO	CA	92154	4731	37	06073	32.586966	-117.08928	San Diego County
7120	Fee-for-Service	1023561081	1023561081	1	1	WRIGHTSCOTT, BONITA M	3/2/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	30520	-	NOT APPLICABLE	0	In state provider	None	14100 GLENGYLE ST	None	WHITTIER	CA	90604	2434	19	06037	33.93799562	-118.0338598	Los Angeles County
7125	Fee-for-Service	1356344758	1356344758	1	5	WEST COUNTY HEALTH CENTERS	8/29/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	445 TAFT STREET	None	SEBASTOPOL	CA	95472	3443	49	06097	38.40603363	-122.8239451	Sonoma County
7137	Fee-for-Service	1356344758	1356344758	1	2	WEST COUNTY HEALTH CENTERS	5/3/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	14630 ARMSTRONG WOODS RD	None	GUERNEVILLE	CA	95446	9576	49	06097	38.51092405	-122.9954993	Sonoma County
7141	Fee-for-Service	1225302300	1225302300	1	1	WANG, JENESSY L NP	5/30/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	350 COLE RANCH RD	None	ENCINITAS	CA	92024	6416	37	06073	33.04247098	-117.2344786	San Diego County
7160	Fee-for-Service	1740919414	1740919414	1	1	WELDON, SUSAN L NP	6/17/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
7181	Fee-for-Service	1033125299	1033125299	1	1	WILSON, JACK M MD	6/30/1984	207P00000X	NA	Other	026	PHYSICIANS	49906	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4747 ENGLE RD	None	CARMICHAEL	CA	95608	2223	34	06067	38.6320173	-121.3545928	Sacramento County
7193	Fee-for-Service	1265505291	1265505291	1	1	WEBER, ROBERT W MD	9/30/1992	207RH0003X	NA	Oncology	026	PHYSICIANS	72551	78	Neoplastic Diseases/Oncology	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
7210	Fee-for-Service	1477613644	1477613644	1	1	WANG, EDWARD C C MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	59717	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
7218	Fee-for-Service	1891952545	1891952545	1	1	WOLFE, VALERIE M MD	4/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134897	46	Hand Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
7229	Fee-for-Service	1811072861	1811072861	1	1	WONG, GORDON A MD	10/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	22027	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3941 J ST	STE 354	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
7257	Fee-for-Service	1013478973	1013478973	1	1	WEST COAST CONGREGATE INC	7/30/2020	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14905 SANDRA ST	None	MISSION HILLS	CA	91345	1614	19	06037	34.27072985	-118.4570489	Los Angeles County
7283	Fee-for-Service	1184744641	1184744641	1	1	WADA OPTOMETRY, INC.	1/25/2005	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	936 S BROOKHURST ST	None	ANAHEIM	CA	92804	4305	30	06059	33.819075	-117.9589105	Orange County
7291	Fee-for-Service	1013077569	1013077569	1	1	WINIKOFF, JANET MD	2/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	44560	08	Family Practice	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
7297	Fee-for-Service	1245318880	1245318880	1	1	WANG, SPENCER H MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85041	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
7341	Fee-for-Service	1851513469	1851513469	1	2	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8665 SALMON AVENUE	None	KINGS BEACH	CA	96143	9800	31	06061	39.23616552	-120.021381	Placer County
7349	Fee-for-Service	1659904365	1659904365	1	1	WATSON, REGAN CNM	9/20/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
7378	Fee-for-Service	1700375656	1700375656	1	1	WU, TIMOTHY Y MD	12/7/2021	207R00000X	NA	Other	026	PHYSICIANS	174044	None	None	0	In state provider	None	9525 MONTE VISTA AVE	STE 105	MONTCLAIR	CA	91763	2231	36	06071	34.080777	-117.698234	San Bernardino County
7411	Fee-for-Service	1356344758	1356344758	1	5	WEST COUNTY HEALTH CENTERS	8/29/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	445 TAFT STREET	None	SEBASTOPOL	CA	95472	3443	49	06097	38.40603363	-122.8239451	Sonoma County
7482	Fee-for-Service	1265505291	1265505291	1	1	WEBER, ROBERT W MD	9/30/1992	207RH0003X	NA	Oncology	026	PHYSICIANS	72551	01	General Practice	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
7492	Fee-for-Service	1073846028	1073846028	1	1	WASHINGTON, JAMES A III MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110072	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
7530	Fee-for-Service	1053513473	1053513473	1	1	WAN, DERRICK C MD	7/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83768	24	Plastic Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
7544	Fee-for-Service	1659594851	1659594851	1	1	WESTCARE CALIFORNIA, INC.	9/30/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2909 S H ST	None	BAKERSFIELD	CA	93304	5602	15	06029	35.328462	-119.0213982	Kern County
7580	Fee-for-Service	1013077569	1013077569	1	1	WINIKOFF, JANET MD	2/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	44560	41	Internal Medicine	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
7585	Fee-for-Service	1518989805	1518989805	1	1	WALKER, STEPHEN C MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34927	66	Emergency Medicine (Urgent Care)	0	In state provider	None	337 EL DORADO ST	None	MONTEREY	CA	93940	4647	27	06053	36.59183357	-121.8924432	Monterey County
7589	Fee-for-Service	1851513469	1851513469	1	11	WESTERN SIERRA MED CLINIC	1/22/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	150 GLASSON WAY	None	GRASS VALLEY	CA	95945	5706	29	06057	39.22882551	-121.0470962	Nevada County
7595	Fee-for-Service	1750604583	1750604583	1	1	WALTHALL, JOHANNA C PHD	12/24/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3330 CENTRE LAKE DR	None	ONTARIO	CA	91761	1211	36	06071	34.066737	-117.581175	San Bernardino County
7608	Fee-for-Service	1720191315	1720191315	1	1	WOLFE, MICHELLE G MD	4/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	77816	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
7611	Fee-for-Service	1497965677	1497965677	1	1	WUNNAVA, BHANU P MD	1/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117871	08	Family Practice	0	In state provider	None	3800 DALE RD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
7674	Fee-for-Service	1124443122	1124443122	1	1	WIGGINS, LUKE M MD	8/4/2020	208G00000X	NA	General Surgery	026	PHYSICIANS	128044	33	Thoracic Surgery	0	In state provider	None	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
7693	Fee-for-Service	1427031558	1427031558	1	1	WHITEMAN, PAULA J MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67147	08	Family Practice	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
7740	Fee-for-Service	1568557130	1568557130	1	1	WESVAL ENTERPRISES INC	1/1/1979	No Taxonomy Provided	NA	None	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	WESVAL ENTERPRISES INC	3714 LONE TREE WAY	None	ANTIOCH	CA	94509	6018	07	06013	37.984185	-121.805878	Contra Costa County
7750	Fee-for-Service	1992774301	1992774301	1	1	WONG, SHARON W MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	73771	41	Internal Medicine	0	In state provider	None	1721 W YOSEMITE AVENUE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
7751	Fee-for-Service	1407384308	1407384308	1	1	WISZNIA, SACHA B LCSW	11/18/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
7758	Fee-for-Service	1225105190	1225105190	1	1	WOO, PAULINE MD	10/31/1994	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	75495	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
7759	Fee-for-Service	1427117720	1427117720	1	1	WANG, MICHAEL PING MD	4/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64934	30	Radiology	0	In state provider	None	1111 W LA PALMA AVE	None	ANAHEIM	CA	92801	2804	30	06059	33.84718298	-117.933758	Orange County
7782	Fee-for-Service	1366453086	1366453086	1	1	WOO, HEIDE MD	4/29/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	73173	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
7783	Fee-for-Service	1073846028	1073846028	1	1	WASHINGTON, JAMES A III MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110072	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
7804	Fee-for-Service	1245571405	1245571405	1	1	WONG, VALERIE L	8/7/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	217 W CERRITOS AVENUE	None	ANAHEIM	CA	92805	6549	30	06059	33.81058193	-117.9065445	Orange County
7866	Fee-for-Service	1013077569	1013077569	1	1	WINIKOFF, JANET MD	2/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	44560	67	Endocrinology	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
7875	Fee-for-Service	1518989805	1518989805	1	1	WALKER, STEPHEN C MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34927	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	337 EL DORADO ST	None	MONTEREY	CA	93940	4647	27	06053	36.59183357	-121.8924432	Monterey County
7880	Fee-for-Service	1851513469	1851513469	1	11	WESTERN SIERRA MED CLINIC	1/22/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	150 GLASSON WAY	None	GRASS VALLEY	CA	95945	5706	29	06057	39.22882551	-121.0470962	Nevada County
7938	Fee-for-Service	1396922647	1396922647	1	1	WESTERN WOMENS MEDICAL	1/1/1979	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	CLINIC INC	4361 S WESTERN AVE	None	LOS ANGELES	CA	90062	1651	19	06037	34.004313	-118.308959	Los Angeles County
7981	Fee-for-Service	1427031558	1427031558	1	1	WHITEMAN, PAULA J MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67147	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
8016	Fee-for-Service	1467405753	1467405753	1	1	WILLIAMS, DEREK F MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72933	01	General Practice	0	In state provider	None	1400 S GRAND AVE	None	LOS ANGELES	CA	90015	3048	19	06037	34.03692236	-118.2655238	Los Angeles County
8017	Fee-for-Service	1326045451	1326045451	1	1	WANG, CALVIN Y MD	5/4/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85716	30	Radiology	0	In state provider	None	1640 E ROSEVILLE PKWY	STE 100	ROSEVILLE	CA	95661	3988	31	06061	38.74871046	-121.2407883	Placer County
8068	Fee-for-Service	1649596933	1649596933	1	1	WARD, DEREK T MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119788	20	Orthopedic Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
8104	Fee-for-Service	1275028854	1275028854	1	1	WILKINSON-MAITLAND, NIGEL M	11/15/2023	207L00000X	NA	Other	026	PHYSICIANS	178130	None	None	0	In state provider	D	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
8108	Fee-for-Service	1144214495	1144214495	1	1	WONNACOTT, MATTHEW P MD	5/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	64012	01	General Practice	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
8128	Fee-for-Service	1780699058	1780699058	1	1	WALGREEN CO	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2140 EL CAMINO REAL	None	SANTA CLARA	CA	95050	4052	43	06085	37.35228453	-121.961556	Santa Clara County
8148	Fee-for-Service	1437164449	1437164449	1	1	WALGREEN CO	1/18/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4949 GOSFORD RD	None	BAKERSFIELD	CA	93313	4992	15	06029	35.309754	-119.0922855	Kern County
8179	Fee-for-Service	1861798944	1861798944	1	1	WRIGHT, ZACHARY MD	8/6/2018	207T00000X	NA	General Surgery	026	PHYSICIANS	155607	14	Neurological Surgery	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
8182	Fee-for-Service	1366476640	1366476640	1	1	WILLIAMS, SARAH R MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66325	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
8186	Fee-for-Service	1669492021	1669492021	1	1	WONG, ERIC HC MD	5/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80117	40	Pediatrics	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
8251	Fee-for-Service	1700083516	1700083516	1	1	WU, ILLIE I MD	5/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107732	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
8340	Fee-for-Service	1548395437	1548395437	1	1	WIVIOTT, LORY D MD	6/11/1998	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	55743	36	Psychiatry	0	In state provider	None	2200 WEBSTER ST	STE 613	SAN FRANCISCO	CA	94115	1821	38	06075	37.79119596	-122.4325986	San Francisco County
8343	Fee-for-Service	1497312821	1497312821	1	1	WHEELER, TYLER S MD	1/2/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	177313	None	None	0	In state provider	None	375 LAGUNA HONDA	None	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
8359	Fee-for-Service	1982990057	1982990057	1	1	WAGNER, LILLY H MD	6/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142763	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
8378	Fee-for-Service	1760972491	1760972491	1	1	WESSELMAN, JILLIAN A CNP	1/3/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
8422	Fee-for-Service	1255535647	1255535647	1	1	WEBB, JOHN M MD	7/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100404	30	Radiology	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
8423	Fee-for-Service	1619014800	1619014800	1	1	WANG, TAMMY N MD	1/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89964	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
8449	Fee-for-Service	1477652782	1477652782	1	1	WARM SPRINGS ROAD CVS LLC	11/14/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	3290 S FORT APACHE RD	None	LAS VEGAS	NV	89117	0738	00	None	36.13055348	-115.2970498	Clark County
8533	Fee-for-Service	1508894361	1508894361	1	1	WEBER, HANS E MD	10/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	29825	66	Emergency Medicine (Urgent Care)	0	In state provider	None	340 GOLDEN SHR	STE 100	LONG BEACH	CA	90802	4237	19	06037	33.76405848	-118.1995605	Los Angeles County
8539	Fee-for-Service	1902820087	1902820087	1	1	WANG, TIMOTHY T MD	1/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	46341	18	Ophthalmology	0	In state provider	None	2350 MCKEE RD	STE 2	SAN JOSE	CA	95116	1617	43	06085	37.36631785	-121.848368	Santa Clara County
8562	Fee-for-Service	1205819133	1205819133	1	1	WILLIAMS, JOHN III MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	39794	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8641 WILSHIRE BLVD	STE 200	BEVERLY HILLS	CA	90211	2920	19	06037	34.06614972	-118.3798912	Los Angeles County
8611	Fee-for-Service	1215236682	1215236682	1	1	WONG, MELISA L MD	6/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123306	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
8674	Fee-for-Service	1215009790	1215009790	1	1	WANG, YU MD	4/1/1995	208800000X	NA	Other	026	PHYSICIANS	64274	34	Urology and Urological Surgery	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
8710	Fee-for-Service	1619014800	1619014800	1	1	WANG, TAMMY N MD	1/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89964	40	Pediatrics	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
8721	Fee-for-Service	1528084993	1528084993	1	1	WAHL TALLEY, JUDY LMFT	11/9/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 E SAN MARCOS BLVD	STE 400	SAN MARCOS	CA	92069	2988	37	06073	33.1409605	-117.162486	San Diego County
8762	Fee-for-Service	1851513469	1851513469	1	1	WESTERN SIERRA MED CLINIC	7/1/1994	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	209 NEVADA ST	None	DOWNIEVILLE	CA	95936	0286	46	06091	39.55907195	-120.8295366	Sierra County
8825	Fee-for-Service	1104082098	1104082098	1	1	WONG, MICHAEL H DO	9/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	6336	05	Anesthesiology	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
8847	Fee-for-Service	1184615676	1184615676	1	7	WESTCLIFF MEDICAL LABS	7/17/2008	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	INC	100 N TUSTIN	None	TUSTIN	CA	92780	2908	30	06059	33.74605568	-117.8341498	Orange County
8848	Fee-for-Service	1992805444	1992805444	1	1	WINSTON, ROBERT MD	6/30/1982	2084P0800X	NA	Psychiatry	026	PHYSICIANS	28197	36	Psychiatry	0	In state provider	None	3333 SKYPARK DR	None	TORRANCE	CA	90505	5023	19	06037	33.81036565	-118.3466218	Los Angeles County
8868	Fee-for-Service	1083716153	1083716153	1	1	WYATT, CASI DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
8965	Fee-for-Service	1760826697	1760826697	1	1	WANG, SHUO MD	7/8/2020	390200000X	NA	Other	026	PHYSICIANS	133605	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
9000	Fee-for-Service	1366469504	1366469504	1	1	WAL-MART STORES INC	8/23/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-5072	19503 NORMANDIE AVE	None	TORRANCE	CA	90501	1361	19	06037	33.85708946	-118.2992656	Los Angeles County
9032	Fee-for-Service	1932351657	1932351657	1	1	WHITE, STEPHANIE L DO	8/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10550	08	Family Practice	0	In state provider	None	795 E SECOND ST	STE 5	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
9049	Fee-for-Service	1851513469	1851513469	1	1	WESTERN SIERRA MED CLINIC	9/1/1993	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	209 NEVADA ST	None	DOWNIEVILLE	CA	95936	0286	46	06091	39.55907195	-120.8295366	Sierra County
9052	Fee-for-Service	1417341439	1417341439	1	1	WANG, ALLYSON A MD	10/17/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	160264	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
9067	Fee-for-Service	1336347145	1336347145	1	1	WILLIAMS, JUDITH A LCSW	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2 FIFER AVE	STE 200	CORTE MADERA	CA	94925	1174	21	06041	37.93844293	-122.5188738	Marin County
9091	Fee-for-Service	1770502718	1770502718	1	1	WU, DIANNE E MD SC APC	11/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	79383	24	Plastic Surgery	0	In state provider	None	1048 S GARFIELD AVE	STE 300	ALHAMBRA	CA	91801	4768	19	06037	34.083009	-118.123041	Los Angeles County
9107	Fee-for-Service	1366501181	1366501181	1	1	WILCOX, ANDREA M CNP	5/12/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
9135	Fee-for-Service	1518349414	1518349414	1	1	WILLIAMS, AYANNA NP	8/12/2024	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2373 COLORADO BLVD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
9148	Fee-for-Service	1497872691	1497872691	1	1	WYANT, TAMARA W	5/26/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14500 ROSCOE BLVD	STE 400	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
9206	Fee-for-Service	1700901139	1700901139	1	1	WANG, CHIH-KUAN MD	7/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	92418	40	Pediatrics	0	In state provider	None	16300 SAND CANYON AVE	STE 311	IRVINE	CA	92618	3703	30	06059	33.66115075	-117.7742405	Orange County
9210	Fee-for-Service	1184233546	1184233546	1	1	WHITE ANGELS HOSPICE INC	7/23/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 153	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
9331	Fee-for-Service	1972874501	1972874501	1	1	WEST COAST DIAGNOSTICS LLC	2/28/2013	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	8978 BAINBRIDGE PLACE	None	STOCKTON	CA	95209	4807	39	06077	38.03124892	-121.3556727	San Joaquin County
9337	Fee-for-Service	1851513469	1851513469	1	1	WESTERN SIERRA MED CLINIC	5/4/2000	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	209 NEVADA ST	None	DOWNIEVILLE	CA	95936	0286	46	06091	39.55907195	-120.8295366	Sierra County
9342	Fee-for-Service	1770945883	1770945883	1	1	WESTSIDE PAIN MANAGEMENT, IN	12/13/2019	207LP2900X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	C.	17822 BEACH BLVD	STE 300	HUNTINGTON BEACH	CA	92647	7172	30	06059	33.70331388	-117.9890471	Orange County
9378	Fee-for-Service	1225680150	1225680150	1	1	WOODARD & ASSOCIATES	10/29/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	AL TRANSPORT	1214 S CYPRESS AVE	APT A	ONTARIO	CA	91762	4915	36	06071	34.050906	-117.6643305	San Bernardino County
9389	Fee-for-Service	1053482968	1053482968	1	1	WATANABE, COLIN T MD	7/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78981	41	Internal Medicine	0	In state provider	None	1127 WILSHIRE BLVD	STE 600	LOS ANGELES	CA	90017	3907	19	06037	34.05270508	-118.2641005	Los Angeles County
9403	Fee-for-Service	1841533395	1841533395	1	1	WU, MINHAO MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143047	05	Anesthesiology	0	In state provider	None	7147 N CEDAR AVENUE	None	FRESNO	CA	93720	3637	10	06019	36.84023418	-119.7563052	Fresno County
9413	Fee-for-Service	1053841759	1053841759	1	1	WILSON, FORRELINE CNP	6/12/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2505 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2011	19	06037	34.03287856	-118.4748782	Los Angeles County
9502	Fee-for-Service	1184233546	1184233546	1	1	WHITE ANGELS HOSPICE INC	7/23/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 153	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
9532	Fee-for-Service	1205112786	1205112786	1	1	WHITE MEMORIAL NEONATAL	11/14/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	1720 CESAR E CHAVEZ AVE	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
9541	Fee-for-Service	1750009791	1750009791	1	1	WALLNER, EDWARD A PT	2/10/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3100 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70453535	-121.8586496	Alameda County
9580	Fee-for-Service	1154337525	1154337525	1	1	WALGREEN CO.	1/30/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2690 MISSION ST	None	SAN FRANCISCO	CA	94110	3102	38	06075	37.75405301	-122.4186463	San Francisco County
9625	Fee-for-Service	1851513469	1851513469	1	1	WESTERN SIERRA MED CLINIC	9/1/1993	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	209 NEVADA ST	None	DOWNIEVILLE	CA	95936	0286	46	06091	39.55907195	-120.8295366	Sierra County
9654	Fee-for-Service	1588790273	1588790273	1	1	WEISS, LISA M OD	8/12/2013	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	303 E MAIN ST	None	EL CAJON	CA	92020	3913	37	06073	32.79492548	-116.9584785	San Diego County
9667	Fee-for-Service	1942863030	1942863030	1	1	WELL-MAMAS FAMILY COUNSELING	1/16/2025	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2831 CAMINO DEL RIO SOUT	STE. 206	SAN DIEGO	CA	92108	3827	37	06073	32.77018113	-117.1334016	San Diego County
9675	Fee-for-Service	1821436221	1821436221	1	1	WEINBERG, MIA K LAC	11/27/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3559 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	1763	49	06097	38.47813376	-122.7279674	Sonoma County
9771	Fee-for-Service	1669545786	1669545786	1	1	WHALEN, JON E MED	8/17/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	34379	-	NOT APPLICABLE	0	In state provider	None	2523 EL PORTAL DRIVE	103	SAN PABLO	CA	94806	5599	07	06013	37.96550037	-122.338586	Contra Costa County
9911	Fee-for-Service	1467914440	1467914440	1	1	WALTERS, SOPHIA L NP	3/16/2022	363LN0005X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	726 N MEDICAL CTR DR E	STE 209	CLOVIS	CA	93611	6886	10	06019	36.84186593	-119.6624867	Fresno County
9957	Fee-for-Service	1558447060	1558447060	1	1	WERNER, HARRIET W MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	37393	08	Family Practice	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
9965	Fee-for-Service	1184815334	1184815334	1	1	WONG, ALICE	10/11/2011	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
9979	Fee-for-Service	1265611107	1265611107	1	1	WANG, LYNN MD	3/27/2008	193400000X	NA	Other	026	PHYSICIANS	74029	13	Neurology (M.D. only)	0	In state provider	None	500 N GARFIELD AVE	STE 102	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
9980	Fee-for-Service	1114125283	1114125283	1	1	WARREN, MIKAKO MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135650	22	Pathology (M.D. only)	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
9987	Fee-for-Service	1043800899	1043800899	1	1	WILDEY, DENNEL R CNP	10/1/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4829 CLAIREMONT DR	None	SAN DIEGO	CA	92117	2706	37	06073	32.83175462	-117.2052088	San Diego County
9994	Fee-for-Service	1144272881	1144272881	1	2	WESTERN TUMOR MED GRP	12/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	1338 S HOPE ST	None	LOS ANGELES	CA	90015	2902	19	06037	34.03778533	-118.2667518	Los Angeles County
10020	Fee-for-Service	1386205185	1386205185	1	1	WOMACK, CHRISTINE NP	10/1/2024	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
10043	Fee-for-Service	1710967740	1710967740	1	1	WYNN JOHNSON, MARY CRNA	6/24/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
10048	Fee-for-Service	1356344758	1356344758	1	10	WEST COUNTY HEALTH CENTERS	2/21/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3802 MAIN STREET	None	OCCIDENTAL	CA	95465	0006	49	06097	38.40900707	-122.9476089	Sonoma County
10061	Fee-for-Service	1225146616	1225146616	1	1	WONG, MYRA MD	6/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130621	None	None	0	In state provider	None	9300 VALLEY CHILDRENS P	None	MADERA	CA	93636	8762	20	06039	36.88437894	-119.8003484	Madera County
10062	Fee-for-Service	1104527324	1104527324	1	1	WEISS, MARIYA	4/12/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	20020 HAWTHORNE BLVD	None	TORRANCE	CA	90503	0000	19	06037	33.849909	-118.353614	Los Angeles County
10169	Fee-for-Service	1083146468	1083146468	1	2	WELLMAN, TYLER MD	6/1/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	169735	-	NOT APPLICABLE	0	In state provider	None	376 HARTNELL AVENUE	SUITE A	REDDING	CA	96002	1881	45	06089	40.56518339	-122.3683085	Shasta County
10172	Fee-for-Service	1982601373	1982601373	1	1	WHYTE, RICHARD I MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	84023	33	Thoracic Surgery	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
10225	Fee-for-Service	1790545044	1790545044	2	1	WHOLE FAMILY CARE INC	7/31/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	637 N 13TH AVE	None	UPLAND	CA	91786	4906	36	06071	34.10143961	-117.6337456	San Bernardino County
10269	Fee-for-Service	1265611107	1265611107	1	1	WANG, LYNN MD	3/27/2008	193400000X	NA	Other	026	PHYSICIANS	74029	41	Internal Medicine	0	In state provider	None	500 N GARFIELD AVE	STE 102	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
10284	Fee-for-Service	1144272881	1144272881	1	2	WESTERN TUMOR MED GRP	12/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GROUP INC	1338 S HOPE ST	None	LOS ANGELES	CA	90015	2902	19	06037	34.03778533	-118.2667518	Los Angeles County
10285	Fee-for-Service	1265678528	1265678528	1	1	WALKER, DANIELLE NP	12/7/2023	164X00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
10288	Fee-for-Service	1447567680	1447567680	1	1	WANG, ALAN Y LAC	3/1/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	17348 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	1628	19	06037	33.9907589	-117.9280238	Los Angeles County
10320	Fee-for-Service	1710236591	1710236591	1	1	WOMENS HEALTH PARTNERS	1/22/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	OF CALIFORNIA INC	112 LA CASA VIA	SUITE 130	WALNUT CREEK	CA	94598	3016	07	06013	37.91229899	-122.0423696	Contra Costa County
10337	Fee-for-Service	1356344758	1356344758	1	10	WEST COUNTY HEALTH CENTERS	2/21/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3802 MAIN STREET	None	OCCIDENTAL	CA	95465	0006	49	06097	38.40900707	-122.9476089	Sonoma County
10364	Fee-for-Service	1003883133	1003883133	1	1	WILLKOM, MIGNONETTE M L MD	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53664	01	General Practice	0	In state provider	None	1133 E STANLEY BLVD	SUITE 203	LIVERMORE	CA	94550	4246	01	06001	37.67914693	-121.7810206	Alameda County
10371	Fee-for-Service	1689690091	1689690091	1	1	WALLACE, MARK D MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	31736	30	Radiology	0	In state provider	None	2020 COURT ST	STE 110	REDDING	CA	96001	1822	45	06089	40.57825667	-122.3936821	Shasta County
10374	Fee-for-Service	1699157297	1699157297	1	1	WANG, GRANT J MD	7/17/2019	207L00000X	NA	Other	026	PHYSICIANS	161534	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
10392	Fee-for-Service	1386691715	1386691715	1	1	WALTON, BETTY D MD	9/6/1994	207P00000X	NA	Other	026	PHYSICIANS	23506	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1330 NATIVIDAD RD	None	SALINAS	CA	93906	3101	27	06053	36.696996	-121.633173	Monterey County
10429	Fee-for-Service	1669765145	1669765145	1	1	WINGER, BETH A MD	6/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124245	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
10442	Fee-for-Service	1285603514	1285603514	1	1	WEI, ALAN S MD	12/3/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34777	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ALAN SHOU-REN WEI	2240 GLADSTONE DR	STE 1	PITTSBURG	CA	94565	5126	07	06013	38.00627609	-121.8667626	Contra Costa County
10448	Fee-for-Service	1144753955	1144753955	1	1	WALSH, TAYLOR MD DO	6/1/2021	207P00000X	NA	Other	026	PHYSICIANS	171310	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
10458	Fee-for-Service	1023373495	1023373495	1	1	WAL-MART STORES INC	2/22/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1189 E MARCH LANE	None	STOCKTON	CA	95210	3545	39	06077	38.00200524	-121.2915408	San Joaquin County
10517	Fee-for-Service	1154881365	1154881365	1	1	WADHWA, MANVIR S	7/18/2022	390200000X	NA	Other	026	PHYSICIANS	179523	None	None	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
10547	Fee-for-Service	1952377806	1952377806	1	1	WELLS, TODD D MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71920	08	Family Practice	0	In state provider	None	17190 BERNARDO CENTER DR	None	SAN DIEGO	CA	92128	7030	37	06073	33.02473938	-117.0778645	San Diego County
10555	Fee-for-Service	1255674461	1255674461	1	1	WANG, SOPHIA Y MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147902	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
10571	Fee-for-Service	1497796320	1497796320	1	1	WESTERN ANESTHESIA MEDICAL	3/1/1998	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	ASSOCIATES INC	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	8580	30	06059	33.56008604	-117.6657795	Orange County
10591	Fee-for-Service	1912207242	1912207242	1	1	WU, KEVIN MD	9/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113422	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
10597	Fee-for-Service	1649780560	1649780560	2	1	WOODHILLS RX CORP	8/16/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20011 VENTURA BLVD	STE. 1006	WOODLAND HILLS	CA	91364	2573	19	06037	34.17183967	-118.5686096	Los Angeles County
10609	Fee-for-Service	1700981263	1700981263	1	1	WHITE, GORDON V PHD	11/9/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2101 EL CAMINO REAL	SUITE 203B	OCEANSIDE	CA	92054	6227	37	06073	33.19058997	-117.3282144	San Diego County
10635	Fee-for-Service	1982420675	1982420675	1	1	WALKER, ALLIE R	11/26/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	45	06089	0	0	None
10659	Fee-for-Service	1780763631	1780763631	1	1	WINKLER, RICHARD MARK MD	7/31/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60137	08	Family Practice	0	In state provider	None	1000 DELBON AVE	STE 4	TURLOCK	CA	95382	2008	50	06099	37.51054507	-120.8367636	Stanislaus County
10681	Fee-for-Service	1255808820	1255808820	1	1	WATSON, NICHOLAS PT	7/10/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
10705	Fee-for-Service	1730575101	1730575101	1	1	WEST, COLIN A MD	8/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
10706	Fee-for-Service	1881720993	1881720993	1	1	WINDETT, LARA M LMFT	12/2/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	43984	-	NOT APPLICABLE	0	In state provider	None	2425 ENBORG LN	None	SAN JOSE	CA	95128	2648	43	06085	37.31105733	-121.937923	Santa Clara County
10719	Fee-for-Service	1669765145	1669765145	1	1	WINGER, BETH A MD	6/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124245	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
10748	Fee-for-Service	1245270099	1245270099	1	1	WHITLEY, GREGORY A MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61740	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
10832	Fee-for-Service	1275029332	1275029332	1	1	WEAVER, WESLEY J PT	10/31/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3800 GEER RD	STE 101	TURLOCK	CA	95382	1146	50	06099	37.52713247	-120.8488664	Stanislaus County
10843	Fee-for-Service	1770808586	1770808586	1	1	WEBB, RYAN G MD	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131512	01	General Practice	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
10849	Fee-for-Service	1447621644	1447621644	1	1	WEST-END PHARMACY	11/6/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	965 HIGHWAY 99W	SUITE 127	CORNING	CA	96021	2734	52	06103	39.92634593	-122.1974807	Tehama County
10855	Fee-for-Service	1821257577	1821257577	1	1	WAGER, BROOK R MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129797	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1415 ROSS AVENUE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
10856	Fee-for-Service	1598272858	1598272858	1	1	WILLMOTT, PRISCILLA A LPCC	2/10/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2068 ORANGE TREE LANE	216	REDLANDS	CA	92374	0109	36	06071	34.0679639	-117.2250148	San Bernardino County
10942	Fee-for-Service	1730836040	1730836040	1	1	WEATHERSPOON, INDIE NP	3/22/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	301 N PRAIRIE AVENUE	SUITE 611	INGLEWOOD	CA	90301	4513	19	06037	33.965712	-118.3439965	Los Angeles County
10949	Fee-for-Service	1154855278	1154855278	1	1	WENCHENG JEN MD INC	8/11/2017	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	416 W LAS TUNAS DR	STE 305	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
10955	Fee-for-Service	1891701298	1891701298	1	1	WALGREEN CO	2/10/1988	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1130 FOXWORTHY AVE	None	SAN JOSE	CA	95118	1209	43	06085	37.27786425	-121.8805711	Santa Clara County
10966	Fee-for-Service	1902007602	1902007602	1	1	WILLIAMS, JANET G MD	10/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83478	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
10982	Fee-for-Service	1659404705	1659404705	1	1	WILSON, JAMES F	2/14/2003	174400000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	1319 W CARSON STREET	None	TORRANCE	CA	90501	3909	19	06037	33.83156351	-118.300248	Los Angeles County
10989	Fee-for-Service	1215907217	1215907217	1	1	WARD, MATTHEW B MD	8/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86618	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
10997	Fee-for-Service	1023144375	1023144375	1	1	WANG, CHING H MD	5/17/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86512	79	Neurology-Child	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
11007	Fee-for-Service	1669765145	1669765145	1	1	WINGER, BETH A MD	6/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124245	78	Neoplastic Diseases/Oncology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
11011	Fee-for-Service	1043420367	1043420367	1	1	WEISER, SHERI D MD	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81820	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	ROOM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
11016	Fee-for-Service	1891430666	1891430666	1	1	WILSON, MAILA E	2/11/2025	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2535 ALPINE BLVD	2	ALPINE	CA	91901	2395	37	06073	32.83490165	-116.7593275	San Diego County
11028	Fee-for-Service	1104071869	1104071869	1	1	WERNIK, EDAN MD	2/11/2011	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	105632	08	Family Practice	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
11035	Fee-for-Service	1083003321	1083003321	1	3	WHITE MEMORIAL COMMUNITY	10/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1828 E CESAR E CHAVEZ AV	SUITE 4300	LOS ANGELES	CA	90033	2400	19	06037	34.05023174	-118.2154927	Los Angeles County
11040	Fee-for-Service	1689626277	1689626277	1	1	WANG, EDWARD S J MD	12/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	45359	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
11088	Fee-for-Service	1942438981	1942438981	1	1	WU, REBECCA	5/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131319	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
11094	Fee-for-Service	1114034832	1114034832	1	1	WU, HAN-HSING I MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63128	41	Internal Medicine	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
11099	Fee-for-Service	1518371400	1518371400	1	1	WILKE, JULIANNE MD	3/22/2021	2080P0203X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
11192	Fee-for-Service	1154383875	1154383875	1	1	WINDHAM, PAUL C MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	57950	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
11208	Fee-for-Service	1760696934	1760696934	1	1	WESTSIDE NEPHROLOGY	11/30/1994	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	MEDICAL GROUP, INC	1301 20TH ST	STE 200	SANTA MONICA	CA	90404	2088	19	06037	34.02976782	-118.4812493	Los Angeles County
11218	Fee-for-Service	1942609714	1942609714	1	1	WEST, ZARATHUSTRA CRNA	5/2/2017	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
11238	Fee-for-Service	1003855792	1003855792	1	1	WOODFORD, JUDITY A CRNA	3/1/2002	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
11269	Fee-for-Service	1659404705	1659404705	1	1	WILSON, JAMES F	7/1/2004	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1319 W CARSON STREET	None	TORRANCE	CA	90501	3909	19	06037	33.83156351	-118.300248	Los Angeles County
11280	Fee-for-Service	1801324264	1801324264	1	1	WALLER, JONATHAN MD	4/17/2024	208M00000X	NA	Other	026	PHYSICIANS	167405	41	Internal Medicine	0	In state provider	None	2700 GRANT ST	STE 200	CONCORD	CA	94520	2266	07	06013	37.98417931	-122.0361585	Contra Costa County
11293	Fee-for-Service	1902973803	1902973803	1	1	WON, ESTHER U MD	8/25/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58458	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
11322	Fee-for-Service	1083003321	1083003321	1	3	WHITE MEMORIAL COMMUNITY	10/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1828 E CESAR E CHAVEZ AV	SUITE 4300	LOS ANGELES	CA	90033	2400	19	06037	34.05023174	-118.2154927	Los Angeles County
11326	Fee-for-Service	1164693859	1164693859	1	1	WALGREEN CO.	1/21/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	82955 AVENUE 48	BLDG. B	INDIO	CA	92201	6757	33	06065	33.70028627	-116.2170761	Riverside County
11330	Fee-for-Service	1720095847	1720095847	1	1	WULFERT, ELIZABETH A MD	10/31/1994	207P00000X	NA	Other	026	PHYSICIANS	76426	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
11332	Fee-for-Service	1548438971	1548438971	1	1	WALTERS, JENNIFER L LMFT	2/14/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE	130	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
11335	Fee-for-Service	1083003321	1083003321	1	1	WHITE MEMORIAL COMMUNITY	4/1/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	1828 E CESAR E CHAVEZ AV	SUITE 5000	LOS ANGELES	CA	90033	2496	19	06037	34.05023174	-118.2154927	Los Angeles County
11337	Fee-for-Service	1801979349	1801979349	1	1	WHITE, ROBERT D	8/12/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
11367	Fee-for-Service	1346701323	1346701323	1	1	WAN, SHUN YI MD	8/1/2023	390200000X	NA	Other	026	PHYSICIANS	182443	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
11383	Fee-for-Service	1114034832	1114034832	1	1	WU, HAN-HSING I MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63128	68	Hematology	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
11425	Fee-for-Service	1700203023	1700203023	1	1	WILSON, JAKE L MD	11/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141468	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
11430	Fee-for-Service	1457857351	1457857351	1	1	WANG, LINDA MD	8/2/2021	207R00000X	NA	Other	026	PHYSICIANS	163609	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
11477	Fee-for-Service	1245662345	1245662345	1	1	WINZELER, BLAKE PSYD	5/1/2020	101Y00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
11495	Fee-for-Service	1760696934	1760696934	1	1	WESTSIDE NEPHROLOGY	11/30/1994	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP, INC	1301 20TH ST	STE 200	SANTA MONICA	CA	90404	2088	19	06037	34.02976782	-118.4812493	Los Angeles County
11503	Fee-for-Service	1376797886	1376797886	1	1	WASHINGTON TOWNSHIP	9/6/2006	261Q00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL DEVELOPMENT COR	39141 CIVIC CENTER DR	STE 120	FREMONT	CA	94538	5831	01	06001	37.55436307	-121.9764708	Alameda County
11580	Fee-for-Service	1902973803	1902973803	1	1	WON, ESTHER U MD	8/25/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58458	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
11584	Fee-for-Service	1609802842	1609802842	1	3	WEST RAD MEDICAL GROUP	5/4/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	16300 SAND CANYON AVE	STE 203	IRVINE	CA	92618	3712	30	06059	33.66115075	-117.7742405	Orange County
11606	Fee-for-Service	1770523771	1770523771	1	1	WEISS, JONATHAN MD	12/8/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	46404	None	None	0	In state provider	None	3001 COLBY ST	# 3625	BERKELEY	CA	94705	2039	01	06001	37.85496934	-122.2575642	Alameda County
11628	Fee-for-Service	1083003321	1083003321	1	1	WHITE MEMORIAL COMMUNITY	4/1/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	1828 E CESAR E CHAVEZ AV	SUITE 5000	LOS ANGELES	CA	90033	2496	19	06037	34.05023174	-118.2154927	Los Angeles County
11645	Fee-for-Service	1497785000	1497785000	1	1	WHITFIELD, DENNIS MD	2/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	42238	None	None	0	In state provider	None	10 WOODLAND RD	None	SAINT HELENA	CA	94574	9554	28	06055	38.54196972	-122.4751787	Napa County
11665	Fee-for-Service	1912929274	1912929274	1	1	WONG, RAYMOND Y MD	11/30/1983	207R00000X	NA	Other	026	PHYSICIANS	43971	41	Internal Medicine	0	In state provider	None	11441 HEACOCK ST	STE A	MORENO VALLEY	CA	92557	7907	33	06065	33.954858	-117.243978	Riverside County
11673	Fee-for-Service	1912101452	1912101452	1	1	WONG, RYAN K MD	10/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106001	24	Plastic Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
11786	Fee-for-Service	1184788523	1184788523	1	2	WANG, WEI W MD	11/15/2022	207R00000X	NA	Other	026	PHYSICIANS	53177	41	Internal Medicine	0	In state provider	WEI WANG MEDICAL CORP	223 N GARFIELD AVE	STE 208	MONTEREY PARK	CA	91754	1700	19	06037	34.0646166	-118.1228948	Los Angeles County
11789	Fee-for-Service	1376203257	1376203257	1	1	WILLOW HOME HEALTH	3/19/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13615 VICTORY BLVD	217	VAN NUYS	CA	91401	6404	19	06037	34.18671049	-118.429353	Los Angeles County
11801	Fee-for-Service	1972526721	1972526721	1	1	WALKER, VALENCIA P MD	7/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96135	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
11838	Fee-for-Service	1134229388	1134229388	1	1	WEBSTER-LONGIN, MARIA MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88914	41	Internal Medicine	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
11847	Fee-for-Service	1891984126	1891984126	1	1	WAGER, LLOYD A LMFT	9/10/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	370 WEST GRAND BLVD	SUITE 104	CORONA	CA	92882	2174	33	06065	33.87826645	-117.5732887	Riverside County
11861	Fee-for-Service	1942215033	1942215033	1	1	WALGREEN CO.	1/15/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8400 ELK GROVE FLORIN RD	None	ELK GROVE	CA	95624	9450	34	06067	38.452203	-121.3727805	Sacramento County
11865	Fee-for-Service	1699832998	1699832998	1	1	WILSON, PATRICIA E CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
11898	Fee-for-Service	1205938917	1205938917	1	1	WHITTMAN,DAVID T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL	None	TUCSON	AZ	85724	0000	00	None	32.240493	-110.9460825	Pima County
11911	Fee-for-Service	1083003321	1083003321	1	1	WHITE MEMORIAL COMMUNITY	4/1/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	1828 E CESAR E CHAVEZ AV	SUITE 5000	LOS ANGELES	CA	90033	2496	19	06037	34.05023174	-118.2154927	Los Angeles County
11952	Fee-for-Service	1912929274	1912929274	1	1	WONG, RAYMOND Y MD	11/30/1983	207R00000X	NA	Other	026	PHYSICIANS	43971	01	General Practice	0	In state provider	None	11441 HEACOCK ST	STE A	MORENO VALLEY	CA	92557	7907	33	06065	33.954858	-117.243978	Riverside County
11962	Fee-for-Service	1790250637	1790250637	1	1	WOOLVERTON, MATTHEW W CRNA	3/6/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
11985	Fee-for-Service	1093703357	1093703357	1	1	WILLIAMS, WENDELL B MD	1/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	72340	08	Family Practice	0	In state provider	None	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
12002	Fee-for-Service	1154704591	1154704591	1	1	WINSTON, SCHEHERAZADE E LMFT	6/2/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3270 MENDOCINO AVE	2D	SANTA ROSA	CA	95403	2263	49	06097	38.469699	-122.722092	Sonoma County
12078	Fee-for-Service	1912045873	1912045873	1	1	WAFA, SAMEENA S MD	3/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97665	40	Pediatrics	0	In state provider	None	830 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
12079	Fee-for-Service	1275745515	1275745515	1	1	WU, SHANG MD INC	3/2/2004	193400000X	NA	Other	026	PHYSICIANS	79748	10	Gastroenterology (M.D. only)	0	In state provider	None	3141 S HACIENDA BLVD	None	HACIENDA HEIGHTS	CA	91745	6304	19	06037	33.98032401	-117.972833	Los Angeles County
12091	Fee-for-Service	1972526721	1972526721	1	1	WALKER, VALENCIA P MD	7/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96135	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
12125	Fee-for-Service	1538391909	1538391909	1	1	WATSON, CHRISTINA M PHD	9/3/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7060 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92111	1003	37	06073	32.83272447	-117.1648125	San Diego County
12126	Fee-for-Service	1427103365	1427103365	1	1	WILKINSON, MARY ANN MD	11/5/2018	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	67652	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	FLOOR 2	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
12179	Fee-for-Service	1811289812	1811289812	1	1	WOOD, JEFFREY P MD	6/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139799	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
12236	Fee-for-Service	1114055563	1114055563	1	1	WU, LAUREN MD	2/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	62843	41	Internal Medicine	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
12277	Fee-for-Service	1841326261	1841326261	1	1	WEINHOUSE, ROGER A MD	5/20/1987	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	22929	30	Radiology	0	In state provider	None	5925 SAN VICENTE BLVD	None	LOS ANGELES	CA	90019	6630	19	06037	34.05682871	-118.360716	Los Angeles County
12337	Fee-for-Service	1316309552	1316309552	1	1	WANG, CLAIRE T MD	7/1/2019	207P00000X	NA	Other	026	PHYSICIANS	150796	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
12339	Fee-for-Service	1073616363	1073616363	1	1	WEISBLUM, LEWIS S MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	52508	30	Radiology	0	In state provider	None	1025 N DOUTY STREET	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
12346	Fee-for-Service	1023588936	1023588936	1	1	WELLNESS CONGREGATED LIVING	10/21/2019	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	FACILITY, INC.	6231 ETHEL AVE	None	VAN NUYS	CA	91401	3220	19	06037	34.183899	-118.418198	Los Angeles County
12349	Fee-for-Service	1063858215	1063858215	1	1	WILLIAM, TIMOTHY R MD	5/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	135608	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
12362	Fee-for-Service	1164912549	1164912549	1	1	WONG, DAPHNE L DO	7/26/2022	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
12373	Fee-for-Service	1356356364	1356356364	1	1	WALGREEN CO	8/19/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	47900 WASHINGTON ST	None	LA QUINTA	CA	92253	2209	33	06065	33.70070848	-116.2947689	Riverside County
12387	Fee-for-Service	1992371793	1992371793	1	1	WAGNER, ZACHARY	9/6/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	517 3RD STREET	22	EUREKA	CA	95501	3203	12	06023	40.80367671	-124.166036	Humboldt County
12400	Fee-for-Service	1366626830	1366626830	1	1	WALL, CHRISTOPHER T MD	4/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102370	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
12419	Fee-for-Service	1609802842	1609802842	1	2	WEST RAD MEDICAL GROUP	5/4/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	16300 SAND CANYON AVE	STE 102	IRVINE	CA	92618	3704	30	06059	33.66115075	-117.7742405	Orange County
12514	Fee-for-Service	1205164761	1205164761	1	1	WARREN, ADAM P MD	12/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103633	None	None	0	In state provider	None	609 E ORANGEBURG AVE	SUITE 201	MODESTO	CA	95350	5512	50	06099	37.66364947	-120.9857985	Stanislaus County
12551	Fee-for-Service	1265939466	1265939466	1	1	WANG, CASSANDRA MD	7/22/2024	2080P0207X	NA	Hematology	026	PHYSICIANS	164874	68	Hematology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
12563	Fee-for-Service	1952914681	1952914681	1	8	WEST COAST KIDNEY	11/23/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	19850 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	4002	01	06001	37.69966123	-122.0876469	Alameda County
12587	Fee-for-Service	1447424023	1447424023	1	1	WOODBURY, BRANDON B MD	5/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111928	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
12589	Fee-for-Service	1134146541	1134146541	1	1	WAL-MART PHARMACY 101583	12/10/1990	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1977 W CLEVELAND AVE	None	MADERA	CA	93637	8717	20	06039	36.97467447	-120.0806055	Madera County
12641	Fee-for-Service	1093052466	1093052466	1	1	WASHINGTON, TERRYL	6/30/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	649 MILITARY E. STREET	None	BENICIA	CA	94510	3555	48	06095	38.04953456	-122.143739	Solano County
12662	Fee-for-Service	1841282407	1841282407	1	1	WONG, DAVIES Y MD	10/31/1987	207RP1001X	NA	Pulmonology	026	PHYSICIANS	58356	41	Internal Medicine	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
12683	Fee-for-Service	1346276813	1346276813	1	1	WRESCH, KEITH R MD	10/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90435	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
12697	Fee-for-Service	1356344758	1356344758	1	4	WEST COUNTY HEALTH CENTERS	10/24/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	16385 FIRST STREET	None	GUERNEVILLE	CA	95446	0000	49	06097	38.50111158	-122.9999868	Sonoma County
12744	Fee-for-Service	1841206414	1841206414	1	1	WALGREEN CO	11/22/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1189 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3520	38	06075	37.75329906	-122.4063227	San Francisco County
12792	Fee-for-Service	1396894366	1396894366	1	1	WILCOX, BRIDGET S PSYD	5/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	110 N LA BREA AVENUE	None	INGLEWOOD	CA	90301	1708	19	06037	33.96345848	-118.3533454	Los Angeles County
12840	Fee-for-Service	1053122424	1053122424	1	1	WILLIAMSON-LEDIN, ERIKA BIR	2/12/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	27	06053	0	0	None
12874	Fee-for-Service	1821175761	1821175761	1	1	WEISS, VIRGINIA A MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37714	30	Radiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
12931	Fee-for-Service	1093052466	1093052466	1	1	WASHINGTON, TERRYL	6/30/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	649 MILITARY E. STREET	None	BENICIA	CA	94510	3555	48	06095	38.04953456	-122.143739	Solano County
12946	Fee-for-Service	1972610160	1972610160	1	1	WOO, HON MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60667	30	Radiology	0	In state provider	None	2288 AUBURN BLVD	STE 102	SACRAMENTO	CA	95821	1619	34	06067	38.625345	-121.4114985	Sacramento County
12953	Fee-for-Service	1568403723	1568403723	1	1	WEBB, EMILY M MD	6/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90524	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
12986	Fee-for-Service	1356344758	1356344758	1	4	WEST COUNTY HEALTH CENTERS	10/24/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	16385 FIRST STREET	None	GUERNEVILLE	CA	95446	0000	49	06097	38.50111158	-122.9999868	Sonoma County
12995	Fee-for-Service	1467725028	1467725028	1	1	WISDOM LAZAR, RACHELLE S	5/14/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	1267 ROSECRANS ST	STE E	SAN DIEGO	CA	92106	2692	37	06073	32.72341569	-117.2302107	San Diego County
13003	Fee-for-Service	1720009301	1720009301	1	1	WENGER, NEIL S MD	1/1/1995	207R00000X	NA	Other	026	PHYSICIANS	55997	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
13007	Fee-for-Service	1922187194	1922187194	1	1	WHITELEY, SCOTT PHD	9/19/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8433 VEREDA DEL PADRE	None	GOLETA	CA	93117	5334	42	06083	34.43922606	-119.9200436	Santa Barbara County
13015	Fee-for-Service	1619389319	1619389319	1	1	WARDAK, MUSTAFA M MD	7/10/2017	207R00000X	NA	Other	026	PHYSICIANS	144766	41	Internal Medicine	0	In state provider	None	2340 CLAY STREET	2ND, 3RD, 4TH FLOOR	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
13050	Fee-for-Service	1437682259	1437682259	1	1	WADHWANI, HEMANT MD	9/1/2020	207R00000X	NA	Other	026	PHYSICIANS	167066	41	Internal Medicine	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
13068	Fee-for-Service	1750776902	1750776902	1	1	WARIS, RABBIA S MD	6/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153578	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
13097	Fee-for-Service	1942538871	1942538871	1	1	WALGREEN CO	5/10/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	995 SPERRY AVE	None	PATTERSON	CA	95363	9262	50	06099	37.46446646	-121.1402745	Stanislaus County
13132	Fee-for-Service	1952914681	1952914681	1	10	WEST COAST KIDNEY	11/23/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	388 9TH ST	STE 218	OAKLAND	CA	94607	4293	01	06001	37.80019425	-122.2715222	Alameda County
13196	Fee-for-Service	1417308198	1417308198	1	1	WONG, JENNIFER W MD	1/29/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168328	None	None	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
13219	Fee-for-Service	1427274208	1427274208	1	1	WEISS,STEVAN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	499 E HAMPDEN AVE	STE #280	ENGLEWOOD	CO	80113	0000	00	None	39.65319046	-104.982129	Arapahoe County
13231	Fee-for-Service	1437221561	1437221561	1	2	WINKLE, CHRISTOPHER MD	6/1/2002	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	73066	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7151 LINCOLN AVE	STE B	BUENA PARK	CA	90620	4614	30	06059	33.83201852	-118.0080675	Orange County
13261	Fee-for-Service	1861754632	1861754632	1	1	WASHINGTON, DEMARIS R PHD	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	24625	-	NOT APPLICABLE	0	In state provider	None	370 SOUTH CRENSHAW BLVD	SUITE E-100	TORRANCE	CA	90503	1727	19	06037	33.84549	-118.3287415	Los Angeles County
13265	Fee-for-Service	1003026840	1003026840	1	1	WELLS, LINDA	5/24/2003	251E00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3413 GEORGE AVENUE	None	MODESTO	CA	95356	3203	50	06099	37.69379999	-121.0600759	Stanislaus County
13298	Fee-for-Service	1255377370	1255377370	1	1	WRIGHT, FREDERICK S MD	8/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	68353	02	General Surgery	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95110	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
13335	Fee-for-Service	1417979626	1417979626	1	1	WONG, KENNETH H MD	11/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87370	67	Endocrinology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
13345	Fee-for-Service	1699121814	1699121814	1	1	WARCUP, MICHAEL DPM	6/17/2019	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2914 W MAIN ST	None	VISALIA	CA	93291	5731	54	06107	36.330075	-119.323458	Tulare County
13376	Fee-for-Service	1346477841	1346477841	1	1	WALKER, JENNIFER A MD	10/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131280	66	Emergency Medicine (Urgent Care)	0	In state provider	None	347 ANDRIEUX STREET	None	SONOMA	CA	95476	6863	49	06097	38.28843573	-122.4651035	Sonoma County
13390	Fee-for-Service	1841552395	1841552395	1	1	WEISS, JESSICA L MD	12/5/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	15098	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
13421	Fee-for-Service	1295101061	1295101061	1	1	WILSON, JESSICA E LMFT	10/8/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	510 S SECOND AVE	SUITE 6 & 7	COVINA	CA	91723	3017	19	06037	34.0805013	-117.8878213	Los Angeles County
13471	Fee-for-Service	1457880320	1457880320	1	1	WISE, DEVI S LCSW	7/29/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5051 CANYON CREST DR	SUITE 204	RIVERSIDE	CA	92507	0000	33	06065	33.9589602	-117.3311519	Riverside County
13482	Fee-for-Service	1760467948	1760467948	1	1	WAGNER, PAULA J RN	2/1/2003	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
13487	Fee-for-Service	1144205295	1144205295	1	1	WALI, DEEPIKA MD	2/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	49021	41	Internal Medicine	0	In state provider	None	2601 E MAIN ST	STE 104	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
13490	Fee-for-Service	1255419933	1255419933	1	1	WONG, JUDY MEE MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	49488	05	Anesthesiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
13518	Fee-for-Service	1316509433	1316509433	1	1	WIKHOLM, KATHERINE E MD	1/9/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182632	None	None	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
13528	Fee-for-Service	1497802524	1497802524	1	1	WATHEN, CLAUDIA A PHD	9/4/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
13798	Fee-for-Service	1851947329	1851947329	1	1	WILSON, ALICE J MD	7/21/2023	207R00000X	NA	Other	026	PHYSICIANS	184473	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
13815	Fee-for-Service	1871508150	1871508150	1	1	WALGREEN CO	10/29/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1790 SHAW AVE	None	CLOVIS	CA	93611	4093	10	06019	36.80849552	-119.682675	Fresno County
13817	Fee-for-Service	1437551652	1437551652	1	1	WILLITS HOSPITAL INC	6/8/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	3 MARCELA DR	None	WILLITS	CA	95490	5769	23	06045	39.38994445	-123.3393497	Mendocino County
13848	Fee-for-Service	1497528004	1497528004	1	1	WIEDNER, ELLEN K	11/19/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
13892	Fee-for-Service	1427883115	1427883115	1	1	WATAN, JAMMIL P PT	9/17/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
13931	Fee-for-Service	1639127434	1639127434	1	1	WISEMAN, MARK D MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79867	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	202 W WILLOW AVE	None	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
13943	Fee-for-Service	1699898122	1699898122	1	1	WESTCARE CALIFORNIA, INC	12/11/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	818 L STREET	None	SANGER	CA	93657	3201	10	06019	36.7047254	-119.5539747	Fresno County
13970	Fee-for-Service	1770010605	1770010605	1	1	WILLIAMS, ERICA LCSW	2/13/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1144 COFFEE RD	None	MODESTO	CA	95355	4205	50	06099	37.659627	-120.9756125	Stanislaus County
13977	Fee-for-Service	1861831117	1861831117	1	1	WONG, ALISON G MD	8/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141248	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
14062	Fee-for-Service	1497821763	1497821763	2	1	WATIKER, VALERIE L	8/18/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	83345	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
14084	Fee-for-Service	1659852788	1659852788	1	1	WILKERSON, ERIN S LMFT	5/3/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
14087	Fee-for-Service	1467482000	1467482000	1	1	WEISS, ETHAN J MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65930	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
14091	Fee-for-Service	1548597594	1548597594	1	1	WU, MARIAN OT	12/6/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12411 SLAUSON AVE	STE H	WHITTIER	CA	90606	2835	19	06037	33.96028839	-118.0529975	Los Angeles County
14101	Fee-for-Service	1376681825	1376681825	1	1	WHITE, STEPHEN PSY D	8/23/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16496 BERNARDO CENTER DR	STE 307	SAN DIEGO	CA	92128	2524	37	06073	33.01375281	-117.0777466	San Diego County
14104	Fee-for-Service	1437551652	1437551652	1	1	WILLITS HOSPITAL INC	3/26/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	3 MARCELA DR	None	WILLITS	CA	95490	5769	23	06045	39.38994445	-123.3393497	Mendocino County
14213	Fee-for-Service	1386674471	1386674471	1	1	WONG, ERVIN P MD	4/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81170	None	None	0	In state provider	None	728 PACIFIC AVE	STE 506	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
14227	Fee-for-Service	1427171727	1427171727	1	1	WHALEY, NICOLE LCSW	3/8/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	811 W. 7TH ST.	12TH FLOOR	LOS ANGELES	CA	90017	3403	19	06037	34.0489635	-118.2591312	Los Angeles County
14250	Fee-for-Service	1326149527	1326149527	1	1	WILLIAMS, CAROLYN PHD	11/26/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	15720 VENTURA BLVD	STE 603	ENCINO	CA	91436	4727	19	06037	34.15524484	-118.4756687	Los Angeles County
14322	Fee-for-Service	1992896591	1992896591	1	1	WEBER, WAYNE R MD	5/1/1990	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	31321	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	13320 RIVERSIDE DR	STE 108	SHERMAN OAKS	CA	91423	2519	19	06037	34.15758348	-118.423233	Los Angeles County
14357	Fee-for-Service	1104280932	1104280932	1	1	WILLIAMS, TIFFANY LPCC	11/11/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	355 GRAND AVE	2450	LOS ANGELES	CA	90071	1560	19	06037	34.05193094	-118.2524437	Los Angeles County
14360	Fee-for-Service	1952617342	1952617342	1	1	WONG, LEWIS Y MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124469	08	Family Practice	0	In state provider	None	520 N PROSPECT AVE	SUITE 103	REDONDO BEACH	CA	90277	3033	19	06037	33.8529819	-118.3802954	Los Angeles County
14393	Fee-for-Service	1437551652	1437551652	1	1	WILLITS HOSPITAL INC	3/26/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	3 MARCELA DR	None	WILLITS	CA	95490	5769	23	06045	39.38994445	-123.3393497	Mendocino County
14426	Fee-for-Service	1780641704	1780641704	1	1	WONG, JASON T MD	9/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113420	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
14435	Fee-for-Service	1366543894	1366543894	1	1	WILLIAM C VOGELPOHL &	12/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	BRADLEY J KEITH MD, INC	337 EL DORADO ST	STE A3	MONTEREY	CA	93940	4638	27	06053	36.59183357	-121.8924432	Monterey County
14473	Fee-for-Service	1215969506	1215969506	1	1	WALKER, RAMONA MD	9/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131004	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LANE	450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
14493	Fee-for-Service	1528062437	1528062437	1	1	WEINER, KERRY E MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	40945	10	Gastroenterology (M.D. only)	0	In state provider	None	12660 RIVERSIDE DR	STE 225	NORTH HOLLYWOOD	CA	91607	3469	19	06037	34.1575795	-118.409499	Los Angeles County
14496	Fee-for-Service	1386177004	1386177004	1	1	WEI, KATHERINE MD	1/25/2021	390200000X	NA	Other	026	PHYSICIANS	159166	None	None	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
14503	Fee-for-Service	1902108293	1902108293	1	1	WEST VALLEY HEMATOLOGY	2/4/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	ONCOLOGY MEDICAL GROUP	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
14504	Fee-for-Service	1053389064	1053389064	1	2	WEST COAST RETINA MEDICAL	11/30/1989	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	1981 N BROADWAY	STE 435	WALNUT CREEK	CA	94596	3829	07	06013	37.90582392	-122.0613697	Contra Costa County
14565	Fee-for-Service	1467648618	1467648618	2	1	WALGREEN CO	3/14/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	72027 DINAH SHORE DR	None	RANCHO MIRAGE	CA	92270	1739	33	06065	33.80165147	-116.40501	Riverside County
14568	Fee-for-Service	1003033846	1003033846	1	1	WAGGONER, TESSA L	2/8/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	90 E THOUSAND OAKS BLVD	SUITE 200	THOUSAND OAKS	CA	91360	5716	56	06111	34.17902886	-118.8749335	Ventura County
14595	Fee-for-Service	1780807636	1780807636	1	1	WILSON-PARISH, KATHLEEN LMF	8/27/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	VICES	250 CHERRY LANE	SUITE 115	MANTECA	CA	95334	4906	39	06077	37.80036522	-121.2310051	San Joaquin County
14632	Fee-for-Service	1669562427	1669562427	1	1	WENDOKUR, RANDALL K MD	1/20/2009	207YX0602X	NA	ENT/Otolaryngology	026	PHYSICIANS	67072	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3194	07	06013	37.9141514	-122.0422089	Contra Costa County
14659	Fee-for-Service	1336569177	1336569177	1	1	WEST COAST CARDIOVASCULAR	8/4/2014	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	106214	01	General Practice	0	In state provider	CONSULTANTS	43860 10TH STREET WEST	SUITE 203	LANCASTER	CA	93534	4848	19	06037	34.68010255	-118.1478903	Los Angeles County
14664	Fee-for-Service	1861447641	1861447641	1	1	WESTERMEYER, RAYMOND E MD	1/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	87943	41	Internal Medicine	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
14687	Fee-for-Service	1184639460	1184639460	1	1	WALGREEN COMPANY	5/24/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	831 E AVENUE K	None	LANCASTER	CA	93535	4712	19	06037	34.67502951	-118.1131425	Los Angeles County
14704	Fee-for-Service	1952583668	1952583668	1	1	WECHTER, VICTOR MD	6/1/1988	207W00000X	NA	Ophthalmology	026	PHYSICIANS	25333	18	Ophthalmology	0	In state provider	INC	1020 E VISTA WAY	None	VISTA	CA	92084	4602	37	06073	33.21280236	-117.2288363	San Diego County
14790	Fee-for-Service	1538319090	1538319090	1	1	WU, MAX C MD	6/13/2012	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	104317	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
14792	Fee-for-Service	1902108293	1902108293	1	1	WEST VALLEY HEMATOLOGY	2/4/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ONCOLOGY MEDICAL GROUP	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
14794	Fee-for-Service	1184664591	1184664591	1	1	WILLEMS, JOHN J MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35952	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
14848	Fee-for-Service	1275584997	1275584997	1	1	WEGNER,DANIEL J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1512 12TH AVE RD	None	NAMPA	ID	83686	6008	00	None	43.55346193	-116.5727785	Canyon County
14854	Fee-for-Service	1700288768	1700288768	1	1	WAVE PROFESSIONAL CLINICAL	7/26/2021	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELORS INC	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
14862	Fee-for-Service	1851825665	1851825665	1	1	WALDROP, ANNE MD	10/14/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	157000	15	Obstetrics (D.O. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
14919	Fee-for-Service	1609234400	1609234400	1	1	WELLCARE SPECIALIST HOSPICE	10/30/2023	251G00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	INCORPORATED	1745 W ORANGEWOOD AVE	STE 101	ORANGE	CA	92868	2041	30	06059	33.79522413	-117.8714299	Orange County
14939	Fee-for-Service	1821030586	1821030586	1	1	WETHERLEY,GRAHAM MD	6/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	TREASURE VALLEY CARDIO	900 N LIBERTY SRE 302	None	BOISE	ID	83704	0000	00	None	43.61322197	-116.2611151	Ada County
14966	Fee-for-Service	1487893327	1487893327	1	1	WECK, MARY A LMFT	7/17/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29748 RANCHO CALIFORNIA	RD	TEMECULA	CA	92591	5286	33	06065	33.50662849	-117.1428887	Riverside County
15028	Fee-for-Service	1407807324	1407807324	1	1	WILL, BELINDA A CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
15057	Fee-for-Service	1053641456	1053641456	1	1	WALSH, JENIFER M	6/3/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	400 CRAVEN RD	None	SAN MARCOS	CA	92078	4201	37	06073	33.12746646	-117.17028	San Diego County
15078	Fee-for-Service	1902108293	1902108293	1	1	WEST VALLEY HEMATOLOGY	2/4/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	ONCOLOGY MEDICAL GROUP	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
15114	Fee-for-Service	1376063461	1376063461	1	2	WOUND MASTERS MEDICAL GROUP	4/29/2021	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	1131 W 6TH ST	250	ONTARIO	CA	91762	1108	36	06071	34.084404	-117.6717015	San Bernardino County
15129	Fee-for-Service	1245421015	1245421015	1	1	WU, PATTY P MD	6/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89822	41	Internal Medicine	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
15143	Fee-for-Service	1700288768	1700288768	1	1	WAVE PROFESSIONAL CLINICAL	6/22/2021	106H00000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELORS INC	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
15152	Fee-for-Service	1891700183	1891700183	1	1	WALGREEN CO	1/18/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	575 N SANBORN RD	None	SALINAS	CA	93905	2246	27	06053	36.68179908	-121.6229784	Monterey County
15244	Fee-for-Service	1881984896	1881984896	1	1	WOODS, CHRISTINE CCC-SLP	12/26/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1261 TRAVIS BLVD	120	FAIRFIELD	CA	94533	4897	48	06095	38.25812361	-122.0495417	Solano County
15254	Fee-for-Service	1063671584	1063671584	1	1	WARREN H LOONEY	3/16/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	709 4TH AVE NE	None	WATFORD CITY	ND	58854	7628	00	None	47.80465048	-103.2714315	McKenzie County
15276	Fee-for-Service	1235144247	1235144247	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14250 PRAIRIE AVE	None	HAWTHORNE	CA	90250	7908	19	06037	33.90229852	-118.3438368	Los Angeles County
15362	Fee-for-Service	1104975580	1104975580	1	1	WONG, DEANNA M OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3609 OCEAN RANCH BLVD	None	OCEANSIDE	CA	92056	2698	37	06073	33.210836	-117.3107856	San Diego County
15398	Fee-for-Service	1578581518	1578581518	1	2	WESTERN HOME CARE, INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6131 ORANGETHORPE AVE	SUITE 360	BUENA PARK	CA	90620	4926	30	06059	33.8588521	-118.0243537	Orange County
15403	Fee-for-Service	1407152358	1407152358	1	1	WATERS, JACK B CRNA	12/8/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
15404	Fee-for-Service	1912036377	1912036377	1	1	WHITE, DAVID A MD	9/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103765	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
15419	Fee-for-Service	1144221797	1144221797	2	1	WEST HEALTHCARE SOLUTIONS	4/2/2013	332BX2000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	1329 34TH ST	None	BAKERSFIELD	CA	93301	2109	15	06029	35.39050554	-119.017098	Kern County
15420	Fee-for-Service	1326251703	1326251703	1	1	WINELAND, RICHARD E MD	8/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	30924	34	Urology and Urological Surgery	0	In state provider	None	1211 W LA PALMA AVE	STE 307	ANAHEIM	CA	92801	2811	30	06059	33.84718298	-117.933758	Orange County
15426	Fee-for-Service	1649526682	1649526682	1	1	WALGREEN CO	8/17/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2040 E MARIPOSA RD	None	STOCKTON	CA	95205	7736	39	06077	37.93881784	-121.2438684	San Joaquin County
15430	Fee-for-Service	1700288768	1700288768	1	1	WAVE PROFESSIONAL CLINICAL	7/30/2021	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	COUNSELORS INC	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
15454	Fee-for-Service	1679859524	1679859524	1	2	WONG EYECARE ASSOCIATES, AN	7/30/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORPORATION	1366 S RIVERSIDE AVE	None	RIALTO	CA	92376	7608	36	06071	34.076583	-117.373455	San Bernardino County
15523	Fee-for-Service	1033136452	1033136452	1	1	WAL-MART STORES, INC	12/15/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	900 E WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8118	08	06015	41.774805	-124.1898615	Del Norte County
15525	Fee-for-Service	1912177627	1912177627	1	1	WANG, JIAKUN MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141512	41	Internal Medicine	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
15567	Fee-for-Service	1518353127	1518353127	1	1	WEIGAND, LINDSEY N DO	2/1/2021	208600000X	NA	General Surgery	026	PHYSICIANS	18474	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
15586	Fee-for-Service	1124279088	1124279088	1	1	WILLIAMS, AMBER K DO	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11145	08	Family Practice	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.2206967	-118.5342638	Los Angeles County
15594	Fee-for-Service	1770679177	1770679177	1	1	WHITE, RICHARD H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29028	01	General Practice	0	In state provider	None	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	34	06067	38.546127	-121.452669	Sacramento County
15720	Fee-for-Service	1700288768	1700288768	1	1	WAVE PROFESSIONAL CLINICAL	11/26/2018	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELORS INC	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
15740	Fee-for-Service	1457451411	1457451411	1	1	WONG, LEE ANNE MD	12/21/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	78665	40	Pediatrics	0	In state provider	None	8680 GREENBACK LN	None	ORANGEVALE	CA	95662	3969	34	06067	38.677617	-121.236228	Sacramento County
15750	Fee-for-Service	1639376312	1639376312	1	1	WEI, HSUAN H MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93894	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
15754	Fee-for-Service	1568405546	1568405546	2	1	WILSON, LIBBY F MD	6/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	18778	24	Plastic Surgery	0	In state provider	None	403 WEST ADAMS BLVD	None	LOS ANGELES	CA	90007	2664	19	06037	34.02741539	-118.2743622	Los Angeles County
15848	Fee-for-Service	1487873568	1487873568	1	1	WHITWORTH, LEAH E LMFT	5/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
15913	Fee-for-Service	1275604233	1275604233	1	1	WALDRON, DORIS T MD	1/1/1999	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	66665	40	Pediatrics	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
15916	Fee-for-Service	1679071153	1679071153	1	1	WANG, SHOU CNP	12/2/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
15917	Fee-for-Service	1679503536	1679503536	1	1	WEBER, ERICH C MD	2/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	842 E MAIN ST	None	MEDFORD	OR	97504	7155	00	None	42.32787853	-122.863311	Jackson County
15979	Fee-for-Service	1841254299	1841254299	2	1	WARRINGTON, WAYNE D DO	1/14/2020	207P00000X	NA	Other	026	PHYSICIANS	12597	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3300 RENNER DR	None	FORTUNA	CA	95540	3120	12	06023	40.58243651	-124.135992	Humboldt County
15987	Fee-for-Service	1639246481	1639246481	1	1	WONG, ANNI Y NP	5/27/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9400 E ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
15989	Fee-for-Service	1730175449	1730175449	1	2	WALTER, DAVID H PHD	3/1/1999	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11980 SAN VICENTE BLVD	STE 810	LOS ANGELES	CA	90049	6606	19	06037	34.05221538	-118.4721745	Los Angeles County
16015	Fee-for-Service	1366733636	1366733636	1	1	WOLFRAM, BRADFORD A MD	8/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136830	36	Psychiatry	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
16034	Fee-for-Service	1356344485	1356344485	1	1	WINTHROP, STUART R MD	3/7/1996	207W00000X	NA	Ophthalmology	026	PHYSICIANS	34164	18	Ophthalmology	0	In state provider	A PROFESSIONAL CORP	515 E MICHELTORENA ST	STE D	SANTA BARBARA	CA	93103	4224	42	06083	34.43172339	-119.7024817	Santa Barbara County
16059	Fee-for-Service	1013247246	1013247246	3	2	WILSON, PAUL J OD	3/29/2022	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	36330 HIDDEN SPRINGS RD.	SUITE A	WILDOMAR	CA	92595	5804	33	06065	33.59339735	-117.2454691	Riverside County
16067	Fee-for-Service	1790165900	1790165900	1	1	WAHEED, AISHA MD	10/22/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	169581	36	Psychiatry	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
16083	Fee-for-Service	1306166343	1306166343	1	1	WONG, CYRUS C L MD	7/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126096	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
16126	Fee-for-Service	1356787949	1356787949	1	1	WARDE, DIANE M LCSW	6/5/2018	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	830 G ST	240	ARCATA	CA	95521	6256	12	06023	40.86831699	-124.0859389	Humboldt County
16150	Fee-for-Service	1184744641	1184744641	1	2	WADA OPTOMETRY, INC.	10/28/2021	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	936 S BROOKHURST ST	None	ANAHEIM	CA	92804	4305	30	06059	33.819075	-117.9589105	Orange County
16179	Fee-for-Service	1639439805	1639439805	1	1	WILSON, P NICK MD INC	7/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112847	05	Anesthesiology	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	4902	33	06065	33.5580705	-117.1835458	Riverside County
16204	Fee-for-Service	1265545537	1265545537	1	1	WALTERS, DELANO I CRNA	2/8/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
16211	Fee-for-Service	1902171069	1902171069	1	1	WILLIAMS SMITH, ROSHUNDA NP	12/18/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1045 N TUSTIN ST	None	ORANGE	CA	92867	5904	30	06059	33.80481643	-117.8356481	Orange County
16238	Fee-for-Service	1437375953	1437375953	1	1	WALK-IN MEDICAL CARE	4/19/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	18326 PIONEER BLVD	None	ARTESIA	CA	90701	5533	19	06037	33.864912	-118.082172	Los Angeles County
16256	Fee-for-Service	1861504789	1861504789	1	1	WEST COVINA PHARMACY INC	8/1/2003	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WEST COVINA PHARMACY	1661 HANOVER RD	STE 104B	CITY OF INDUSTRY	CA	91748	1796	19	06037	33.99109665	-117.920988	Los Angeles County
16291	Fee-for-Service	1902242712	1902242712	1	1	WAL-MART STORES INC	8/12/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19340 HAWTHORNE BLVD	None	TORRANCE	CA	90503	1506	19	06037	33.8533117	-118.3536167	Los Angeles County
16293	Fee-for-Service	1750791067	1750791067	1	1	WONG, JUDI DO	8/3/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	14627	None	None	0	In state provider	None	899 VALENCIA ST	GROUND FLOOR	SAN FRANCISCO	CA	94110	1736	38	06075	37.75867161	-122.4212468	San Francisco County
16304	Fee-for-Service	1265734404	1265734404	1	1	WARREN, NANCY D	11/4/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
16345	Fee-for-Service	1558376889	1558376889	1	1	WALGREENS CO	7/18/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #06036	4051 DOUGLAS BLVD	None	GRANITE BAY	CA	95746	5901	31	06061	38.74390645	-121.2244714	Placer County
16416	Fee-for-Service	1730348764	1730348764	1	1	WOODLAND RESIDENTIAL SERVICE	9/24/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	40145 BEST RANCH RD	None	WOODLAND	CA	95776	9106	57	06113	38.716533	-121.761963	Yolo County
16438	Fee-for-Service	1699986950	1699986950	1	1	WHEELER CONSIGLIERI	6/25/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	& SELINGER MDS INC	1850 SULLIVAN AVE	STE 550	DALY CITY	CA	94015	2234	41	06081	37.68085904	-122.4728842	San Mateo County
16458	Fee-for-Service	1215016365	1215016365	1	1	WIKLER, CYNTHIA E MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45796	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
16470	Fee-for-Service	1982639316	1982639316	1	1	WU, ANDREW Q	8/24/1989	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	20600 MARIANI AVE	None	CUPERTINO	CA	95014	2044	43	06085	37.33020054	-122.0340645	Santa Clara County
16474	Fee-for-Service	1376785048	1376785048	1	1	WANG, HANK MD	8/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99294	10	Gastroenterology (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
16479	Fee-for-Service	1407934128	1407934128	1	1	WILLAMS,ALAN R MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67524	14	Neurological Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
16485	Fee-for-Service	1386203339	1386203339	1	1	WAGGERMAN, LINDSAY MD	12/5/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181004	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
16497	Fee-for-Service	1275952293	1275952293	1	1	WONG, SE FUM MD	7/17/2019	207L00000X	NA	Other	026	PHYSICIANS	141726	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
16505	Fee-for-Service	1821219965	1821219965	1	1	WITHEE, MICHELLE MD	4/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129695	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
16522	Fee-for-Service	1073528352	1073528352	1	1	WALGREEN CO	2/26/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1660 WINCHESTER BLVD	None	CAMPBELL	CA	95008	1114	43	06085	37.293849	-121.949873	Santa Clara County
16556	Fee-for-Service	1295190890	1295190890	1	1	WEST, KATE E NP	9/12/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	50 ALAMO DRIVE	None	WEED	CA	96094	2352	47	06093	41.42691185	-122.3847933	Siskiyou County
16567	Fee-for-Service	1821154949	1821154949	1	1	WILLIAMS, JASON C CRNA	3/30/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
16573	Fee-for-Service	1841229317	1841229317	1	1	WONG, ANDREA MD	12/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95605	40	Pediatrics	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
16589	Fee-for-Service	1659387892	1659387892	1	1	WU, DERRINA L MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80622	41	Internal Medicine	0	In state provider	None	3580 CALIFORNIA ST	STE 303	SAN FRANCISCO	CA	94118	1715	38	06075	37.78648975	-122.452943	San Francisco County
16664	Fee-for-Service	1699780965	1699780965	1	1	WALGREEN CO	6/8/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3001 TARAVAL ST	None	SAN FRANCISCO	CA	94116	2106	38	06075	37.74200588	-122.4987236	San Francisco County
16695	Fee-for-Service	1912043654	1912043654	1	1	WINDSOR MONTEREY CARE CT LLC	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1575 SKYLINE DR	None	MONTEREY	CA	93940	4110	27	06053	36.59190732	-121.9174351	Monterey County
16697	Fee-for-Service	1336201680	1336201680	1	1	WHITE, GARY C OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2340 SUNRISE BLVD	STE 17	RANCHO CORDOVA	CA	95670	4368	34	06067	38.617839	-121.2702435	Sacramento County
16711	Fee-for-Service	1629091145	1629091145	1	1	WORSEY, MICHAEL J MD	6/24/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69016	28	Proctology (colon and rectal)	0	In state provider	None	9850 GENESEE AVE	STE 640	LA JOLLA	CA	92037	1217	37	06073	32.882913	-117.226341	San Diego County
16719	Fee-for-Service	1043349772	1043349772	1	1	WERTMAN, BRETT MD	8/9/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	90231	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
16772	Fee-for-Service	1275926446	1275926446	1	1	WAL-MART STORES, INC	11/18/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8915 GERBER RD	None	SACRAMENTO	CA	95829	1155	34	06067	38.482695	-121.369923	Sacramento County
16788	Fee-for-Service	1093722159	1093722159	1	1	WOODS, CLARENCE JR MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	25767	20	Orthopedic Surgery	0	In state provider	None	3628 E IMPERIAL HWY	STE 402	LYNWOOD	CA	90262	2646	19	06037	33.93070837	-118.2044557	Los Angeles County
16823	Fee-for-Service	1811903297	1811903297	1	1	WALGREEN CO	4/25/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1802 S HARBOR BLVD	None	ANAHEIM	CA	92802	3510	30	06059	33.80286201	-117.9151674	Orange County
16826	Fee-for-Service	1922314145	1922314145	1	1	WYLIE, BLAKE A DO	5/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11088	01	General Practice	0	In state provider	None	260 CALLE CAMPESINO	None	SAN CLEMENTE	CA	92672	4553	30	06059	33.39668737	-117.5964297	Orange County
16860	Fee-for-Service	1841229317	1841229317	1	1	WONG, ANDREA MD	12/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95605	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
16878	Fee-for-Service	1730954884	1730954884	1	1	WILSON, TRACY DOULA	4/10/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	48	06095	0	0	None
16885	Fee-for-Service	1396878377	1396878377	1	1	WYNN JONES, PATRICIA A MD	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	69124	05	Anesthesiology	0	In state provider	None	5900 WEST OLYMPIC BLVD	None	LOS ANGELES	CA	90036	4671	19	06037	34.05760692	-118.3604361	Los Angeles County
16903	Fee-for-Service	1013203710	1013203710	1	1	WALGREEN CO	10/20/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8230 SARATOGA WAY	None	EL DORADO HILLS	CA	95762	4531	09	06017	38.65603483	-121.0726726	El Dorado County
16962	Fee-for-Service	1053490789	1053490789	1	1	WHITE II, JAMES W MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70288	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
17001	Fee-for-Service	1629091145	1629091145	1	1	WORSEY, MICHAEL J MD	6/24/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69016	02	General Surgery	0	In state provider	None	9850 GENESEE AVE	STE 640	LA JOLLA	CA	92037	1217	37	06073	32.882913	-117.226341	San Diego County
17003	Fee-for-Service	1205863701	1205863701	1	1	WAIDER, WINFRIED MD	4/24/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	26074	41	Internal Medicine	0	In state provider	None	1430 PACIFIC AVE	None	LONG BEACH	CA	90813	1717	19	06037	33.78449968	-118.1936986	Los Angeles County
17054	Fee-for-Service	1922698091	1922698091	1	1	WEST WAVE NEURODIAGNOSTICS L	10/12/2022	156F00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	LC	937 E MAIN ST	STE 107	SANTA MARIA	CA	93454	5309	42	06083	34.95309189	-120.4209855	Santa Barbara County
17079	Fee-for-Service	1306834957	1306834957	1	1	WALKER, BRIAN K MD	9/1/1995	208600000X	NA	General Surgery	026	PHYSICIANS	43347	02	General Surgery	0	In state provider	None	13847 E 14TH ST	STE 118	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
17142	Fee-for-Service	1063496289	1063496289	1	1	WAITE, JOHN R PT	2/25/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25495 MEDICAL CENTER DR.	SUITE 304	MURRIETA	CA	92562	0000	33	06065	33.55804188	-117.1834064	Riverside County
17193	Fee-for-Service	1184646358	1184646358	1	1	WATSON, KAROL E MD	12/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	72736	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA #530	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
17203	Fee-for-Service	1598949612	1598949612	1	1	WONG, HEIDI H MD	2/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116151	41	Internal Medicine	0	In state provider	None	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94143	3354	38	06075	37.79989786	-122.4090369	San Francisco County
17233	Fee-for-Service	1225287196	1225287196	1	1	WOODS, JACQUELINE G LMFT	11/6/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	TER	1949 HUNTINGTON DRIVE	A	SOUTH PASADENA	CA	91030	4989	19	06037	34.10409053	-118.141992	Los Angeles County
17249	Fee-for-Service	1013065184	1013065184	1	1	WU, MEEI-LING MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40891	18	Ophthalmology	0	In state provider	None	991 N TUSTIN ST	STE 101	ORANGE	CA	92867	5900	30	06059	33.80406172	-117.8356368	Orange County
17255	Fee-for-Service	1043779473	1043779473	1	1	WESTERN HEALTH RESOURCES	3/24/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2650 JONES WAY	SUITE 26	SIMI VALLEY	CA	93065	1220	56	06111	34.28861251	-118.745991	Ventura County
17269	Fee-for-Service	1952914681	1952914681	1	4	WEST COAST KIDNEY	9/27/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2222 EAST STREET	STE 305	CONCORD	CA	94520	2066	07	06013	37.98125538	-122.0329375	Contra Costa County
17287	Fee-for-Service	1629091145	1629091145	1	1	WORSEY, MICHAEL J MD	6/24/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69016	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9850 GENESEE AVE	STE 640	LA JOLLA	CA	92037	1217	37	06073	32.882913	-117.226341	San Diego County
17289	Fee-for-Service	1417928664	1417928664	1	1	WILLIAMS, BRIAN T MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138841	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
17302	Fee-for-Service	1316988561	1316988561	1	1	WAGNER, RICHARD E M MD	1/1/1984	207P00000X	NA	Other	026	PHYSICIANS	42367	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
17323	Fee-for-Service	1326468521	1326468521	1	1	WEBSTER, NICHOLAS D MD	7/10/2020	208200000X	NA	General Surgery	026	PHYSICIANS	164059	24	Plastic Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
17378	Fee-for-Service	1720191729	1720191729	1	1	WOLF, PAUL S MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91087	79	Neurology-Child	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
17403	Fee-for-Service	1699754317	1699754317	1	1	WALSH, ROBERT T PT	1/17/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	570 COLLINS DR	None	MERCED	CA	95348	3121	24	06047	37.32262774	-120.4768681	Merced County
17419	Fee-for-Service	1114169760	1114169760	1	1	WALLNER, CAROLINE L MD	5/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113187	34	Urology and Urological Surgery	0	In state provider	None	200 MEDICAL PLAZA	SUITE 140	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
17421	Fee-for-Service	1326053612	1326053612	1	1	WALGREENS CO	3/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #07081	416 ALVARADO ST	None	MONTEREY	CA	93940	2711	27	06053	36.59940067	-121.8945128	Monterey County
17432	Fee-for-Service	1801800370	1801800370	1	1	WHEELER, HEATHER J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	931 HIGHLAND BLVD	STE 3360	BOZEMAN	MT	59715	6914	00	None	45.66951	-111.0209265	Gallatin County
17442	Fee-for-Service	1053643684	1053643684	1	1	WILLOUGHBY, KATHARINE MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110248	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3624 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4006	07	06013	38.00418494	-121.8432075	Contra Costa County
17484	Fee-for-Service	1184646358	1184646358	1	1	WATSON, KAROL E MD	12/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	72736	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA #530	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
17488	Fee-for-Service	1477025567	1477025567	1	1	WALSHE, SUSAN M LMFT	11/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6621 E PACIFIC COAST HWY	STE 220	LONG BEACH	CA	90803	4200	19	06037	33.755373	-118.105911	Los Angeles County
17490	Fee-for-Service	1881897023	1881897023	1	1	WANG, HAO MD	7/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140940	41	Internal Medicine	0	In state provider	None	2601 E MAIN ST	None	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
17492	Fee-for-Service	1598949612	1598949612	1	1	WONG, HEIDI H MD	2/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116151	83	Rheumatology	0	In state provider	None	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94143	3354	38	06075	37.79989786	-122.4090369	San Francisco County
17538	Fee-for-Service	1720455454	1720455454	1	1	WANG, LU MD	9/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151603	41	Internal Medicine	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91346	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
17540	Fee-for-Service	1952914681	1952914681	1	1	WEST COAST KIDNEY	5/5/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1498 SOUTHGATE AVE	STE 102	DALY CITY	CA	94015	4015	41	06081	37.67558947	-122.4761175	San Mateo County
17553	Fee-for-Service	1952914681	1952914681	1	2	WEST COAST KIDNEY	9/13/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4383	01	06001	37.63347961	-122.0897735	Alameda County
17556	Fee-for-Service	1023470689	1023470689	1	1	WARD, SHAUNTAVIA D NP	3/31/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
17651	Fee-for-Service	1821010455	1821010455	1	1	WILLIAM H KREISLE MD	1/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 E IDAHO ST	None	BOISE	ID	83712	6267	00	None	43.61191085	-116.1938523	Ada County
17676	Fee-for-Service	1285384750	1285384750	1	1	WAGNER, DEBORAH J LCSW	10/13/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
17680	Fee-for-Service	1083870075	1083870075	1	1	WILLIAMS, JOAN R MD	7/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130696	20	Orthopedic Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
17739	Fee-for-Service	1548276199	1548276199	1	1	WALGREENS CO	1/1/1966	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3601 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1701	38	06075	37.78635452	-122.4535829	San Francisco County
17811	Fee-for-Service	1003119975	1003119975	1	1	WANG, LEE L MD	6/27/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	146921	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
17823	Fee-for-Service	1710351895	1710351895	1	1	WALGREEN CO	2/23/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1726 SUPERIOR AVE	None	COSTA MESA	CA	92627	3615	30	06059	33.63718326	-117.9226045	Orange County
17830	Fee-for-Service	1952914681	1952914681	1	1	WEST COAST KIDNEY	5/5/2022	207RN0300X	NA	Nephrology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1498 SOUTHGATE AVE	STE 102	DALY CITY	CA	94015	4015	41	06081	37.67558947	-122.4761175	San Mateo County
17831	Fee-for-Service	1346331113	1346331113	1	1	WEBB, BRIAN S MD	10/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52358	None	None	0	In state provider	None	450 GREENFIELD AVE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
17853	Fee-for-Service	1750324323	1750324323	1	1	WRIGHT, TERI	9/30/1991	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1310 W STEWART DR	STE 302	ORANGE	CA	92868	3838	30	06059	33.78236048	-117.8664975	Orange County
17869	Fee-for-Service	1356571731	1356571731	1	1	WU, JAMES J MD	7/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119747	40	Pediatrics	0	In state provider	None	1818 N ORANGE GROVE AVE	STE 200	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
17913	Fee-for-Service	1760877674	1760877674	1	1	WARREN, LINDSAY MD	7/1/2019	207P00000X	NA	Other	026	PHYSICIANS	162334	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
17931	Fee-for-Service	1487340725	1487340725	1	1	WESTHOUT MD INC	1/19/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	209 N PACIFIC AVE	None	SAN PEDRO	CA	90731	2015	19	06037	33.744411	-118.287909	Los Angeles County
17944	Fee-for-Service	1083116586	1083116586	1	1	WHALEN, VICTORIA L CNP	12/10/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	638 CAMINO DE LOS MARES	None	SAN CLEMENTE	CA	92673	2848	30	06059	33.45932277	-117.6517315	Orange County
18013	Fee-for-Service	1255435822	1255435822	1	1	WIRTA, DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	81350	18	Ophthalmology	0	In state provider	None	1501 SUPERIOR AVE	STE 303	NEWPORT BEACH	CA	92663	3641	30	06059	33.62918676	-117.9305675	Orange County
18042	Fee-for-Service	1346570892	1346570892	1	1	WOO BAIDAL, JENNIFER A MD	7/4/2024	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	107819	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
18124	Fee-for-Service	1134534290	1134534290	1	1	WASIL, MICHELENE M MFT	4/9/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
18156	Fee-for-Service	1447487657	1447487657	1	1	WALGREEN CO	9/10/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3320 CHINO HILLS PKWY	None	CHINO HILLS	CA	91709	4228	36	06071	33.9825291	-117.7318314	San Bernardino County
18178	Fee-for-Service	1932593274	1932593274	1	1	WINGO, MATTHEW E MD	5/18/2024	208600000X	NA	General Surgery	026	PHYSICIANS	176485	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
18191	Fee-for-Service	1295751097	1295751097	1	1	WOLFF, DANIELLE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 W 5TH AVE	None	SPOKANE	WA	99204	2803	00	None	47.651778	-117.423477	Spokane County
18196	Fee-for-Service	1013444553	1013444553	1	1	WISEMAN, KATIE LMFT	6/20/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1902 ORANGE TREE LN	SUITE 200	REDLANDS	CA	92374	2888	36	06071	34.06785293	-117.2179967	San Bernardino County
18246	Fee-for-Service	1275977019	1275977019	1	1	WIJESINGHE, ISURU U DO	6/6/2022	207L00000X	NA	Other	026	PHYSICIANS	14005	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
18251	Fee-for-Service	1619405875	1619405875	1	1	WIELE, ERIK D DO	8/6/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17237	08	Family Practice	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
18273	Fee-for-Service	1023284049	1023284049	1	1	WALKER, SAMANTHA E LMFT	6/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1702 E BULLARD AVE	STE 102	FRESNO	CA	93710	5800	10	06019	36.82318447	-119.7563985	Fresno County
18287	Fee-for-Service	1437439726	1437439726	1	1	WEINKAM, TARYN A PHD	5/6/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD ROAD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
18288	Fee-for-Service	1538579073	1538579073	1	1	WIN, HTET HTET MD	4/29/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	162347	41	Internal Medicine	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
18299	Fee-for-Service	1235462490	1235462490	2	1	WEST COAST PHARMACY	10/25/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP,INC.	1422 EAST FLORENCE AVE	None	LOS ANGELES	CA	90001	1937	19	06037	33.97471947	-118.2490785	Los Angeles County
18311	Fee-for-Service	1679119333	1679119333	1	1	WOLFE, BRITTNEY NP	6/18/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
18330	Fee-for-Service	1346570892	1346570892	1	1	WOO BAIDAL, JENNIFER A MD	7/4/2024	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	107819	10	Gastroenterology (M.D. only)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
18405	Fee-for-Service	1255479192	1255479192	1	1	WILLIAMS, JAMES G MD	9/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48653	18	Ophthalmology	0	In state provider	COVINA EAR NOSE & THR	202 W COLLEGE ST	None	COVINA	CA	91723	1902	19	06037	34.0874173	-117.8924606	Los Angeles County
18471	Fee-for-Service	1396856894	1396856894	1	1	WOLF, CHRISTOPHER F MD	7/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111850	20	Orthopedic Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
18478	Fee-for-Service	1710921564	1710921564	1	1	WIESE, CRISTINA S MD	6/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91425	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90094	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
18486	Fee-for-Service	1184628695	1184628695	1	1	WONG, KENNETH K MD	5/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70048	30	Radiology	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
18589	Fee-for-Service	1366587503	1366587503	1	1	WESTERN HEALTH SCIENCES	6/12/1984	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	21018 OSBORNE ST	STE 4	CANOGA PARK	CA	91304	1786	19	06037	34.23299319	-118.5912807	Los Angeles County
18620	Fee-for-Service	1225037757	1225037757	1	1	WOOLLEY,JAMES L MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	45484	34	Urology and Urological Surgery	0	In state provider	None	660 SANITARIUM RD	STE 104	DEER PARK	CA	94576	9710	28	06055	38.54206023	-122.47561	Napa County
18622	Fee-for-Service	1790711513	1790711513	1	1	WILLIAMS, MONICA MD	8/29/2019	207P00000X	NA	Other	026	PHYSICIANS	161831	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1515 E OCEAN AVE	None	LOMPOC	CA	93436	7092	42	06083	34.63941491	-120.4393023	Santa Barbara County
18623	Fee-for-Service	1336211184	1336211184	1	1	WILLIAMS, LAURA H MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	41025	22	Pathology (M.D. only)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
18700	Fee-for-Service	1346878824	1346878824	1	1	WARD, LINDSEY M MD	7/7/2023	207R00000X	NA	Other	026	PHYSICIANS	187177	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
18703	Fee-for-Service	1558650200	1558650200	1	1	WIECK, MINNA M MD	8/1/2020	390200000X	NA	Other	026	PHYSICIANS	130197	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
18711	Fee-for-Service	1487694055	1487694055	1	1	WONG, WILLARD B MD	5/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76618	20	Orthopedic Surgery	0	In state provider	None	240 SAN JOSE ST	None	SALINAS	CA	93901	3901	27	06053	36.6582359	-121.6463252	Monterey County
18715	Fee-for-Service	1366933749	1366933749	1	1	WOODLAND HILLS DIALYSIS	7/2/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	5939 CANOGA AVE	None	WOODLAND HILLS	CA	91367	5010	19	06037	34.17819379	-118.5975446	Los Angeles County
18756	Fee-for-Service	1770748956	1770748956	1	1	WILTSIE, MEREDITH N NP	10/24/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	3341	43	06085	37.43304542	-122.1759654	Santa Clara County
18757	Fee-for-Service	1821708850	1821708850	1	1	WASEEM KHADER DO INC	3/26/2023	2083A0300X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	11878 AVENUE OF INDUSTRY	None	SAN DIEGO	CA	92128	3423	37	06073	32.99058739	-117.0752486	San Diego County
18773	Fee-for-Service	1184628695	1184628695	1	1	WONG, KENNETH K MD	5/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70048	78	Neoplastic Diseases/Oncology	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
18781	Fee-for-Service	1164865028	1164865028	1	1	WILSHUSEN, KELLY A LCSW	7/18/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
18825	Fee-for-Service	1881033629	1881033629	1	1	WOLFE, BRIAN H LMFT	4/9/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
18852	Fee-for-Service	1609821057	1609821057	1	1	WADHWANI, ANIL N MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78980	30	Radiology	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
18931	Fee-for-Service	1417374679	1417374679	1	1	WILSON, BRANT O MD	6/19/2018	207L00000X	NA	Other	026	PHYSICIANS	141476	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
18962	Fee-for-Service	1720329667	1720329667	1	1	WADHWANI, SHARAD I MD	7/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124815	40	Pediatrics	0	In state provider	None	3700 CALIFORNIA ST	5TH FLOOR	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
19016	Fee-for-Service	1902884265	1902884265	1	1	WATSON, ERIC J DO	8/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10400	25	Physical Medicine and Rehabilitation	0	In state provider	None	316 S STRATFORD	STE B	SANTA MARIA	CA	93454	5908	42	06083	34.95019447	-120.4147816	Santa Barbara County
19018	Fee-for-Service	1174576268	1174576268	1	1	WATSON, THOMAS D MD	10/31/1983	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	31658	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
19027	Fee-for-Service	1306851696	1306851696	1	1	WALGREEN CO	4/9/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #06187	11950 VALLEY VIEW ST	None	GARDEN GROVE	CA	92845	1239	30	06059	33.7890093	-118.0283611	Orange County
19074	Fee-for-Service	1083268742	1083268742	1	1	WEISS, COLLEEN M NP	11/6/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
19133	Fee-for-Service	1063453827	1063453827	1	1	WENTHE, MARTIN T MD	4/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78460	08	Family Practice	0	In state provider	None	4770 W HERNDON AVE	None	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
19136	Fee-for-Service	1699732941	1699732941	1	1	WALLACE, ANNE M MD	9/30/1993	208200000X	NA	General Surgery	026	PHYSICIANS	73000	02	General Surgery	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
19158	Fee-for-Service	1801280359	1801280359	1	1	WANG, CHEN MD	5/14/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	143851	07	Dermatology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
19172	Fee-for-Service	1295980423	1295980423	2	1	WALWORTH, NICHOLAS R	9/17/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	30145 ANTELOPE RD	SUITE 105	MENIFEE	CA	92584	8065	33	06065	33.68299914	-117.1673659	Riverside County
19177	Fee-for-Service	1427435379	1427435379	1	1	WIN, EMILY F MD	8/22/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	154136	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
19188	Fee-for-Service	1437221561	1437221561	1	1	WINKLE, CHRISTOPHER MD	4/1/1998	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	73066	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 708	GARDEN GROVE	CA	92843	1921	30	06059	33.77450141	-117.9123364	Orange County
19283	Fee-for-Service	1962872978	1962872978	1	1	WAHI, GAURAV DO INC	12/2/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	14117	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2490 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4356	52	06103	40.14934625	-122.2206345	Tehama County
19360	Fee-for-Service	1932393220	1932393220	1	1	WILLIAMS, TOM E MD	9/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100446	08	Family Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
19425	Fee-for-Service	1639299407	1639299407	1	1	WHITTAKER, KATHERYN L LMFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	43908	-	NOT APPLICABLE	0	In state provider	None	844 PICO BLVD	None	SANTA MONICA	CA	90405	1326	19	06037	34.01263151	-118.4813759	Los Angeles County
19474	Fee-for-Service	1558728055	1558728055	1	1	WOOLSEY, KAREN NP	12/3/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
19491	Fee-for-Service	1780680132	1780680132	2	1	WHEELCHAIRS OF BERKELEY	5/30/2019	332BC3200X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2911 SHATTUCK AVE	None	BERKELEY	CA	94705	1808	01	06001	37.85630105	-122.2666232	Alameda County
19519	Fee-for-Service	1972622553	1972622553	1	1	WARKENTIN, EDIE L LCSW	10/19/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	19329	-	NOT APPLICABLE	0	In state provider	None	1018 21ST STREET	None	BAKERSFIELD	CA	93301	4709	15	06029	35.37813217	-119.0132767	Kern County
19559	Fee-for-Service	1265051718	1265051718	1	1	WHITE OAK HOSPICE	4/15/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	17547 VENTURA BLVD	STE 107A	ENCINO	CA	91316	3854	19	06037	34.16176929	-118.5157806	Los Angeles County
19592	Fee-for-Service	1598703951	1598703951	1	1	WILLIAM E ESHAM	4/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MIDWEST PHYSICIAN ASNES	5151 REED ROAD SUITE 105	None	COLUMBUS	OH	43220	0000	00	None	40.06279476	-83.06661134	Franklin County
19596	Fee-for-Service	1790875128	1790875128	1	1	WHINNERY, CATHERINE MD	11/3/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41460	08	Family Practice	0	In state provider	None	500 SAN PABLO AVE	#300	ALBANY	CA	94706	1127	01	06001	37.89781848	-122.3014067	Alameda County
19599	Fee-for-Service	1376215004	1376215004	1	1	WARD, AUTUMN M LCSW	6/1/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16519 VICTOR ST	421	VICTORVILLE	CA	92395	3935	36	06071	34.5212432	-117.3044617	San Bernardino County
19621	Fee-for-Service	1437309796	1437309796	1	1	WHITE, NANCY A LMFT	2/15/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
19633	Fee-for-Service	1720883804	1720883804	1	1	WILGENHOF-ESTRADA, CRISTINA	3/6/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
19657	Fee-for-Service	1861673972	1861673972	1	1	WILLIAMS, MITZI L DPM	6/15/2009	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
19722	Fee-for-Service	1902234511	1902234511	1	1	WATKINS, JACLYN MD	6/30/2023	207ZP0101X	NA	Other	026	PHYSICIANS	186515	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
19735	Fee-for-Service	1407818024	1407818024	1	1	WOMEN'S HLTH SPECIALISTS	9/5/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2299 MOWRY AVE	STE 3C	FREMONT	CA	94538	1621	01	06001	37.55671415	-121.9817758	Alameda County
19738	Fee-for-Service	1437221561	1437221561	1	3	WINKLE, CHRISTOPHER MD	6/1/2002	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	73066	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1720 W BALL RD	None	ANAHEIM	CA	92804	5500	30	06059	33.8178465	-117.9425115	Orange County
19749	Fee-for-Service	1508115858	1508115858	1	1	WATSON, EVELINA LMFT	8/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
19752	Fee-for-Service	1598477499	1598477499	1	1	WHITING, STEPHANIE T	1/3/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
19790	Fee-for-Service	1043448707	1043448707	1	1	WEINSTEIN DECOSTA, LILI MD	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121096	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
19848	Fee-for-Service	1265051718	1265051718	1	1	WHITE OAK HOSPICE	4/15/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	17547 VENTURA BLVD	STE 107A	ENCINO	CA	91316	3854	19	06037	34.16176929	-118.5157806	Los Angeles County
19850	Fee-for-Service	1801829569	1801829569	1	1	WESSEL, RALPH J MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	21904	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
19871	Fee-for-Service	1639172562	1639172562	1	1	WINT, ROGER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9501 ROOSEVELT BLVD	STE 501	PHILADELPHIA	PA	19114	1030	00	None	40.08128736	-75.0278209	Philadelphia County
19930	Fee-for-Service	1760409098	1760409098	1	1	WAL-MART PHARMACY 102052	11/29/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1155 AIRPORT PARK BLVD	None	UKIAH	CA	95482	5998	23	06045	39.133656	-123.1987635	Mendocino County
19946	Fee-for-Service	1114031663	1114031663	1	1	WATKINS, AI MAE C MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80707	15	Obstetrics (D.O. only)	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
19955	Fee-for-Service	1245202647	1245202647	1	1	WIBBELSMAN, CHRISTOPHER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1001 WELLINGTON AVE	None	GRAND JCT	CO	81501	8122	00	None	39.0899461	-108.5562163	Mesa County
20019	Fee-for-Service	1528529526	1528529526	1	1	WONG, SCOTT DO	10/12/2022	390200000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
20038	Fee-for-Service	1295701159	1295701159	1	1	WHITE, KERI L MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73336	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
20051	Fee-for-Service	1376683276	1376683276	1	1	WALTER, MARC C MD	10/31/1986	207P00000X	NA	Other	026	PHYSICIANS	50250	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
20078	Fee-for-Service	1083974455	1083974455	1	1	WEN, LOUISE Y-L MD	5/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126893	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
20089	Fee-for-Service	1689715021	1689715021	1	1	WELLNESS MATTERS INC	11/16/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	WELLNESS MATTERS INC	6047 TAMPA AVE	STE 104	TARZANA	CA	91356	1169	19	06037	34.180812	-118.553488	Los Angeles County
20124	Fee-for-Service	1215296371	1215296371	1	1	WANG, RACHEL R MD	6/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122510	05	Anesthesiology	0	In state provider	None	1555 SOQUEL DRIVE	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
20141	Fee-for-Service	1639184914	1639184914	1	1	WALGREEN CO	5/24/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1510 N SANTA FE AVE	None	VISTA	CA	92083	2001	37	06073	33.22189891	-117.2454882	San Diego County
20184	Fee-for-Service	1316227572	1316227572	1	1	WALGREEN CO	12/18/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4029 43RD ST	STE 700	SAN DIEGO	CA	92105	1510	37	06073	32.75012697	-117.1019424	San Diego County
20201	Fee-for-Service	1710037197	1710037197	1	1	WEE, ERIC L	7/20/1998	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6333 WILSHIRE BLVD	STE 200	LOS ANGELES	CA	90048	5724	19	06037	34.06355697	-118.366413	Los Angeles County
20207	Fee-for-Service	1336301159	1336301159	1	1	WOLFE, ASHBY J MD	10/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109831	08	Family Practice	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
20243	Fee-for-Service	1437683950	1437683950	1	1	WONG, JEREN M MD	8/30/2020	207P00000X	NA	Other	026	PHYSICIANS	169470	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
20326	Fee-for-Service	1295701159	1295701159	1	1	WHITE, KERI L MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73336	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
20328	Fee-for-Service	1013922392	1013922392	1	1	WALGREEN CO	9/1/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3655 ALHAMBRA AVE	None	MARTINEZ	CA	94553	3912	07	06013	37.9984807	-122.1321299	Contra Costa County
20369	Fee-for-Service	1679515217	1679515217	1	2	WESTERN UNIVERSITY OF	7/5/2016	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	HEALTH SCIENCES	8686 HAVEN AVE	STE 200	RANCHO CUCAMONGA	CA	91730	9110	36	06071	34.095681	-117.575927	San Bernardino County
20417	Fee-for-Service	1497173702	1497173702	1	1	WOAN, KARRUNE V MD	6/3/2021	207RH0003X	NA	Oncology	026	PHYSICIANS	171889	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
20421	Fee-for-Service	1770779530	1770779530	1	1	WILLIAMS, LINNEA M DO	12/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15843	01	General Practice	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
20432	Fee-for-Service	1134318025	1134318025	1	1	WINDSOR, KATKI M LMFT	3/9/2017	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8339 CHURCH STREET	SUITE 217	GILROY	CA	95020	4450	43	06085	37.01812115	-121.5765553	Santa Clara County
20439	Fee-for-Service	1982667820	1982667820	1	1	WICKHAM, LAWRENCE K MD	4/30/1990	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	29385	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
20459	Fee-for-Service	1760424907	1760424907	1	1	WAL-MART STORES INC	9/20/2006	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHMCY 10-5133	5000 RHONDA RD	None	ANDERSON	CA	96007	9010	45	06089	40.431285	-122.2898535	Shasta County
20551	Fee-for-Service	1184112799	1184112799	1	1	WU, SIJIA M MD	12/13/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165671	None	None	0	In state provider	None	2081 BRONZE STAR DR	None	WOODLAND	CA	95776	5423	57	06113	38.67049812	-121.7238394	Yolo County
20562	Fee-for-Service	1811175615	1811175615	1	1	WILEY, JACQUELINE M AUD	11/13/2018	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3009 DE LA VINA	None	SANTA BARBARA	CA	93105	3311	42	06083	34.43897881	-119.7286257	Santa Barbara County
20604	Fee-for-Service	1679733398	1679733398	1	1	WATSON, ALEXANDER R MD	12/13/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
20656	Fee-for-Service	1174250161	1174250161	1	1	WILKS, BERNADETTE M MD	8/5/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
20704	Fee-for-Service	1639594625	1639594625	1	1	WELLS HOUSE OF CALIFORNIA	2/14/2020	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	245 CHERRY AVE	None	LONG BEACH	CA	90802	3901	19	06037	33.76768431	-118.1678547	Los Angeles County
20707	Fee-for-Service	1942311402	1942311402	1	1	WEINTRAUB, MARCIA K MD	5/25/1995	207L00000X	NA	Other	026	PHYSICIANS	65418	05	Anesthesiology	0	In state provider	None	11601 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2907	19	06037	34.04458879	-118.4542015	Los Angeles County
20728	Fee-for-Service	1982667820	1982667820	1	1	WICKHAM, LAWRENCE K MD	4/30/1990	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	29385	40	Pediatrics	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
20741	Fee-for-Service	1255383212	1255383212	1	1	WILLER.JOHN D DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CASCADE EYE CENTER	301 CHERRY HEIGHTS RD	None	DALLAS	OR	97058	0000	00	None	45.60543315	-121.1926235	Wasco County
20768	Fee-for-Service	1851447445	1851447445	1	1	WILLIAMS, JESSICA MD	10/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
20778	Fee-for-Service	1487346169	1487346169	1	1	WEST PICO TERRACE ASSISTED	1/26/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LIVING CENTER, LP	6050 W PICO BLVD	None	LOS ANGELES	CA	90035	2647	19	06037	34.05253409	-118.3723394	Los Angeles County
20827	Fee-for-Service	1285936518	1285936518	1	1	WISHAH, FIDAA J MD	5/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153510	30	Radiology	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
20835	Fee-for-Service	1902873326	1902873326	1	1	WENDY MCLAUGHLIN	10/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	37000 N GANTZEL RD	None	QUEEN CREEK	AZ	85140	7303	00	None	33.21531	-111.565503	Pinal County
20848	Fee-for-Service	1205819497	1205819497	1	1	WISEMAN, JOE B MD	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86344	04	Otology, Laryngology, Rhinology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
20870	Fee-for-Service	1629059092	1629059092	1	1	WANLASS, RICHARD L PHD	3/4/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
20872	Fee-for-Service	1801309869	1801309869	1	1	WESTLAKE VILLA HOSPICE INC	4/23/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1272 CENTER COURT DR	SUITE 206	COVINA	CA	91724	0000	19	06037	34.07289566	-117.864007	Los Angeles County
20928	Fee-for-Service	1073561346	1073561346	1	1	WILLIS, ADELAIDE B MD	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	44131	01	General Practice	0	In state provider	None	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
20948	Fee-for-Service	1366875320	1366875320	1	1	WILLIAMS, CHARLES A PHD	3/24/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
20980	Fee-for-Service	1083606487	1083606487	1	1	WIN, KYI KYI MD	8/3/2009	207R00000X	NA	Other	026	PHYSICIANS	56373	41	Internal Medicine	0	In state provider	None	29099 HOSPITAL RD	STE 107	LAKE ARROWHEAD	CA	92352	0000	36	06071	34.26652661	-117.1690546	San Bernardino County
20987	Fee-for-Service	1881013035	1881013035	1	1	WU, KATHERINE MD	9/26/2019	207RR0500X	NA	Other	026	PHYSICIANS	141727	83	Rheumatology	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
20994	Fee-for-Service	1619339777	1619339777	1	1	WISNIEWSKI, DANIELLE T MD	8/30/2019	390200000X	NA	Other	026	PHYSICIANS	150742	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
21011	Fee-for-Service	1629206925	1629206925	1	1	WYBOURN, CHRISTOPHER A MD	5/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130416	02	General Surgery	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
21015	Fee-for-Service	1447575709	1447575709	1	1	WALLIN, KELLY J DPM	9/3/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
21070	Fee-for-Service	1386677912	1386677912	1	1	WOODDELL, MARGARET K MD	1/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	74587	08	Family Practice	0	In state provider	None	2331 CAPITOL AVE	None	SACRAMENTO	CA	95816	5812	34	06067	38.572236	-121.476123	Sacramento County
21126	Fee-for-Service	1144429994	1144429994	1	1	WOLFORD, BRENNA E CRNA	3/15/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	444 BRUCE STREET	None	YREKA	CA	96097	3450	47	06093	41.71863548	-122.6458755	Siskiyou County
21162	Fee-for-Service	1801309869	1801309869	1	1	WESTLAKE VILLA HOSPICE INC	4/23/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1272 CENTER COURT DR	SUITE 206	COVINA	CA	91724	0000	19	06037	34.07289566	-117.864007	Los Angeles County
21180	Fee-for-Service	1114581360	1114581360	1	1	WILLIAMS, CAITLIN A MD	12/14/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	183089	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
21203	Fee-for-Service	1609341197	1609341197	1	1	WALDEN, AYESHA F CNM	1/19/2021	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	229 W CHERRY AVE	None	PORTERVILLE	CA	93257	3401	54	06107	36.06917549	-119.0215574	Tulare County
21213	Fee-for-Service	1073561346	1073561346	1	1	WILLIS, ADELAIDE B MD	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	44131	08	Family Practice	0	In state provider	None	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
21227	Fee-for-Service	1659428704	1659428704	1	1	WIEBE, TIMOTHY M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	53943	14	Neurological Surgery	0	In state provider	None	1332 W HERNDON AVE	STE 101	FRESNO	CA	93711	7118	10	06019	36.83737137	-119.8148304	Fresno County
21237	Fee-for-Service	1033785548	1033785548	1	1	WYMAN, PAMELA S NP	4/22/2022	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
21274	Fee-for-Service	1881013035	1881013035	1	1	WU, KATHERINE MD	9/26/2019	207RR0500X	NA	Other	026	PHYSICIANS	141727	41	Internal Medicine	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
21282	Fee-for-Service	1023328291	1023328291	1	1	WESTERN CARE HOSPICE INC	6/19/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 VICTORY BLVD	SUITE 505	VAN NUYS	CA	91411	4183	19	06037	34.18668846	-118.450152	Los Angeles County
21309	Fee-for-Service	1467511063	1467511063	1	1	WALTER, KARL F MD	6/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70395	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
21332	Fee-for-Service	1154815991	1154815991	1	1	WEST, JACOB A MD	11/21/2019	390200000X	NA	Other	026	PHYSICIANS	163874	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
21365	Fee-for-Service	1407861792	1407861792	1	1	WALGREEN CO	10/23/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13052 NEWPORT AVE	None	TUSTIN	CA	92780	3535	30	06059	33.74896613	-117.8112946	Orange County
21372	Fee-for-Service	1356852495	1356852495	1	1	WOOTEN, COLLEN E PT	10/2/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12411 POWAY RD	STE 202B	POWAY	CA	92064	4302	37	06073	32.95170468	-117.0621893	San Diego County
21443	Fee-for-Service	1487031373	1487031373	1	1	WHALE, CORY R DO	8/5/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	17186	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
21475	Fee-for-Service	1205029451	1205029451	1	1	WOODS-PEIRCE, CASSANDRA C LP	11/9/2018	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	T	1857 KNOLL DR	None	VENTURA	CA	93003	7321	56	06111	34.2558809	-119.2202677	Ventura County
21481	Fee-for-Service	1881772630	1881772630	1	1	WATERHOUSE, JAMES MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	57842	01	General Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
21571	Fee-for-Service	1023328291	1023328291	1	1	WESTERN CARE HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 VICTORY BLVD	SUITE 505	VAN NUYS	CA	91411	4183	19	06037	34.18668846	-118.450152	Los Angeles County
21577	Fee-for-Service	1598782914	1598782914	1	1	WAL-MART PHARMACY	9/28/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	# 10-2280	600 SHOWERS DR	None	MOUNTAIN VIEW	CA	94040	1434	43	06085	37.40033422	-122.108957	Santa Clara County
21768	Fee-for-Service	1255351698	1255351698	1	1	WANGLER, MICHAEL D MD	10/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87175	05	Anesthesiology	0	In state provider	None	2701 W ALAMEDA AVE	STE 203	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
21779	Fee-for-Service	1164564217	1164564217	1	1	WEINLANDER, EVA E MD	11/30/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49121	08	Family Practice	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
21790	Fee-for-Service	1609064302	1609064302	1	1	WONG, JIMMY K	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72033	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
21890	Fee-for-Service	1285161125	1285161125	1	1	WEIERS, ANDREA K MD	3/22/2022	207P00000X	NA	Other	026	PHYSICIANS	172882	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
21899	Fee-for-Service	1285295675	1285295675	1	1	WALDEMER-STREYER, RACHEL MD	6/19/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	186357	07	Dermatology	0	In state provider	None	675 18TH STREET	None	SAN FRANCISCO	CA	94143	0984	38	06075	37.76085391	-122.4356007	San Francisco County
21914	Fee-for-Service	1295878031	1295878031	1	1	WILDER, BEEM C PHD	8/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD ROAD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
21948	Fee-for-Service	1063647568	1063647568	1	1	WEINBERG, AVIVA E MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113293	34	Urology and Urological Surgery	0	In state provider	None	975 MAPLE ST	None	REDWOOD CITY	CA	94063	2057	41	06081	37.48822836	-122.2226601	San Mateo County
21956	Fee-for-Service	1942556139	1942556139	2	1	WESTENGARD, KATHERINE M LMFT	12/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 E REDLANDS BLVD	170D	REDLANDS	CA	92373	8014	36	06071	34.05731952	-117.181197	San Bernardino County
22002	Fee-for-Service	1881882173	1881882173	1	1	WARD, MINOR E MD INC	4/14/2017	208600000X	NA	General Surgery	026	PHYSICIANS	23027	02	General Surgery	0	In state provider	None	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
22011	Fee-for-Service	1659581775	1659581775	1	1	WILLIAMS, VENITA L MD	11/6/2008	2085R0203X	NA	Other	026	PHYSICIANS	90354	30	Radiology	0	In state provider	None	1500 ROSECRANS AVE	#100	MANHATTAN BEACH	CA	90266	3720	19	06037	33.90179652	-118.3874715	Los Angeles County
22012	Fee-for-Service	1407043110	1407043110	1	1	WALGREEN CO.	8/5/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3643 PECK RD.	None	EL MONTE	CA	91731	3530	19	06037	34.07273235	-118.0242338	Los Angeles County
22042	Fee-for-Service	1023040839	1023040839	1	1	WANG, NAN MD	1/31/1987	208G00000X	NA	General Surgery	026	PHYSICIANS	55739	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
22052	Fee-for-Service	1780601823	1780601823	1	1	WALMART INC	10/8/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	3600 WASHBURN WAY	None	KLAMATH FALLS	OR	97603	4539	00	None	42.193215	-121.760604	Klamath County
22076	Fee-for-Service	1619395639	1619395639	1	1	WANG, LINDA X MD	7/13/2020	390200000X	NA	Other	026	PHYSICIANS	148549	10	Gastroenterology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
22130	Fee-for-Service	1952914681	1952914681	1	3	WEST COAST KIDNEY	9/27/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	5720 STONERIDGE MALL RD	STE 300	PLEASANTON	CA	94588	2831	01	06001	37.69247085	-121.9301884	Alameda County
22144	Fee-for-Service	1336681907	1336681907	1	1	WILLOW ACUPUNCTURE CLINIC	10/30/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1916 30TH ST.	None	SAN DIEGO	CA	92102	1106	37	06073	32.72583776	-117.1302217	San Diego County
22229	Fee-for-Service	1528504289	1528504289	1	1	WEBER, ANNAMAY A CCC-SLP	9/14/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7128 PACIFIC BLVD	2ND FLOOR, SUITE I	HUNTINGTON PARK	CA	90255	4776	19	06037	33.97494243	-118.2251099	Los Angeles County
22289	Fee-for-Service	1457367005	1457367005	1	1	WALGREEN CO	8/15/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13691 SAN PABLO AVE	None	SAN PABLO	CA	94806	3837	07	06013	37.95834677	-122.339696	Contra Costa County
22298	Fee-for-Service	1659581775	1659581775	1	1	WILLIAMS, VENITA L MD	11/6/2008	2085R0203X	NA	Other	026	PHYSICIANS	90354	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 ROSECRANS AVE	#100	MANHATTAN BEACH	CA	90266	3720	19	06037	33.90179652	-118.3874715	Los Angeles County
22389	Fee-for-Service	1336593771	1336593771	1	1	WONG, MATTHEW S MD	2/2/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	20169	40	Pediatrics	0	In state provider	None	18370 BURBANK BLVD	SUITE 307	TARZANA	CA	91356	2804	19	06037	34.17173059	-118.5331881	Los Angeles County
22416	Fee-for-Service	1205349636	1205349636	1	1	WAWRZYNIAK, BRYCE M PT	8/27/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
22446	Fee-for-Service	1366654469	1366654469	1	1	WIBISONO, PETER PT	3/26/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6 WILLARD	None	IRVINE	CA	92604	4694	30	06059	33.67534801	-117.7900415	Orange County
22465	Fee-for-Service	1831740240	1831740240	1	1	WHEELER, RACHEL P PT	2/24/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
22509	Fee-for-Service	1750064630	1750064630	1	1	WATSON, NEVON M	8/14/2023	174H00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
22578	Fee-for-Service	1043347610	1043347610	1	1	WANG, BINBIN MD	7/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	96746	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	0648	38	06075	37.7634502	-122.4579779	San Francisco County
22579	Fee-for-Service	1124148671	1124148671	1	1	WILLENS, RICHARD B MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	36896	-	NOT APPLICABLE	0	In state provider	None	15305 RAYEN STREET	None	NORTH HILLS	CA	91343	5117	19	06037	34.23191048	-118.4657625	Los Angeles County
22616	Fee-for-Service	1720421704	1720421704	1	1	WEBER, LAURA E MD	8/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143203	66	Emergency Medicine (Urgent Care)	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
22637	Fee-for-Service	1902984743	1902984743	1	1	WILSON, MICHELE L MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73733	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
22667	Fee-for-Service	1114058229	1114058229	1	1	WARD, SABRINA I MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	61236	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
22729	Fee-for-Service	1689636797	1689636797	1	1	WESTERN LABS MED GRP	2/28/1986	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	2070 CLINTON AVE	None	ALAMEDA	CA	94501	0000	01	06001	37.76333626	-122.253868	Alameda County
22740	Fee-for-Service	1093125478	1093125478	1	1	WAGNER, KATHERINE E MD	6/7/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	171941	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
22760	Fee-for-Service	1598956021	1598956021	1	1	WORKMAN, WILLIAM J PT	5/19/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7311 GREENHAVEN	200	SACRAMENTO	CA	95831	3572	34	06067	38.492622	-121.5219195	Sacramento County
22796	Fee-for-Service	1891446464	1891446464	1	1	WANDER, DILPREET CRNA	3/22/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 CHESTER AVE.	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
22806	Fee-for-Service	1750455028	1750455028	1	1	WILLLIAMS, GRAY R DPM	4/30/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
22822	Fee-for-Service	1083666721	1083666721	1	1	WALSH, CHRISTINE MD	8/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78874	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	# 3611	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
22842	Fee-for-Service	1609954494	1609954494	1	1	WEATHERBY, SANDRA MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84250	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
22847	Fee-for-Service	1063460301	1063460301	1	1	WHANG, KEVIN T MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	65815	30	Radiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
22888	Fee-for-Service	1467720656	1467720656	1	1	WOO, LINDA N MD	8/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	121814	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
22903	Fee-for-Service	1326136862	1326136862	1	1	WINNER, NICOLE C MD	4/3/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	64938	08	Family Practice	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
22920	Fee-for-Service	1538334065	1538334065	1	1	WEST COUNTY HEALTH CENTER	5/27/2009	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	6800 PALM AVE	STE C	SEBASTOPOL	CA	95472	4269	49	06097	38.39602719	-122.8185446	Sonoma County
22956	Fee-for-Service	1720328107	1720328107	1	1	WILLETT, MATTHEW C MD	4/17/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	132174	07	Dermatology	0	In state provider	None	6605 NANCY RIDGE DR	None	SAN DIEGO	CA	92121	2253	37	06073	32.88682438	-117.1796133	San Diego County
22974	Fee-for-Service	1265645790	1265645790	1	1	WESTRA, DAVID L MD	3/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	93870	14	Neurological Surgery	0	In state provider	None	168 N BRENT STREET	STE 408	VENTURA	CA	93003	2824	56	06111	34.27448266	-119.2572489	Ventura County
22978	Fee-for-Service	1255494969	1255494969	1	1	WILLIS, MARC H DO	1/8/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17737	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
22988	Fee-for-Service	1790124162	1790124162	1	1	WONG, MICHELLE M OD	9/6/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1598 WASHINGTON AVE	None	SAN LEANDRO	CA	94577	4465	01	06001	37.72227514	-122.1546132	Alameda County
22999	Fee-for-Service	1700862133	1700862133	1	1	WOLFF, D JASON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PROGRESSIVE MEDICAL ASSO	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
23075	Fee-for-Service	1841566023	1841566023	1	1	WHITMORE, JENNIFER L	9/30/2020	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
23112	Fee-for-Service	1659466373	1659466373	1	1	WANETICK, L H MD INC	6/1/1983	193400000X	NA	Other	026	PHYSICIANS	13201	02	General Surgery	0	In state provider	None	1580 VALENCIA ST	STE 807	SAN FRANCISCO	CA	94110	4412	38	06075	37.74746923	-122.4202583	San Francisco County
23119	Fee-for-Service	1336145184	1336145184	1	2	WOOD, JAMES B MD	7/1/2004	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	863 FILBERT AVE	None	CHICO	CA	95926	4015	04	06007	39.73886692	-121.8291568	Butte County
23138	Fee-for-Service	1245269943	1245269943	1	1	WALLACE, WILLIAM D MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77907	22	Pathology (M.D. only)	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
23168	Fee-for-Service	1093061954	1093061954	1	1	WHITFIELD, DONNA L PSY	2/2/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	28812	-	NOT APPLICABLE	0	In state provider	None	982 MISSION ST	None	SAN FRANCISCO	CA	94103	2911	38	06075	37.7813638	-122.4082438	San Francisco County
23267	Fee-for-Service	1649425158	1649425158	1	1	WANG, ZIQING V MD	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106032	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
23293	Fee-for-Service	1811155765	1811155765	1	1	WAKILY, HUSSNA MD	5/28/2020	208600000X	NA	General Surgery	026	PHYSICIANS	156789	02	General Surgery	0	In state provider	None	3601 VISTA WAY	STE 203	OCEANSIDE	CA	92056	4559	37	06073	33.18140858	-117.3093221	San Diego County
23304	Fee-for-Service	1972374072	1972374072	1	1	WILKIN, ASHLEE M	1/9/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	29	06057	0	0	None
23316	Fee-for-Service	1659345478	1659345478	1	1	WU,HERMAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SKAGIT RADIOLOGY INC	1415 E KINCAID	None	MOUNT VERNON	WA	98274	0000	00	None	48.41748257	-122.3241732	Skagit County
23317	Fee-for-Service	1114930757	1114930757	1	1	WANG, SCOTT A MD	8/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83268	None	None	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
23325	Fee-for-Service	1245261114	1245261114	1	1	WILLIAMS, RANDALL S MD	10/1/1995	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	68885	01	General Practice	0	In state provider	None	1040 MANGROVE AVE	None	CHICO	CA	95926	3509	04	06007	39.7403994	-121.8373152	Butte County
23423	Fee-for-Service	1083192801	1083192801	1	1	WOLF, BRADLEY L PSYD	11/16/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
23426	Fee-for-Service	1003817693	1003817693	2	1	WEISSTEIN, JASON S MD	7/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	71367	20	Orthopedic Surgery	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
23428	Fee-for-Service	1588681837	1588681837	1	1	WAL-MART STORES INC	2/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-2985	7065 N INGRAM AVE	None	FRESNO	CA	93650	1083	10	06019	36.83911702	-119.8018782	Fresno County
23430	Fee-for-Service	1598770828	1598770828	2	1	WALGREEN CO	8/10/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2605 MIDDLEFIELD ROAD	None	PALO ALTO	CA	94306	2516	43	06085	37.43410933	-122.1303843	Santa Clara County
23434	Fee-for-Service	1912999806	1912999806	1	1	WASSERMAN, DAVID F PHD	9/21/2005	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4882 MCGRATH ST	STE 210	VENTURA	CA	93003	7721	56	06111	34.25466859	-119.2252103	Ventura County
23442	Fee-for-Service	1922215540	1922215540	1	1	WANG, ALLEN Y MD	12/17/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	106329	08	Family Practice	0	In state provider	None	1045 N TUSTIN ST	None	ORANGE	CA	92867	5904	30	06059	33.80481643	-117.8356481	Orange County
23489	Fee-for-Service	1215135496	1215135496	1	1	WANG, XIUJIE MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133870	02	General Surgery	0	In state provider	None	3660 PARK SIERRA	105	RIVERSIDE	CA	92505	3701	33	06065	33.90330693	-117.4707039	Riverside County
23499	Fee-for-Service	1497154314	1497154314	1	1	WANG, WILBUR MD	7/29/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	139083	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
23509	Fee-for-Service	1760688295	1760688295	1	1	WALKER, SHAYNA MD	1/30/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	107393	36	Psychiatry	0	In state provider	None	1130 COFFEE RD	SUITE 10	MODESTO	CA	95355	4228	50	06099	37.65884948	-120.9755938	Stanislaus County
23531	Fee-for-Service	1245545581	1245545581	1	1	WALKINS, BETHANY M CNP	2/8/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4829 CLAIREMONT DR	None	SAN DIEGO	CA	92117	2706	37	06073	32.83175462	-117.2052088	San Diego County
23609	Fee-for-Service	1700407111	1700407111	1	1	WONG, KENDALL R MD	7/2/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178295	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
23652	Fee-for-Service	1164477105	1164477105	1	1	WILLIAM M KELLEY, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10 COBURG RD	STE 201	EUGENE	OR	97401	7487	00	None	44.06021904	-123.0821474	Lane County
23660	Fee-for-Service	1598701500	1598701500	1	1	WILLIS, BRIGHAM C MD	3/1/2021	2080P0203X	NA	Other	026	PHYSICIANS	71310	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
23665	Fee-for-Service	1699545715	1699545715	1	1	WRIGHT, TRACY YVETTE	2/7/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	26954 BUFFALO RD	None	WINCHESTER	CA	92596	2246	33	06065	33.73008672	-117.0811812	Riverside County
23683	Fee-for-Service	1821442286	1821442286	1	1	WEBB, ELIZABETH C	11/21/2016	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
23684	Fee-for-Service	1134653785	1134653785	1	1	WOFSY, JESSIE H NP	10/26/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
23777	Fee-for-Service	1740895903	1740895903	1	1	WILLIAMSON, CONNOR A PT	10/23/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1060 CAMERADO DRIVE	None	CAMERON PARK	CA	95682	7600	09	06017	38.6856171	-120.9860614	El Dorado County
23789	Fee-for-Service	1841402195	1841402195	1	1	WILSON, HILARY L MD	6/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88774	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
23807	Fee-for-Service	1457433971	1457433971	1	1	WOODLING, BRUCE A MD INC	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	24570	01	General Practice	0	In state provider	None	148 N BRENT ST	STE 102	VENTURA	CA	93003	2825	56	06111	34.27406087	-119.2571562	Ventura County
23838	Fee-for-Service	1265558407	1265558407	1	1	WANG, SUZANNE P NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8080 PARKWAY DRIVE	None	LA MESA	CA	91942	2104	37	06073	32.77560706	-117.0231998	San Diego County
23851	Fee-for-Service	1831377175	1831377175	1	1	WROBEL, TERRY J DO	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	5636	01	General Practice	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
23873	Fee-for-Service	1528719101	1528719101	1	1	WHITTEN, AMANDA LPCC	1/7/2025	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3550 WATT AVE	404	SACRAMENTO	CA	95821	2667	34	06067	38.630115	-121.3819245	Sacramento County
23899	Fee-for-Service	1437380086	1437380086	1	1	WOO, JASON R MD	6/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114634	34	Urology and Urological Surgery	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
23956	Fee-for-Service	1699545715	1699545715	1	1	WRIGHT, TRACY YVETTE	2/7/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	26954 BUFFALO RD	None	WINCHESTER	CA	92596	2246	33	06065	33.73008672	-117.0811812	Riverside County
23986	Fee-for-Service	1003968462	1003968462	1	1	WOODS, JULIAN R MD	4/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80232	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
23988	Fee-for-Service	1154348563	1154348563	1	1	WAL-MART PHARMACY	8/24/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#10-2119	301 RANCH DR	None	MILPITAS	CA	95035	5100	43	06085	37.43255481	-121.9208004	Santa Clara County
24006	Fee-for-Service	1336216225	1336216225	1	1	WONG, VICTOR K MD	9/10/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	53589	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
24012	Fee-for-Service	1356344758	1356344758	1	1	WEST COUNTY HEALTH CENTERS	5/1/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	16387 FIRST STREET	None	GUERNEVILLE	CA	95446	0000	49	06097	38.50111158	-122.9999868	Sonoma County
24019	Fee-for-Service	1831550771	1831550771	1	1	WEISERT, MOLLY A MD	6/9/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	140815	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
24024	Fee-for-Service	1104971472	1104971472	1	1	WESTSIDE FAMILY PRACTICE	3/31/1986	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP	400 E SANTA BARBARA ST	STE A	SANTA PAULA	CA	93060	2675	56	06111	34.35269772	-119.069955	Ventura County
24055	Fee-for-Service	1700371523	1700371523	1	1	WAGNER, ALLAN K DO	7/27/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18045	None	None	0	In state provider	None	147 BRENT	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
24078	Fee-for-Service	1699755934	1699755934	1	1	WANG, GRANT W MD	12/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73378	08	Family Practice	0	In state provider	None	2850 TELEGRAPH AVE	STE 130	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
24098	Fee-for-Service	1457433971	1457433971	1	1	WOODLING, BRUCE A MD INC	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	24570	08	Family Practice	0	In state provider	None	148 N BRENT ST	STE 102	VENTURA	CA	93003	2825	56	06111	34.27406087	-119.2571562	Ventura County
24111	Fee-for-Service	1417962788	1417962788	1	1	WALGREEN CO (02152)	4/9/1990	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1899 FILLMORE ST	None	SAN FRANCISCO	CA	94115	3125	38	06075	37.78678656	-122.4334322	San Francisco County
24112	Fee-for-Service	1831198647	1831198647	1	1	WIKHOLM, RICHARD P MD	11/12/2011	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	55811	04	Otology, Laryngology, Rhinology	0	In state provider	None	116 S PALISADE DR	STE 206	SANTA MARIA	CA	93454	8906	42	06083	34.9523869	-120.4120717	Santa Barbara County
24131	Fee-for-Service	1205271236	1205271236	1	1	WINKLER, ETHAN A MD	5/2/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	139840	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
24141	Fee-for-Service	1831377175	1831377175	1	1	WROBEL, TERRY J DO	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	5636	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
24173	Fee-for-Service	1336601707	1336601707	1	1	WITH OPEN ARMS REPRODUCTIVE	9/26/2019	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	HEALTH CARE SERVICES, IN	2505 LUCAS STREET	SUITE B	EUREKA	CA	95501	4436	12	06023	40.79130448	-124.139304	Humboldt County
24174	Fee-for-Service	1851513469	1851513469	1	6	WESTERN SIERRA MED CLINIC	1/1/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	150 GLASSON WAY	None	GRASS VALLEY	CA	95945	5706	29	06057	39.22882551	-121.0470962	Nevada County
24189	Fee-for-Service	1891138699	1891138699	1	1	WANG, NICHOLE A DO	5/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13643	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
24207	Fee-for-Service	1770871055	1770871055	1	1	WATERS, JENNIFER N LPCC	4/14/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3719 TULLY RD	STE A1	MODESTO	CA	95356	1026	50	06099	37.69286011	-121.0126098	Stanislaus County
24211	Fee-for-Service	1881609113	1881609113	1	1	WALGREEN CO	11/21/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1775 EUREKA WAY	None	REDDING	CA	96001	0456	45	06089	40.58654561	-122.3967104	Shasta County
24221	Fee-for-Service	1548339534	1548339534	1	1	WANG, AI WEI MD	10/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91882	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	655 EUCLID AVE	STE 409	NATIONAL CITY	CA	91950	2981	37	06073	32.68353398	-117.082625	San Diego County
24300	Fee-for-Service	1356344758	1356344758	1	1	WEST COUNTY HEALTH CENTERS	2/3/2006	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	16387 FIRST STREET	None	GUERNEVILLE	CA	95446	0000	49	06097	38.50111158	-122.9999868	Sonoma County
24322	Fee-for-Service	1821439068	1821439068	1	1	WASHINGTON, ANNA M PHD	12/1/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4900 BRAODWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
24411	Fee-for-Service	1679048813	1679048813	1	1	WATSON, MIRIAM A LCSW	8/22/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
24417	Fee-for-Service	1720014525	1720014525	1	1	WAGMEISTER, ROBERT MD	4/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	41624	02	General Surgery	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
24456	Fee-for-Service	1467560094	1467560094	1	1	WASSERSTEIN, PAUL N MD	6/11/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	35891	22	Pathology (M.D. only)	0	In state provider	None	535 MILLER AVE	None	MILL VALLEY	CA	94941	2905	21	06041	37.89403279	-122.5320604	Marin County
24459	Fee-for-Service	1851513469	1851513469	1	6	WESTERN SIERRA MED CLINIC	1/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	150 GLASSON WAY	None	GRASS VALLEY	CA	95945	5706	29	06057	39.22882551	-121.0470962	Nevada County
24460	Fee-for-Service	1336601707	1336601707	1	1	WITH OPEN ARMS REPRODUCTIVE	9/26/2019	207V00000X	NA	Obstetrics & Gynecology	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	HEALTH CARE SERVICES, IN	2505 LUCAS STREET	SUITE B	EUREKA	CA	95501	4436	12	06023	40.79130448	-124.139304	Humboldt County
24466	Fee-for-Service	1154482495	1154482495	1	1	WONG, VINCENT S	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
24514	Fee-for-Service	1053485557	1053485557	1	1	WANG, ZHIQIANG	7/1/2000	207L00000X	NA	Other	026	PHYSICIANS	65222	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
24517	Fee-for-Service	1639589641	1639589641	1	1	WEBB, ALANAH K MD	1/18/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	157381	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
24519	Fee-for-Service	1225295033	1225295033	1	1	WANG, SEAN X MD	6/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124816	04	Otology, Laryngology, Rhinology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
24523	Fee-for-Service	1912496944	1912496944	1	1	WALKER, CARLISHA S LCSW	3/28/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
24548	Fee-for-Service	1497197974	1497197974	1	1	WONG, VINCENT T DO	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12545	01	General Practice	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
24551	Fee-for-Service	1356895429	1356895429	1	1	WOODARD, JONATHAN LMFT	4/10/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 E SHAW AVE	STE 230	FRESNO	CA	93710	7708	10	06019	36.80886739	-119.7731624	Fresno County
24562	Fee-for-Service	1609684604	1609684604	1	1	WRIGHT, VANESSA N CD	1/27/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	45	06089	0	0	None
24585	Fee-for-Service	1275113326	1275113326	1	1	WILSON, ANNALISA MD	3/10/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
24587	Fee-for-Service	1356344758	1356344758	1	1	WEST COUNTY HEALTH CENTERS	5/1/1997	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	16387 FIRST STREET	None	GUERNEVILLE	CA	95446	0000	49	06097	38.50111158	-122.9999868	Sonoma County
24590	Fee-for-Service	1922275411	1922275411	1	1	WEISBEIN, JACQUELINE S DO	9/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12297	None	None	0	In state provider	None	3434 VILLA LANE	STE 150	NAPA	CA	94558	6405	28	06055	38.32515937	-122.2938358	Napa County
24656	Fee-for-Service	1053570267	1053570267	1	1	WIDDOWSON, CONNIE T MD	9/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10427	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
24691	Fee-for-Service	1851824817	1851824817	1	1	WOO, WONHEE MD	10/28/2022	207R00000X	NA	Other	026	PHYSICIANS	170228	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
24725	Fee-for-Service	1396061461	1396061461	1	1	WILSON, RUJUTA B MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12025	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	MDCC 12-311	LOS ANGELES	CA	90095	0001	19	06037	34.06373445	-118.443537	Los Angeles County
24728	Fee-for-Service	1750139580	1750139580	1	1	WYNN MEDICAL CENTER NEPHROLO	7/15/2024	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	GY	9120 VALLEY BLVD	None	ROSEMEAD	CA	91770	1920	19	06037	34.08088774	-118.0706785	Los Angeles County
24737	Fee-for-Service	1003808072	1003808072	1	1	WOLVOS,TOM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SCOTTSDALE SURGICAL CON	3501 N SCOTTSDALE RD 234	None	SCOTTSDALE	AZ	85251	0000	00	None	33.489027	-111.9254265	Maricopa County
24743	Fee-for-Service	1730944042	1730944042	1	1	WOO, REBECCA PSYD	4/5/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
24766	Fee-for-Service	1780373522	1780373522	1	1	WICKLUND, PATTI A NP	6/19/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2428 CASTILLO STREET	SUITE C	SANTA BARBARA	CA	93105	5308	42	06083	34.43122758	-119.7251364	Santa Barbara County
24779	Fee-for-Service	1023182342	1023182342	1	1	WERTZ, KARIN K MD	1/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89477	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
24810	Fee-for-Service	1437267952	1437267952	1	1	WONG, ROBIN L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31241	08	Family Practice	0	In state provider	None	2003 N CALIFORNIA ST	None	STOCKTON	CA	95204	6006	39	06077	37.97231426	-121.2898134	San Joaquin County
24839	Fee-for-Service	1609253699	1609253699	1	1	WU, KESTER A DO	10/4/2018	207R00000X	NA	Other	026	PHYSICIANS	15175	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
24844	Fee-for-Service	1407241318	1407241318	1	1	WHITTIER NURSING AND	4/1/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTER INC	7926 S PAINTER AVENUE	None	WHITTIER	CA	90602	2413	19	06037	33.96926538	-118.0326569	Los Angeles County
24875	Fee-for-Service	1356344758	1356344758	1	1	WEST COUNTY HEALTH CENTERS	7/1/1994	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	16387 FIRST STREET	None	GUERNEVILLE	CA	95446	0000	49	06097	38.50111158	-122.9999868	Sonoma County
24883	Fee-for-Service	1699084970	1699084970	1	2	WEST COAST HOSPICE	8/25/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	MANAGEMENT INC	7100 HAYVENHURST AVE	SUITE 210	VAN NUYS	CA	91406	3208	19	06037	34.199064	-118.4923845	Los Angeles County
24893	Fee-for-Service	1538334289	1538334289	1	2	WON K YU MD MPH INC	12/24/2021	207RG0100X	NA	Gastroenterology	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	17400 IRVINE BLVD	STE F	TUSTIN	CA	92780	3030	30	06059	33.74814651	-117.828558	Orange County
24900	Fee-for-Service	1346279932	1346279932	1	1	WONG, PATRICK Y MD INC	1/1/1969	No Taxonomy Provided	NA	None	026	PHYSICIANS	23571	10	Gastroenterology (M.D. only)	0	In state provider	None	728 PACIFIC AVE	STE 506	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
24915	Fee-for-Service	1497994420	1497994420	1	1	WANG, SHUO S MD INC	5/4/2009	193400000X	NA	Other	026	PHYSICIANS	76144	41	Internal Medicine	0	In state provider	None	711 W COLLEGE ST	STE 210	LOS ANGELES	CA	90012	1092	19	06037	34.06541412	-118.2414102	Los Angeles County
24966	Fee-for-Service	1154417061	1154417061	1	1	WANG, PEAN-YUAN MD	1/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	37759	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	12225 SOUTH ST	STE 105	ARTESIA	CA	90701	7046	19	06037	33.85857051	-118.0713645	Los Angeles County
24998	Fee-for-Service	1093744542	1093744542	1	1	WANG, ANCHI MD	6/5/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79381	13	Neurology (M.D. only)	0	In state provider	None	3907 WARING RD	STE 2	OCEANSIDE	CA	92056	4454	37	06073	33.18780783	-117.2918439	San Diego County
25016	Fee-for-Service	1750139580	1750139580	1	1	WYNN MEDICAL CENTER NEPHROLO	7/15/2024	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GY	9120 VALLEY BLVD	None	ROSEMEAD	CA	91770	1920	19	06037	34.08088774	-118.0706785	Los Angeles County
25020	Fee-for-Service	1851354765	1851354765	1	1	WARNER, ROBERT L MD	4/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	75696	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
25066	Fee-for-Service	1033297619	1033297619	1	1	WILSON, SHUREA A MD	10/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	91743	05	Anesthesiology	0	In state provider	None	39400 PASEO PADRE PRKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
25078	Fee-for-Service	1386658730	1386658730	1	1	WELLS, ERIC D MD	8/31/1986	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51925	40	Pediatrics	0	In state provider	None	20055 LAKE CHABOT RD	STE 320	CASTRO VALLEY	CA	94546	5334	01	06001	37.69836512	-122.0873587	Alameda County
25116	Fee-for-Service	1902620750	1902620750	1	1	WIMBERLY, ERIN A	11/22/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
25120	Fee-for-Service	1881989861	1881989861	1	1	WAL-MART STORES, INC	8/3/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	88 E ORANGETHORPE AVE	None	ANAHEIM	CA	92801	1206	30	06059	33.857577	-117.918702	Orange County
25166	Fee-for-Service	1275574543	1275574543	1	1	WEINSTEIN, FAYE M	8/24/2004	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
25168	Fee-for-Service	1699084970	1699084970	1	2	WEST COAST HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	MANAGEMENT INC	7100 HAYVENHURST AVE	SUITE 210	VAN NUYS	CA	91406	3208	19	06037	34.199064	-118.4923845	Los Angeles County
25182	Fee-for-Service	1447663133	1447663133	1	1	WOODRUFF, ELISSA J	7/25/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
25191	Fee-for-Service	1992059471	1992059471	1	1	WONG, COLLEEN D LCSW	10/14/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
25225	Fee-for-Service	1356550636	1356550636	1	1	WU, ANDREW S MD	7/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106166	30	Radiology	0	In state provider	None	3700 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
25244	Fee-for-Service	1669616124	1669616124	1	1	WEYKER, PAUL D MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124691	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
25270	Fee-for-Service	1174770929	1174770929	1	2	WHITE, D'ANNE E NP	7/11/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2970 HILLTOP MALL ROAD	305	RICHMOND	CA	94806	1947	07	06013	37.97819764	-122.329244	Contra Costa County
25273	Fee-for-Service	1386185601	1386185601	1	1	WONG, JARED A MD	9/18/2020	208M00000X	NA	Other	026	PHYSICIANS	159822	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
25283	Fee-for-Service	1902815483	1902815483	1	1	WRIGHT, ALLAN M MD	2/28/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	53096	30	Radiology	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
25351	Fee-for-Service	1548276405	1548276405	1	1	WONG, ANTONIO L MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71921	05	Anesthesiology	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
25393	Fee-for-Service	1861768327	1861768327	1	1	WALGREENS CO	7/27/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	305 N BREED ST	None	LOS ANGELES	CA	90033	2936	19	06037	34.04750163	-118.208751	Los Angeles County
25396	Fee-for-Service	1700302494	1700302494	1	1	WHITTINGTON, NANETTE K NP	9/1/2022	363LN0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
25423	Fee-for-Service	1114932407	1114932407	1	1	WALGREEN CO	4/10/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 S GRAND AVE	None	GLENDORA	CA	91741	4211	19	06037	34.129584	-117.872534	Los Angeles County
25426	Fee-for-Service	1578926606	1578926606	1	1	WINCKLER, BRITANNY E MD	7/20/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160979	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
25437	Fee-for-Service	1184914541	1184914541	1	1	WU, JEFFREY L MD	8/1/2016	207L00000X	NA	Other	026	PHYSICIANS	137586	05	Anesthesiology	0	In state provider	None	438 W LAS TUNAS	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
25535	Fee-for-Service	1669616124	1669616124	1	1	WEYKER, PAUL D MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124691	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
25573	Fee-for-Service	1508967480	1508967480	1	1	WELTSCH, MATTHEW J PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	502 W EL NORTE PARKWAY	None	ESCONDIDO	CA	92026	3983	37	06073	33.14438924	-117.098135	San Diego County
25591	Fee-for-Service	1851716138	1851716138	1	1	WAL-MART STORES, INC	6/5/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8844 LIMONITE AVE	None	RIVERSIDE	CA	92509	5021	33	06065	33.97561724	-117.4766669	Riverside County
25610	Fee-for-Service	1083494736	1083494736	1	1	WALKER, SHELLEY ANNE LCSW	12/6/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
25613	Fee-for-Service	1659009215	1659009215	1	1	WU, FIONA CRNA	8/11/2024	163WC0200X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
25645	Fee-for-Service	1235431933	1235431933	1	1	WOODS, CANDICE R LMFT	2/23/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
25708	Fee-for-Service	1427318955	1427318955	1	1	WONG, THAI DO	3/24/2019	208600000X	NA	General Surgery	026	PHYSICIANS	None	89	Surgery-Traumatic	0	In state provider	None	215 WEST JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
25713	Fee-for-Service	1568540391	1568540391	1	1	WHITNEY, MELISSA A MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	68935	78	Neoplastic Diseases/Oncology	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
25731	Fee-for-Service	1225315963	1225315963	1	1	WASSELL, ANNETTE D NP	10/13/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
25778	Fee-for-Service	1205117280	1205117280	1	2	W & P PHARMACY INC	8/20/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9205 WHITTIER BLVD	None	PICO RIVERA	CA	90660	2450	19	06037	34.00012617	-118.0808702	Los Angeles County
25800	Fee-for-Service	1073156964	1073156964	1	2	WINGS PHYSIOTHERAPY, INC.	10/31/2023	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18231 US HIGHWAY 18	STE 3	APPLE VALLEY	CA	92307	2213	36	06071	34.54032714	-117.26611	San Bernardino County
25805	Fee-for-Service	1306971429	1306971429	1	1	WONG, CAROLYN M OD	10/5/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11540 SANTA MONICA BLVD	STE 202	LOS ANGELES	CA	90025	7905	19	06037	34.04524404	-118.452534	Los Angeles County
25819	Fee-for-Service	1669616124	1669616124	1	1	WEYKER, PAUL D MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124691	05	Anesthesiology	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
25824	Fee-for-Service	1689729352	1689729352	1	1	WESTLANE MEDICAL CLINIC,INC	12/28/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4873 WEST LN	SUITE A	STOCKTON	CA	95210	4548	39	06077	37.99861886	-121.289451	San Joaquin County
25841	Fee-for-Service	1033666326	1033666326	1	1	WOLFE, RACHEL PT	7/25/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
25844	Fee-for-Service	1356644504	1356644504	1	1	WALGREEN CO	4/8/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2700 WILLOW PASS RD	None	BAY POINT	CA	94565	3312	07	06013	38.0267885	-121.94163	Contra Costa County
25853	Fee-for-Service	1174085070	1174085070	1	1	WOJDYLA, LUKE DO	2/2/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	20361	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
25858	Fee-for-Service	1215225321	1215225321	1	1	WALSMA, KELLY L MD	8/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130686	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
25897	Fee-for-Service	1003868449	1003868449	1	1	WOLFE, LEE T MD	7/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	86812	05	Anesthesiology	0	In state provider	None	1801 HANOVER DRIVE	STE F	DAVIS	CA	95616	1067	57	06113	38.55895232	-121.7567316	Yolo County
25933	Fee-for-Service	1366513319	1366513319	1	1	WINSHIP, JOSEPH G MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51396	07	Dermatology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
25964	Fee-for-Service	1013337492	1013337492	1	1	WANG, NANCY MD	12/15/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	154529	None	None	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
26001	Fee-for-Service	1568540391	1568540391	1	1	WHITNEY, MELISSA A MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	68935	68	Hematology	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
26034	Fee-for-Service	1609843499	1609843499	1	1	WEISE, MARC W MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	44223	20	Orthopedic Surgery	0	In state provider	None	855 4TH ST	None	PISMO BEACH	CA	93449	3102	40	06079	35.13511685	-120.622287	San Luis Obispo County
26045	Fee-for-Service	1265915615	1265915615	1	1	WALL, MARISSA B OD	9/20/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1011 SYLVAN AVE	STE A	MODESTO	CA	95350	1693	50	06099	37.68896459	-120.979468	Stanislaus County
26054	Fee-for-Service	1174102735	1174102735	1	1	WANG, CHARLENE S	9/16/2024	207R00000X	NA	Other	026	PHYSICIANS	181952	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
26114	Fee-for-Service	1679570451	1679570451	1	1	WATSON, RICHARD B MD	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
26182	Fee-for-Service	1710201603	1710201603	1	1	WADIA, RACHNA G MD	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111442	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
26223	Fee-for-Service	1366513319	1366513319	1	1	WINSHIP, JOSEPH G MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51396	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
26232	Fee-for-Service	1326263856	1326263856	1	1	WEGNER, DAVID A CPO	7/1/1996	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2624 F ST	None	BAKERSFIELD	CA	93301	1816	15	06029	35.38353776	-119.0234458	Kern County
26252	Fee-for-Service	1730328063	1730328063	1	1	WOLFF, LAUREN A LMFT	2/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28632 ROADSIDE DR	210	AGOURA HILLS	CA	91301	3316	19	06037	34.14375168	-118.7497422	Los Angeles County
26329	Fee-for-Service	1194190314	1194190314	1	1	WEISENBURG, LORI D LMFT	10/5/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	107080	-	NOT APPLICABLE	0	In state provider	None	1735 ENTERPRISE DR	STE 105A	FAIRFIELD	CA	94553	6822	48	06095	38.24294683	-122.060841	Solano County
26370	Fee-for-Service	1245346626	1245346626	1	1	WAN, CHRISTOPHER A MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88069	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
26433	Fee-for-Service	1548701188	1548701188	1	1	WEST COLGATE, DENA B LMFT	7/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
26438	Fee-for-Service	1952914681	1952914681	1	9	WEST COAST KIDNEY	12/29/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1860 EL CAMINO REAL	STE 310	BURLINGAME	CA	94010	3114	41	06081	37.59615729	-122.3846379	San Mateo County
26459	Fee-for-Service	1588802870	1588802870	1	1	WOO, YANGHEE MD	6/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137349	02	General Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
26470	Fee-for-Service	1710201603	1710201603	1	1	WADIA, RACHNA G MD	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111442	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
26479	Fee-for-Service	1184787582	1184787582	1	1	WEEKS, EDWIN L MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	25234	08	Family Practice	0	In state provider	None	2060 ABORN RD	None	SAN JOSE	CA	95121	1584	43	06085	37.3114718	-121.8072775	Santa Clara County
26502	Fee-for-Service	1114587003	1114587003	1	1	WONG, ASHLEE	8/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
26510	Fee-for-Service	1689812794	1689812794	1	1	WALGREEN CO	5/4/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11121 SIERRA AVE	None	FONTANA	CA	92337	7529	36	06071	34.05159204	-117.4353952	San Bernardino County
26529	Fee-for-Service	1780659276	1780659276	1	1	WENGER, SCOTT J DO	7/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	10859	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
26596	Fee-for-Service	1013451194	1013451194	1	1	WELLER, VERONIKA J CNP	3/1/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10565 CIVIC CENTER DR	WEST BLDG., SUITE 165	RANCHO CUCAMONGA	CA	91730	3853	36	06071	34.10278226	-117.5747989	San Bernardino County
26611	Fee-for-Service	1033205869	1033205869	1	1	WANG, HAIPING MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	44710	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	123 N GARFIELD AVE	STE D	ALHAMBRA	CA	91801	3564	19	06037	34.09636542	-118.127778	Los Angeles County
26665	Fee-for-Service	1407896806	1407896806	1	1	WILLIAM WATTS MD	2/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	OVERLAKE INTERNAL MED	1035 116TH AVE	None	BELLEVUE	WA	98004	0000	00	None	47.620296	-122.1856955	King County
26668	Fee-for-Service	1942654959	1942654959	1	1	WONG, AMY DPM	8/29/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	9850 GENESEE AVE	SUITE 510	LA JOLLA	CA	92037	1213	37	06073	32.882913	-117.226341	San Diego County
26712	Fee-for-Service	1811255185	1811255185	1	1	WINARKO, BENJAMIN MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115005	41	Internal Medicine	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
26745	Fee-for-Service	1588802870	1588802870	1	1	WOO, YANGHEE MD	6/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137349	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
26893	Fee-for-Service	1871757021	1871757021	1	1	WINKLEMAYER, WOLFGANG C MD	4/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113419	45	Nephrology (Renal-Kidney)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
26929	Fee-for-Service	1326381443	1326381443	1	1	WALKER, JASMINE J A MD	5/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134120	40	Pediatrics	0	In state provider	None	2335 E KASHIAN LANE	STE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
26936	Fee-for-Service	1639310998	1639310998	1	1	WELLNER, RACHIA LMFT	5/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
26993	Fee-for-Service	1932308681	1932308681	1	1	WU, PEGGY A MD	6/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152975	01	General Practice	0	In state provider	None	3301 C ST	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
26998	Fee-for-Service	1306810353	1306810353	1	1	WOO, VICTOR L MD	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	38297	30	Radiology	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
27017	Fee-for-Service	1891225298	1891225298	1	1	WAUL, MICHAEL MD	6/7/2021	207N00000X	NA	Dermatology	026	PHYSICIANS	160658	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
27064	Fee-for-Service	1366556102	1366556102	1	1	WEINSTEIN, STEPHEN G MD	8/31/1989	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	18806	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1616 N MAIN ST	None	WALNUT CREEK	CA	94596	4609	07	06013	37.90078642	-122.0613559	Contra Costa County
27065	Fee-for-Service	1992094973	1992094973	1	1	WEI, ERMAN MD	5/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126892	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
27069	Fee-for-Service	1104876952	1104876952	1	1	WACHSMAN, WILLIAM MD	12/1/2004	207RH0003X	NA	Oncology	026	PHYSICIANS	49697	78	Neoplastic Diseases/Oncology	0	In state provider	UCLA CTR FOR HLTH SCIENC	200 W ARBOR DR	DEPT 8201	SAN DIEGO	CA	92103	8201	37	06073	32.7537975	-117.1658298	San Diego County
27129	Fee-for-Service	1568580249	1568580249	1	1	WHITMAN PHYSICAL THERAPY	5/31/2011	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	55500 SOUTH CIRCLE DR	None	IDYLLWILD	CA	92549	3125	33	06065	33.7522554	-116.7042571	Riverside County
27171	Fee-for-Service	1740441732	1740441732	1	1	WEINER, ELIZABETH A MD	10/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131113	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
27211	Fee-for-Service	1346321981	1346321981	1	1	WALID MICHAEL KUTAYLI M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2300 SOUTH 16	None	LINCOLN	NE	68502	0000	00	None	40.78813482	-96.69915653	Lancaster County
27223	Fee-for-Service	1750466264	1750466264	1	1	WANG, NANCY OD INC	9/25/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ARGO OPTOMETRY	300 N EUCLID AVE	STE A	UPLAND	CA	91786	6031	36	06071	34.097508	-117.6509735	San Bernardino County
27246	Fee-for-Service	1588756977	1588756977	1	1	WEI, KENNETH K MD	12/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77370	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
27292	Fee-for-Service	1982647939	1982647939	1	1	WU, JIMMY MD	5/31/1993	207R00000X	NA	Other	026	PHYSICIANS	49571	01	General Practice	0	In state provider	None	1814 W LINCOLN AVE	None	ANAHEIM	CA	92801	6730	30	06059	33.83241852	-117.946323	Orange County
27322	Fee-for-Service	1427433929	1427433929	1	1	WARDE, ANASTASIA MD	11/30/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	158329	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
27339	Fee-for-Service	1285701110	1285701110	1	1	WYTHE, WARREN G MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	32567	01	General Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
27359	Fee-for-Service	1104876952	1104876952	1	1	WACHSMAN, WILLIAM MD	12/1/2004	207RH0003X	NA	Oncology	026	PHYSICIANS	49697	68	Hematology	0	In state provider	UCLA CTR FOR HLTH SCIENC	200 W ARBOR DR	DEPT 8201	SAN DIEGO	CA	92103	8201	37	06073	32.7537975	-117.1658298	San Diego County
27409	Fee-for-Service	1740608777	1740608777	1	1	WHITEHEAD, TASHYA J MD	7/9/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	152829	40	Pediatrics	0	In state provider	None	31180 ROAD 72	None	GOSHEN	CA	93227	9997	54	06107	36.35594779	-119.4124242	Tulare County
27413	Fee-for-Service	1073643920	1073643920	2	1	WALLS, EMERSON B DO	4/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	5923	40	Pediatrics	0	In state provider	None	2570 JENSEN AVE	None	SANGER	CA	93657	2269	10	06019	36.70680647	-119.5736715	Fresno County
27458	Fee-for-Service	1316956857	1316956857	1	1	WYMAN, RAY MICHAEL	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45826	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1360 W 6TH ST	STE 200	SAN PEDRO	CA	90732	3561	19	06037	33.73886546	-118.3075065	Los Angeles County
27462	Fee-for-Service	1255346532	1255346532	1	1	WALGREEN CO	12/23/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	444 BLOSSOM HILL RD	None	SAN JOSE	CA	95123	1608	43	06085	37.25120454	-121.829967	Santa Clara County
27463	Fee-for-Service	1477616993	1477616993	1	1	WYNIA, MATTHEW K MD	12/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	77	Infectious Disease	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
27477	Fee-for-Service	1104090687	1104090687	1	1	WALL, ANDREW J MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	109005	None	None	0	In state provider	None	1303 E HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
27533	Fee-for-Service	1063788222	1063788222	1	1	WEI, JIANDONG MD	2/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133632	None	None	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95670	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
27566	Fee-for-Service	1467999169	1467999169	1	1	WEN, MARISSA M MD	4/11/2022	207R00000X	NA	Other	026	PHYSICIANS	161459	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
27569	Fee-for-Service	1720090657	1720090657	1	1	WELLS, KENNETH B MD	10/1/1998	2084P0800X	NA	Psychiatry	026	PHYSICIANS	30121	36	Psychiatry	0	In state provider	UCLA NEUROPSYCHIATRIC	760 WESTWOOD PLZ	RM C8169	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
27580	Fee-for-Service	1124195623	1124195623	2	1	WU, RAYMOND H H OD	2/2/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	911 N GRAND AVE	None	COVINA	CA	91724	2046	19	06037	34.09685628	-117.8727243	Los Angeles County
27621	Fee-for-Service	1275822405	1275822405	1	1	WEILER-LISOWSKI, BETHANY MD	11/5/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	2	Out of state provider	None	350 HERITAGE WAY	2100	KALISPELL	MT	59901	3167	00	None	48.216645	-114.324948	Flathead County
27709	Fee-for-Service	1700088069	1700088069	1	1	WATERFIELD, MICHAEL R MD	6/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99442	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2722	38	06075	37.76332993	-122.4582988	San Francisco County
27724	Fee-for-Service	1396078085	1396078085	1	1	WOOD, RACHAELL K LMFT	4/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
27748	Fee-for-Service	1316956857	1316956857	1	1	WYMAN, RAY MICHAEL	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45826	41	Internal Medicine	0	In state provider	None	1360 W 6TH ST	STE 200	SAN PEDRO	CA	90732	3561	19	06037	33.73886546	-118.3075065	Los Angeles County
27752	Fee-for-Service	1477616993	1477616993	1	1	WYNIA, MATTHEW K MD	12/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
27784	Fee-for-Service	1053651372	1053651372	1	1	WEST COAST HEALTHCARE LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	29222 RANCHO VIEJO RD	SUITE 102	SAN JUAN CAPISTRA	CA	92675	1042	30	06059	33.53905045	-117.6736364	Orange County
27806	Fee-for-Service	1750820007	1750820007	1	1	WICKHAM, CAREY J MD	9/10/2018	208600000X	NA	General Surgery	026	PHYSICIANS	145897	02	General Surgery	0	In state provider	None	12001 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5801	19	06037	33.99760695	-118.4228296	Los Angeles County
27821	Fee-for-Service	1144252636	1144252636	1	1	WOMEN'S CARE RD	6/24/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	590 COUNTRY CLUB PKWY	STE B	EUGENE	OR	97401	6038	00	None	44.06393879	-123.0919866	Lane County
27822	Fee-for-Service	1306007323	1306007323	1	1	WONG, SAMANTHA L MD	9/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122461	05	Anesthesiology	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
27831	Fee-for-Service	1982720595	1982720595	1	1	WOLFORD, JULIA K	2/1/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4131 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3101	38	06075	37.78096053	-122.4637512	San Francisco County
27834	Fee-for-Service	1245573393	1245573393	1	1	WATKINS, KENSHATA M MD	12/10/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158524	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
27894	Fee-for-Service	1871881458	1871881458	1	1	WILLIAMS, AMY K MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	115393	20	Orthopedic Surgery	0	In state provider	None	1760 TERMINO AVE	SUITE 306	LONG BEACH	CA	90804	2182	19	06037	33.78889871	-118.1458784	Los Angeles County
27913	Fee-for-Service	1376933820	1376933820	1	1	WALGREEN CO	4/28/2015	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	602 EUCLID AVE	None	SAN DIEGO	CA	92114	2207	37	06073	32.711796	-117.0850785	San Diego County
27928	Fee-for-Service	1871706473	1871706473	1	1	WOODS, KAMAL R M MD	8/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97961	14	Neurological Surgery	0	In state provider	None	25455 BARTON RD	STE A108	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
27984	Fee-for-Service	1043639040	1043639040	1	1	WU, KARIN C MD	7/2/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	138521	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
28019	Fee-for-Service	1043219678	1043219678	1	2	WENG, JIAXIONG MD INC	6/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70965	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
28025	Fee-for-Service	1982468427	1982468427	1	1	WASHINGTON, KRYSTAL I BIRTH	3/11/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
28071	Fee-for-Service	1053651372	1053651372	1	1	WEST COAST HEALTHCARE LLC	8/25/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	29222 RANCHO VIEJO RD	SUITE 102	SAN JUAN CAPISTRA	CA	92675	1042	30	06059	33.53905045	-117.6736364	Orange County
28097	Fee-for-Service	1356339543	1356339543	1	1	WILLITS HOSPITAL INC	10/1/1986	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1 MARCELA DRIVE	None	WILLITS	CA	95490	5769	23	06045	39.3901086	-123.339055	Mendocino County
28163	Fee-for-Service	1700313517	1700313517	1	1	WONG, ANNE LMFT	10/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
28276	Fee-for-Service	1043916331	1043916331	1	1	WHOLISTIC MIDWIFERY SCHOOL O	5/18/2023	374J00000X	NA	Other	107	DOULA GROUP PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
28307	Fee-for-Service	1043219678	1043219678	1	2	WENG, JIAXIONG MD INC	6/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70965	41	Internal Medicine	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
28312	Fee-for-Service	1891345070	1891345070	1	1	WILLIS, TANYA R NP	3/13/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
28317	Fee-for-Service	1144576299	1144576299	1	1	WU, CHEN-YING MD	7/22/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	133011	36	Psychiatry	0	In state provider	None	540 W BASELINE RD	SUITE 3	CLAREMONT	CA	91711	1612	19	06037	34.12158153	-117.723276	Los Angeles County
28373	Fee-for-Service	1811061856	1811061856	1	1	WILLIAMS, DANIELLE T	12/2/2014	207L00000X	NA	Other	026	PHYSICIANS	96182	05	Anesthesiology	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
28383	Fee-for-Service	1174160790	1174160790	1	1	WHEELER, AMANDA AU	12/9/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	920 PARK ROW	None	SALINAS	CA	93901	2407	27	06053	36.66409481	-121.6592738	Monterey County
28423	Fee-for-Service	1407123417	1407123417	1	1	WILDCREEK HEALTHCARE	8/20/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	1	Border provider	None	2045 SILVERADA BLVD	None	RENO	NV	89512	2052	00	None	39.54907847	-119.7832945	Washoe County
28439	Fee-for-Service	1629085683	1629085683	1	1	WALGREEN CO	5/6/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	459 POWELL ST	None	SAN FRANCISCO	CA	94102	1503	38	06075	37.78902921	-122.4085938	San Francisco County
28504	Fee-for-Service	1043226889	1043226889	1	1	WAKEHAM, ILIA J L C MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85980	40	Pediatrics	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
28518	Fee-for-Service	1699931097	1699931097	1	1	WAHIDI, QAIS M MD	4/19/2010	207R00000X	NA	Other	026	PHYSICIANS	111390	41	Internal Medicine	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.669562	-121.31379	Sacramento County
28530	Fee-for-Service	1467053272	1467053272	1	1	WEST SACRAMENTO PRIMARY CARE	11/30/2023	261QP2300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2455 JEFFERSON BLVD	100	WEST SACRAMENTO	CA	95691	5313	57	06113	38.55304251	-121.5367185	Yolo County
28559	Fee-for-Service	1699795088	1699795088	1	1	WILLIAMS, GREGORY G MD	2/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	73172	01	General Practice	0	In state provider	None	1500 HAGGIN OAKS BLVD	STE 202	BAKERSFIELD	CA	93311	1332	15	06029	35.341758	-119.1011105	Kern County
28635	Fee-for-Service	1356459986	1356459986	1	1	WHITGOB, STEPHEN J	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	24893	08	Family Practice	0	In state provider	None	2900 TELEGRAPH AVE	None	BERKELEY	CA	94705	2018	01	06001	37.85746342	-122.2595359	Alameda County
28637	Fee-for-Service	1386659670	1386659670	1	1	WALGREEN CO	8/16/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1810 FREEDOM BLVD	None	FREEDOM	CA	95019	3000	44	06087	36.93442012	-121.7726139	Santa Cruz County
28698	Fee-for-Service	1790947828	1790947828	1	1	WALLACE HOME MED SUPPLIES	6/5/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	WALLACE HOME MED SUPPLIE	1414 PARK ST	None	PASO ROBLES	CA	93446	2160	40	06079	35.62913455	-120.6902844	San Luis Obispo County
28790	Fee-for-Service	1043226889	1043226889	1	1	WAKEHAM, ILIA J L C MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85980	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
28819	Fee-for-Service	1467053272	1467053272	1	1	WEST SACRAMENTO PRIMARY CARE	11/30/2023	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2455 JEFFERSON BLVD	100	WEST SACRAMENTO	CA	95691	5313	57	06113	38.55304251	-121.5367185	Yolo County
28877	Fee-for-Service	1386933505	1386933505	1	1	WEHRLI, SARAH J MD	10/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137901	18	Ophthalmology	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
28880	Fee-for-Service	1790045714	1790045714	1	1	WEI, RANDY L MD	6/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	129580	78	Neoplastic Diseases/Oncology	0	In state provider	None	18111 BROOKHURST ST	STE LL0300	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
28881	Fee-for-Service	1205046653	1205046653	1	1	WASHUT, TRAVIS P DO	1/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
28884	Fee-for-Service	1952315350	1952315350	1	1	WILLIAMS, RICHARD A MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	43122	30	Radiology	0	In state provider	None	231 GREEN VALLEY RD	None	FREEDOM	CA	95019	3140	44	06087	36.93832783	-121.7708828	Santa Cruz County
28954	Fee-for-Service	1245748201	1245748201	1	2	WORKIT HEALTH PC	10/30/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	911 MORAGA RD	STE 200	LAFAYETTE	CA	94549	4500	07	06013	37.88758326	-122.1181419	Contra Costa County
28985	Fee-for-Service	1427528710	1427528710	1	1	WESTERFIELD, ALYSSA R NP	12/11/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
29083	Fee-for-Service	1396711917	1396711917	1	1	WAY, TIN M MD	4/13/2001	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	85725	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	969 PLUMAS ST	STE 200	YUBA CITY	CA	95991	4011	51	06101	39.14263634	-121.6176593	Sutter County
29093	Fee-for-Service	1861471633	1861471633	1	1	WOLD, PETER B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	333 SMITH AVE N	None	SAINT PAUL	MN	55102	2344	00	None	44.94251219	-93.1074995	Ramsey County
29154	Fee-for-Service	1659542470	1659542470	1	1	WALDMAN, CHRISTENE M LCSW	10/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
29300	Fee-for-Service	1780652792	1780652792	1	2	WALLACE, CHARLES W MD	6/18/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55918	08	Family Practice	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
29325	Fee-for-Service	1326850736	1326850736	1	1	WULFF TULL, HEATHER C	1/23/2025	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	621 W MICHELTORENA ST	STE B	SANTA BARBARA	CA	93101	4195	42	06083	34.41914194	-119.7157341	Santa Barbara County
29417	Fee-for-Service	1942300991	1942300991	1	1	WHITCOMBE, ELENA R MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66621	08	Family Practice	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
29426	Fee-for-Service	1093951444	1093951444	1	1	WEERASETHSIRI, RUNGTIWA MD	8/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106684	40	Pediatrics	0	In state provider	None	220 EAST 13TH ST	None	MERCED	CA	95341	6250	24	06047	37.29309532	-120.4748791	Merced County
29436	Fee-for-Service	1578543963	1578543963	1	1	WONG, ANDREW K MD	12/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	64276	41	Internal Medicine	0	In state provider	None	5301 F ST	STE 100	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
29445	Fee-for-Service	1194905323	1194905323	1	1	WANG, DANIEL Y MD CORP	12/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	96792	None	None	0	In state provider	None	920 SUNNYSLOPE RD	None	HOLLISTER	CA	95023	5616	35	06069	36.83913141	-121.3857821	San Benito County
29448	Fee-for-Service	1518026244	1518026244	1	1	WONG, TERESA H NP	11/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1249 S SUNSET AVE	None	WEST COVINA	CA	91790	3960	19	06037	34.06068542	-117.9468692	Los Angeles County
29464	Fee-for-Service	1104977008	1104977008	1	1	WONG, STEPHEN C MD	5/24/2019	207KA0200X	NA	Other	026	PHYSICIANS	51644	03	Allergy	0	In state provider	None	1850 S AZUSA AVE STE 206	None	HACIENDA HEIGHTS	CA	91745	6853	19	06037	33.98895597	-117.9322797	Los Angeles County
29465	Fee-for-Service	1720155609	1720155609	1	1	WANG, AMY Q MD	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72227	68	Hematology	0	In state provider	None	1043 ELM AVE	STE 104	LONG BEACH	CA	90813	3244	19	06037	33.779655	-118.1880065	Los Angeles County
29507	Fee-for-Service	1386659654	1386659654	1	1	WALGREEN CO.	3/13/1995	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2628 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	2922	15	06029	35.39121722	-118.9676027	Kern County
29621	Fee-for-Service	1386697514	1386697514	1	1	WOODS, ROBERT A MD	12/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	51755	41	Internal Medicine	0	In state provider	None	211 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	1412	19	06037	33.965136	-118.3439955	Los Angeles County
29644	Fee-for-Service	1821309022	1821309022	1	1	WOOD, WILLIAM G	8/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	119594	02	General Surgery	0	In state provider	None	39141 CIVIC CENTER DR	STE 335	FREMONT	CA	94538	5878	01	06001	37.55436307	-121.9764708	Alameda County
29645	Fee-for-Service	1962962944	1962962944	1	1	WINNINGHOFF, HAYLEY D MD	1/9/2024	207QS0010X	NA	Adult Primary Care	026	PHYSICIANS	176060	None	None	0	In state provider	None	1071 BLOSSOM HILL RD	None	SAN JOSE	CA	95123	1103	43	06085	37.2509447	-121.8743507	Santa Clara County
29719	Fee-for-Service	1619940376	1619940376	1	1	WATKINS, BILLY S MD	1/1/1974	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	32365	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	250 SAN JOSE ST	None	SALINAS	CA	93901	3901	27	06053	36.65817286	-121.6460674	Monterey County
29728	Fee-for-Service	1336154343	1336154343	1	1	WALGREEN CO	4/21/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 DRUMMOND AVE	None	RIDGECREST	CA	93555	3117	15	06029	35.63701549	-117.670653	Kern County
29753	Fee-for-Service	1720155609	1720155609	1	1	WANG, AMY Q MD	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72227	78	Neoplastic Diseases/Oncology	0	In state provider	None	1043 ELM AVE	STE 104	LONG BEACH	CA	90813	3244	19	06037	33.779655	-118.1880065	Los Angeles County
29754	Fee-for-Service	1700286465	1700286465	1	1	WALKER, LANI H Y LCSW	5/8/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82671	-	NOT APPLICABLE	0	In state provider	None	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	19	06037	34.007238	-118.2653065	Los Angeles County
29773	Fee-for-Service	1497830152	1497830152	1	1	WALVICK, MICHAEL P DO	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
29800	Fee-for-Service	1932129483	1932129483	1	1	WIRSING, NELLIE M MD	10/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	2801 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25271647	-121.787181	Klamath County
29804	Fee-for-Service	1780705665	1780705665	1	1	WATSON, JAMES A MD	2/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98977	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	260 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
29813	Fee-for-Service	1962078493	1962078493	1	1	WELLNESS MIND HOME HEALTH	7/26/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE	209 E ALAMEDA AVE	SUITE 103	BURBANK	CA	91502	2673	19	06037	34.17496555	-118.2993463	Los Angeles County
29814	Fee-for-Service	1932347689	1932347689	1	1	WALSH, CONSTANCE LCSW	10/13/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
29823	Fee-for-Service	1467604678	1467604678	1	1	WALLACE, DENISE E PHD	8/4/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
29879	Fee-for-Service	1760560825	1760560825	1	1	WALDMAN, BARRY A MD	10/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	68109	07	Dermatology	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
29932	Fee-for-Service	1588659460	1588659460	1	1	WANG, ROBERT H MD	12/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	1	Border provider	None	2231 W CHARLESTON BLVD	2ND FLOOR	LAS VEGAS	NV	89102	2254	00	None	36.15879115	-115.1718806	Clark County
30049	Fee-for-Service	1013556141	1013556141	1	1	WAMBUGU, ROSALIND WAKIURU	11/3/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1709 ADONIS WAY	None	SACRAMENTO	CA	95864	1701	34	06067	38.596167	-121.356963	Sacramento County
30055	Fee-for-Service	1669426078	1669426078	1	1	WOLK, FREDRICK N MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38222	34	Urology and Urological Surgery	0	In state provider	None	23441 MADISON ST	STE 140	TORRANCE	CA	90505	4755	19	06037	33.81240248	-118.3477463	Los Angeles County
30069	Fee-for-Service	1841338159	1841338159	1	1	WHITE, CHRISTOPHER R MD	3/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78199	40	Pediatrics	0	In state provider	None	2340 CLAY ST	FL 3	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
30084	Fee-for-Service	1932129483	1932129483	1	1	WIRSING, NELLIE M MD	10/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2801 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25271647	-121.787181	Klamath County
30102	Fee-for-Service	1538474960	1538474960	1	1	WILLIAM KING MD PC	10/8/2018	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	3756 SANTA ROSALIA DRIVE	SUITE 506	LOS ANGELES	CA	90008	3656	19	06037	34.00888336	-118.3389334	Los Angeles County
30127	Fee-for-Service	1396783387	1396783387	1	1	WITTER, BRET A MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	45250	06	Cardiovascular Disease (M.D. only)	0	In state provider	CARDIOVASCULAR ASSOC	3771 KATELLA AVE	STE 300	LOS ALAMITOS	CA	90720	3115	30	06059	33.80319153	-118.067274	Orange County
30136	Fee-for-Service	1154907830	1154907830	1	1	WU, CAROLYN DO	9/13/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	22391	40	Pediatrics	0	In state provider	None	2071 EAST HERNDON	None	CLOVIS	CA	93611	6001	10	06019	36.8375685	-119.6781105	Fresno County
30157	Fee-for-Service	1609088350	1609088350	1	1	WAYMENT, MAC T DO	7/1/2008	2080P0203X	NA	Other	026	PHYSICIANS	9172	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
30187	Fee-for-Service	1841205937	1841205937	1	1	WALGREEN CO.	4/26/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2901 RAILROAD AVE	None	PITTSBURG	CA	94565	5224	07	06013	38.00974746	-121.8920249	Contra Costa County
30217	Fee-for-Service	1730164716	1730164716	1	1	WILLSEY, MONICA R MD FACOG	10/1/1997	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	83469	None	None	0	In state provider	None	1370 PRAIRIE RD	None	FOLSOM	CA	95630	9554	34	06067	38.65493608	-121.1686756	Sacramento County
30247	Fee-for-Service	1720407067	1720407067	1	1	WON, EUGENE MD	6/20/2019	390200000X	NA	Other	026	PHYSICIANS	162961	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
30261	Fee-for-Service	1538234182	1538234182	1	1	WEINAND,MARTIN E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
30282	Fee-for-Service	1083193635	1083193635	1	1	WOO, JAE CNP	6/2/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6900 LINCOLN AVENUE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
30293	Fee-for-Service	1346317369	1346317369	1	1	WILKINSON, GEORGE E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34261	85	Surgery-Pediatric	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
30308	Fee-for-Service	1457447617	1457447617	1	1	WAUGH, DENISE G MD	8/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53261	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4311 THIRD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
30335	Fee-for-Service	1013556141	1013556141	1	1	WAMBUGU, ROSALIND WAKIURU	11/3/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1709 ADONIS WAY	None	SACRAMENTO	CA	95864	1701	34	06067	38.596167	-121.356963	Sacramento County
30340	Fee-for-Service	1609935204	1609935204	1	1	WILSON, MARY L MD	11/11/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	43430	40	Pediatrics	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
30354	Fee-for-Service	1134384290	1134384290	1	1	WALGREENS CO	2/10/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #11612	12 W HANFORD ARMONA RD.	None	LEMOORE	CA	93245	2320	16	06031	36.31346953	-119.7816075	Kings County
30392	Fee-for-Service	1891393880	1891393880	1	1	WINTER, EMILY OT	6/16/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	151 N SUNRISE AVE	SUITE 1105	ROSEVILLE	CA	95661	2924	31	06061	38.74746043	-121.2655348	Placer County
30400	Fee-for-Service	1346687456	1346687456	1	1	WALGREEN CO	11/6/2013	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2590 N TEXAS ST	None	FAIRFIELD	CA	94533	1306	48	06095	38.27606445	-122.0340458	Solano County
30415	Fee-for-Service	1396783387	1396783387	1	1	WITTER, BRET A MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	45250	41	Internal Medicine	0	In state provider	CARDIOVASCULAR ASSOC	3771 KATELLA AVE	STE 300	LOS ALAMITOS	CA	90720	3115	30	06059	33.80319153	-118.067274	Orange County
30416	Fee-for-Service	1285260216	1285260216	1	1	WILSON, CHRISTINE R MD	8/30/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	185100	None	None	0	In state provider	None	4300 ROSE DR	None	YORBA LINDA	CA	92886	2026	30	06059	33.89815111	-117.8419708	Orange County
30435	Fee-for-Service	1770576597	1770576597	1	1	WEYER JANELLE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9327 N 3RD ST STE 206	None	PHOENIX	AZ	85020	0000	00	None	33.571089	-112.069287	Maricopa County
30443	Fee-for-Service	1609088350	1609088350	1	1	WAYMENT, MAC T DO	7/1/2008	2080P0203X	NA	Other	026	PHYSICIANS	9172	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
30445	Fee-for-Service	1629437363	1629437363	1	1	WELSH, ERIK J PHD	11/28/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
30458	Fee-for-Service	1659386928	1659386928	1	1	WALGREEN CO.	5/1/1995	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	855 COLUSA AVE	None	YUBA CITY	CA	95991	3717	51	06101	39.1418138	-121.6288755	Sutter County
30464	Fee-for-Service	1154006724	1154006724	1	1	WORTHINGTON, SHAUNA DOULA	12/13/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	27	06053	0	0	None
30465	Fee-for-Service	1376081323	1376081323	1	1	WHITESIDE MANOR, INC	12/18/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2452 & 2456 WILSHIRE ST	None	RIVERSIDE	CA	92501	2144	33	06065	33.9944179	-117.3676132	Riverside County
30508	Fee-for-Service	1558766535	1558766535	1	1	WILLIAMS, CHERISE L NP	11/19/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
30567	Fee-for-Service	1275880460	1275880460	1	1	WILKERSON, DENISE M LMFT	11/29/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MFT	1210 CENTRAL BLVD	SUITE #125	BRENTWOOD	CA	94513	2360	07	06013	37.93851243	-121.6981458	Contra Costa County
30581	Fee-for-Service	1689996100	1689996100	1	1	WESTERN UNIVERSITY OF HEALTH	2/12/2016	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	SCIENCES	795 E SECOND ST	SUITE 7	POMONA	CA	91766	2007	19	06037	34.05845654	-117.7423951	Los Angeles County
30583	Fee-for-Service	1346317369	1346317369	1	1	WILKINSON, GEORGE E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34261	02	General Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
30596	Fee-for-Service	1114964160	1114964160	1	1	WOUDEN, JACOB R MD	6/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106813	30	Radiology	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
30680	Fee-for-Service	1699071209	1699071209	1	1	WARTMAN, SARAH M MD	8/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115391	02	General Surgery	0	In state provider	None	6041 CADILLAC AVENUE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
30683	Fee-for-Service	1225109150	1225109150	1	1	WANG, REX T MD	12/5/2007	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	76544	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
30690	Fee-for-Service	1164641270	1164641270	1	1	WEST LA SUPPORT SERVICES INC	11/14/1996	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1857 S HAYWORTH AVE	None	LOS ANGELES	CA	90035	4619	19	06037	34.04173997	-118.3709774	Los Angeles County
30720	Fee-for-Service	1104151042	1104151042	1	1	WALKER, XAVIOUR J MD	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142764	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
30746	Fee-for-Service	1770185498	1770185498	1	1	WEINBERG, NASH D PT	1/24/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	STE 306	SAN DIEGO	CA	92108	4404	37	06073	32.77677653	-117.1592911	San Diego County
30795	Fee-for-Service	1740053529	1740053529	1	1	WANG, KETTY C CNP	11/30/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
30804	Fee-for-Service	1003994542	1003994542	1	1	WANG, STEPHEN L MD	12/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76433	30	Radiology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
30849	Fee-for-Service	1053367599	1053367599	1	1	WEBSTER, WADE	9/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12040 NE 128TH	None	KIRKLAND	WA	98034	3013	00	None	47.71493427	-122.1792761	King County
30870	Fee-for-Service	1023035359	1023035359	1	1	WAL-MART PHARM. 10-1941	4/15/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1950 AUTO CENTRE DR	None	GLENDORA	CA	91740	6700	19	06037	34.11746952	-117.826875	Los Angeles County
30944	Fee-for-Service	1881736395	1881736395	1	1	WALDBERG, JEFF PT	3/26/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1145 LINDERO CANYON RD	STE. D7	WESTLAKE VILLAGE	CA	91362	5475	56	06111	34.184952	-118.788264	Ventura County
30964	Fee-for-Service	1659533867	1659533867	1	1	WANG, STANLEY Y MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116865	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
30990	Fee-for-Service	1619512563	1619512563	1	1	WARRINER, RICHARD A LCSW	10/14/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2801 BRISTOL STREET	STE 200	COSTA MESA	CA	92626	5996	30	06059	33.67474907	-117.889122	Orange County
31051	Fee-for-Service	1992895056	1992895056	1	1	WEIGOLD, SCOTT L MD	3/11/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	84380	-	NOT APPLICABLE	0	In state provider	None	771 BLAINE STREET	SUITE C AND D	RIVERSIDE	CA	92507	3940	33	06065	33.98300646	-117.327555	Riverside County
31052	Fee-for-Service	1811249790	1811249790	1	1	WARDAK, ZABIHULLAH S MD	11/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122644	41	Internal Medicine	0	In state provider	None	200 JOSE FIGUERES AVE	STE 325	SAN JOSE	CA	95116	1592	43	06085	37.36122014	-121.8505998	Santa Clara County
31062	Fee-for-Service	1740562891	1740562891	1	1	WALKER-HERBERT, REJI	7/18/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1827 KNOLL DR	None	VENTURA	CA	93003	7321	56	06111	34.25641704	-119.2199387	Ventura County
31068	Fee-for-Service	1245463934	1245463934	1	1	WALLACE, KAREN L MD	6/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119986	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
31082	Fee-for-Service	1629254446	1629254446	1	1	WALGREENS CO	5/6/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #09102	2271 BALFOUR RD	None	BRENTWOOD	CA	94513	4923	07	06013	37.92541953	-121.7373165	Contra Costa County
31084	Fee-for-Service	1568455251	1568455251	1	1	WAKAM, IRENE B MD APC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50092	08	Family Practice	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
31111	Fee-for-Service	1427413772	1427413772	1	1	WEST SAC MEDICAL GROUP	9/9/2016	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2455 JEFFERSON BLVD	STE 100	WEST SACRAMENTO	CA	95691	5313	57	06113	38.55304251	-121.5367185	Yolo County
31131	Fee-for-Service	1568663136	1568663136	1	1	WU, TINA MD	6/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99185	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
31183	Fee-for-Service	1134147606	1134147606	1	1	WOODY, PAUL R MD	12/14/1977	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	24499	20	Orthopedic Surgery	0	In state provider	None	360 SANTA FE DR	# C	ENCINITAS	CA	92024	5142	37	06073	33.03623548	-117.284436	San Diego County
31206	Fee-for-Service	1861794968	1861794968	1	1	WAN, QIU H DO	9/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11475	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
31219	Fee-for-Service	1225696487	1225696487	1	1	WONG, JESSIE J PHD	6/11/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
31220	Fee-for-Service	1922270230	1922270230	1	1	WEISSMAN, STEPHANIE PSYD	11/15/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1545 CHURCH STREET	None	SAN FRANCISCO	CA	94131	9411	38	06075	37.74621757	-122.4268882	San Francisco County
31227	Fee-for-Service	1104098185	1104098185	1	1	WILSON, CHRISTOPHER R MD	5/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	1	Border provider	None	1500 EAST 2ND STREET	SUITE 400	RENO	NV	89502	1198	00	None	39.52743427	-119.7932613	Washoe County
31231	Fee-for-Service	1255918231	1255918231	1	1	WANG, KAROLINE C MD	10/7/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	13400 JAMBOREE RD	None	IRVINE	CA	92602	2308	30	06059	33.724863	-117.788022	Orange County
31251	Fee-for-Service	1982619250	1982619250	1	1	WALGREEN CO.	10/20/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1050 GILMAN ST	None	BERKELEY	CA	94710	1532	01	06001	37.8792	-122.296293	Alameda County
31257	Fee-for-Service	1801324017	1801324017	1	1	WILLIAMS, JANINE C	10/6/2017	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4311 UNIVERSITY AVENUE	None	RIVERSIDE	CA	92501	3143	33	06065	33.98527945	-117.3816737	Riverside County
31271	Fee-for-Service	1477721207	1477721207	1	1	WU, SIMON D MD	11/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87300	34	Urology and Urological Surgery	0	In state provider	None	8851 CENTER DR	SUITE 208	LA MESA	CA	91942	3189	37	06073	32.78189749	-117.0075062	San Diego County
31282	Fee-for-Service	1033203500	1033203500	1	1	WONG, JOANNE H MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72849	40	Pediatrics	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
31323	Fee-for-Service	1407810666	1407810666	1	1	WU, CHENGCONG MD	8/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88193	66	Emergency Medicine (Urgent Care)	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
31346	Fee-for-Service	1376864884	1376864884	1	1	WANG, JONATHAN S MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110419	20	Orthopedic Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
31393	Fee-for-Service	1063043347	1063043347	1	1	WILLIAMS, JOY PT	4/13/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
31407	Fee-for-Service	1003846254	1003846254	1	1	WALIANY, ABDUL R MD	10/31/1996	207P00000X	NA	Other	026	PHYSICIANS	50053	41	Internal Medicine	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
31476	Fee-for-Service	1154571404	1154571404	1	1	WATSONVILLE EMERGENCY ME	1/1/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GRP INC	75 NIELSON ST	EM DEPT	WATSONVILLE	CA	95076	2488	44	06087	36.9282117	-121.7937089	Santa Cruz County
31495	Fee-for-Service	1538193842	1538193842	1	1	WININGER, DWIGHT E MD	11/1/2002	207L00000X	NA	Other	026	PHYSICIANS	41034	05	Anesthesiology	0	In state provider	MT DIABLO HOSPITAL	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
31496	Fee-for-Service	1780924233	1780924233	1	1	WESTERN PATHOLOGY INC	1/24/2017	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	3440 EMPRESA DR	SUITE B	SAN LUIS OBISPO	CA	93401	7345	40	06079	35.253333	-120.667047	San Luis Obispo County
31504	Fee-for-Service	1679702179	1679702179	1	1	WALGREEN CO	9/29/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	21650 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	3990	36	06071	34.50101847	-117.1914367	San Bernardino County
31544	Fee-for-Service	1801324017	1801324017	1	1	WILLIAMS, JANINE C	10/6/2017	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4311 UNIVERSITY AVENUE	None	RIVERSIDE	CA	92501	3143	33	06065	33.98527945	-117.3816737	Riverside County
31545	Fee-for-Service	1679561286	1679561286	1	1	WOLK, PETER J	5/31/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	34455	None	None	0	In state provider	None	1430 ESPLANADE	STE 8	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
31546	Fee-for-Service	1235207184	1235207184	2	1	WEBER, ROBERT J MD	12/19/2013	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1066 S GREENVALLEY RD	None	WATSONVILLE	CA	95076	4163	44	06087	36.91746931	-121.7842657	Santa Cruz County
31565	Fee-for-Service	1619069184	1619069184	1	1	WHITEHEAD, KELLI NP	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	341 WHEATFIELD DR	None	SUNNYVALE	TX	75182	4638	00	None	32.77771609	-96.56965184	Dallas County
31577	Fee-for-Service	1083784573	1083784573	1	1	WARD, AMY	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
31592	Fee-for-Service	1487668711	1487668711	1	1	WALGREEN CO	5/9/1983	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	498 CASTRO ST	None	SAN FRANCISCO	CA	94114	2020	38	06075	37.76111969	-122.4350504	San Francisco County
31597	Fee-for-Service	1457315194	1457315194	1	1	WACHTEL, JOHN S MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	35219	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
31598	Fee-for-Service	1699936930	1699936930	1	1	WRIGHT, ERIC R MD	8/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116908	41	Internal Medicine	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
31604	Fee-for-Service	1407810666	1407810666	1	1	WU, CHENGCONG MD	8/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88193	41	Internal Medicine	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
31612	Fee-for-Service	1396990479	1396990479	1	1	WOOLLEY, JOSHUA D MD	9/30/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	105549	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
31667	Fee-for-Service	1740207091	1740207091	1	1	WAL-MART STORES, INC	1/11/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102517	3600 W MCFADDEN AVE	None	SANTA ANA	CA	92704	1330	30	06059	33.73817702	-117.915255	Orange County
31679	Fee-for-Service	1962566091	1962566091	1	1	WRIGHT, MICHAEL F PHD	2/25/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
31753	Fee-for-Service	1356339543	1356339543	1	2	WILLITS HOSPITAL INC	10/1/1986	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1 MARCELA DRIVE	None	WILLITS	CA	95490	5769	23	06045	39.3901086	-123.339055	Mendocino County
31761	Fee-for-Service	1093974222	1093974222	1	1	WARREN, AIMEE J DO	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11713	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
31781	Fee-for-Service	1285644872	1285644872	1	1	WOFSY, JUDITH MD	10/31/1995	174400000X	NA	Other	026	PHYSICIANS	38531	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
31793	Fee-for-Service	1235135534	1235135534	1	1	WARD, SUSAN JAMES MD	10/31/2005	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	77 PRINGLE WAY	None	RENO	NV	89502	1474	00	None	39.52484706	-119.7951825	Washoe County
31795	Fee-for-Service	1275800310	1275800310	1	1	WESTERN ACUTE CARE	1/1/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PHYSICIANS INC	531 WEST COLLEGE STREET	None	LOS ANGELES	CA	90012	2315	19	06037	34.0645892	-118.2391033	Los Angeles County
31829	Fee-for-Service	1265785828	1265785828	1	1	WANG, ANDRE	1/4/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
31837	Fee-for-Service	1235207184	1235207184	2	1	WEBER, ROBERT J MD	12/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56836	01	General Practice	0	In state provider	None	1066 S GREENVALLEY RD	None	WATSONVILLE	CA	95076	4163	44	06087	36.91746931	-121.7842657	Santa Cruz County
31871	Fee-for-Service	1780625046	1780625046	1	1	WILSON, WILLIAM CHARLES	5/31/1992	207LC0200X	NA	Other	026	PHYSICIANS	59859	05	Anesthesiology	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
31895	Fee-for-Service	1578620597	1578620597	1	1	WONG, VINCENT H OD	2/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1001 RIVERSIDE AVENUE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
31922	Fee-for-Service	1033576400	1033576400	1	1	WILSON, NICOLE LCSW	11/30/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
32049	Fee-for-Service	1265797591	1265797591	1	1	WANG-GIUFFRE, ELIZABETH W DO	1/3/2025	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	23368	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
32057	Fee-for-Service	1851658850	1851658850	1	1	WELLS, CORNELL JR MD	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131635	36	Psychiatry	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
32094	Fee-for-Service	1225202971	1225202971	1	1	WU, PO-HUI M MD	10/20/2018	208M00000X	NA	Other	026	PHYSICIANS	113735	None	None	0	In state provider	None	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	57	06113	38.66314048	-121.794696	Yolo County
32115	Fee-for-Service	1346582731	1346582731	1	1	WU, GRACE MD	11/3/2019	207R00000X	NA	Other	026	PHYSICIANS	162480	41	Internal Medicine	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
32121	Fee-for-Service	1174705099	1174705099	1	1	WHITE, JULIA A MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98852	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE.	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
32123	Fee-for-Service	1811126998	1811126998	1	2	WHEATON, NATASHA B MD	6/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148564	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
32124	Fee-for-Service	1952388845	1952388845	1	1	WIENER, JOSEPH M MD	2/27/2020	207R00000X	NA	Other	026	PHYSICIANS	161178	08	Family Practice	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
32146	Fee-for-Service	1912921479	1912921479	1	1	WELLS, PAMELA A MD	8/31/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	68056	40	Pediatrics	0	In state provider	None	3230 WARING CT	None	OCEANSIDE	CA	92056	4509	37	06073	33.18776771	-117.2893136	San Diego County
32185	Fee-for-Service	1538727599	1538727599	1	1	WILSON, KAYTON J DO	6/26/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	21008	None	None	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
32201	Fee-for-Service	1164857140	1164857140	1	1	WINGREN, GREGORY S OD	2/27/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	895 TRANCAS ST	None	NAPA	CA	94558	3040	28	06055	38.32406807	-122.2928218	Napa County
32202	Fee-for-Service	1285649517	1285649517	1	1	WALGREEN CO	8/2/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1932 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5606	19	06037	34.03121204	-118.4833937	Los Angeles County
32231	Fee-for-Service	1740507763	1740507763	1	1	WHANG, DENNIS MD	6/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119431	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
32239	Fee-for-Service	1699064766	1699064766	1	1	WILLIAMS, DUSTYN E MD	8/20/2024	207RE0101X	NA	Endocrinology	026	PHYSICIANS	141191	67	Endocrinology	0	In state provider	None	3620 BIRCH STREET	SUITE 210	NEWPORT BEACH	CA	92660	2624	30	06059	33.66216626	-117.8722496	Orange County
32250	Fee-for-Service	1386612208	1386612208	1	1	WHITFIELD, DENISE A MD	4/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	92318	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
32379	Fee-for-Service	1629313515	1629313515	1	1	WANG, SIMSON J CRNA	3/9/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
32426	Fee-for-Service	1184875270	1184875270	1	1	WESTERN PODMED CLINIC INC A	9/29/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	PODIATRIC CORPORATION	1500 S CENTRAL AVE	101	GLENDALE	CA	91204	2530	19	06037	34.12736888	-118.257777	Los Angeles County
32470	Fee-for-Service	1437579570	1437579570	1	1	WAGNER, HILLARY J MD	7/16/2020	390200000X	NA	Other	026	PHYSICIANS	138764	34	Urology and Urological Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
32494	Fee-for-Service	1730281478	1730281478	1	1	WANDER,THEODORE J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8TH AVE & CO STREET	None	SALT LAKE CITY	UT	84143	0000	00	None	40.778496	-111.8789303	Salt Lake County
32497	Fee-for-Service	1659666048	1659666048	1	1	WEISS, MAGGIE L NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
32510	Fee-for-Service	1558366229	1558366229	1	1	WALLOWA CO HEALTH CARE DIST	1/3/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	601 MEDICAL PARKWAY	None	ENTERPRISE	OR	97828	5124	00	None	45.43172194	-117.2843445	Wallowa County
32533	Fee-for-Service	1376552539	1376552539	1	1	WOOD, KATRINA PHD	7/16/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	19	06037	34.15682212	-118.4871886	Los Angeles County
32597	Fee-for-Service	1396993325	1396993325	1	1	WONG, ANNELIESE L OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 PENNSYLVANIA AVE	STE B	FAIRFIELD	CA	94533	3510	48	06095	38.259945	-122.0498745	Solano County
32625	Fee-for-Service	1356647739	1356647739	1	1	WOO, WILLIAM O MD	12/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115071	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
32666	Fee-for-Service	1154884377	1154884377	1	1	WINSTON, LISLE A MD	6/21/2023	207R00000X	NA	Other	026	PHYSICIANS	187073	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
32732	Fee-for-Service	1275921264	1275921264	1	1	WILLIS, MOLLY M NP	3/26/2018	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
32773	Fee-for-Service	1033124300	1033124300	1	1	WALGREENS 03030	10/19/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1591 GEER RD	None	TURLOCK	CA	95380	3200	50	06099	37.506834	-120.848997	Stanislaus County
32788	Fee-for-Service	1891879086	1891879086	1	1	WAXER, DANIEL A MD	7/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	53093	05	Anesthesiology	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
32791	Fee-for-Service	1558366229	1558366229	1	1	WALLOWA CO HEALTH CARE DIST	7/1/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	601 MEDICAL PARKWAY	None	ENTERPRISE	OR	97828	5124	00	None	45.43172194	-117.2843445	Wallowa County
32881	Fee-for-Service	1417967464	1417967464	1	1	WEINTRAUB, GERALD MD	1/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	29151	40	Pediatrics	0	In state provider	None	3230 WARING CT	STE P	OCEANSIDE	CA	92056	4509	37	06073	33.18776771	-117.2893136	San Diego County
32901	Fee-for-Service	1790918324	1790918324	1	1	WESTSIDE PHARMACY CORP	11/24/2009	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WESTSIDE PHARMACY	11504 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	3008	19	06037	34.0453044	-118.4522662	Los Angeles County
32907	Fee-for-Service	1124340666	1124340666	1	1	WELDEN, ARNOLD O MD INC	3/30/2010	193400000X	NA	Other	026	PHYSICIANS	42350	08	Family Practice	0	In state provider	None	1090 N CHERRY ST	None	TULARE	CA	93274	2210	54	06107	36.22376401	-119.3372125	Tulare County
32993	Fee-for-Service	1588954424	1588954424	1	1	WELCH, DEANNE N PSYD	5/30/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
32995	Fee-for-Service	1083629372	1083629372	1	1	WALGREEN CO.	11/27/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 E 17TH ST	None	SANTA ANA	CA	92705	8503	30	06059	33.75995053	-117.851211	Orange County
33018	Fee-for-Service	1679646095	1679646095	1	1	WOLLMUTH, KIMBERLY A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2200 NE PROFESSIONAL CT	None	BEND	OR	97701	6063	00	None	44.06492445	-121.270761	Deschutes County
33064	Fee-for-Service	1558326587	1558326587	1	1	WAGER, EDWIN W JR MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29953	08	Family Practice	0	In state provider	None	800 DOUGLAS RD	None	STOCKTON	CA	95207	3607	39	06077	38.00786919	-121.3210892	San Joaquin County
33076	Fee-for-Service	1861931750	1861931750	1	1	WONG, JULIE OD	8/2/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1400 N HARBOR BLVD	STE 101	FULLERTON	CA	92835	9283	30	06059	33.88408114	-117.9253959	Orange County
33083	Fee-for-Service	1326192980	1326192980	1	1	WILLIAMS, DIANE E INC	12/23/1998	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	BETTER SOUND AUDIOLOGY	7024 AIRWAY AVE	STE D	YUCCA VALLEY	CA	92284	3069	36	06071	34.12560837	-116.410578	San Bernardino County
33098	Fee-for-Service	1568662351	1568662351	1	1	WEAVER, JESSICA G	12/14/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
33103	Fee-for-Service	1477620235	1477620235	1	1	WAGNER, KATHERINE T CRNA	2/20/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
33112	Fee-for-Service	1669423505	1669423505	1	1	WHALEN, PATRICK MD	8/1/1984	207L00000X	NA	Other	026	PHYSICIANS	51834	05	Anesthesiology	0	In state provider	None	2500 HOSPITAL DR	STE 10	MOUNTAIN VIEW	CA	94040	4106	43	06085	37.36908	-122.081819	Santa Clara County
33148	Fee-for-Service	1104052109	1104052109	1	1	WATSON, JAMES A MD INC	2/17/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	98977	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8833 MONTEREY ST	STE G	GILROY	CA	95020	7200	43	06085	37.02501265	-121.5777555	Santa Clara County
33155	Fee-for-Service	1518385970	1518385970	1	1	WELCH, ELIZABETH A MD	5/16/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	139192	15	Obstetrics (D.O. only)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
33166	Fee-for-Service	1255580072	1255580072	1	1	WONG, CHIH-AN MD	8/8/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	123525	36	Psychiatry	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
33217	Fee-for-Service	1952912388	1952912388	1	1	WEST HILLS ASSISTED LIVING	11/20/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7055 SHOUP AVE	None	WEST HILLS	CA	91307	2335	19	06037	34.19840739	-118.6146873	Los Angeles County
33239	Fee-for-Service	1205841582	1205841582	1	1	WALGREEN CO.	6/1/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	227 SHORELINE HWY	None	MILL VALLEY	CA	94941	3678	21	06041	37.88055641	-122.5240059	Marin County
33245	Fee-for-Service	1932660057	1932660057	1	1	WANG, BRANDON J MD	12/13/2022	207P00000X	NA	Other	026	PHYSICIANS	182331	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
33260	Fee-for-Service	1275788622	1275788622	1	1	WALSHE, SUSAN LMFT	2/14/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
33326	Fee-for-Service	1043440548	1043440548	1	1	WANG, JINGTIAN MD	10/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109983	13	Neurology (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
33449	Fee-for-Service	1689648966	1689648966	1	1	WILSON, CORY M MD	7/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54675	08	Family Practice	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
33492	Fee-for-Service	1326798893	1326798893	1	1	WONG YIP, ZIKI NP	9/9/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
33495	Fee-for-Service	1417568122	1417568122	1	1	WINTZ, ANNALISE	2/3/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
33496	Fee-for-Service	1205241734	1205241734	1	1	WESTMAN, HARINI R MD	8/29/2018	390200000X	NA	Other	026	PHYSICIANS	148277	05	Anesthesiology	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
33518	Fee-for-Service	1821334814	1821334814	1	1	WISE-DIANGSON, CHELSEA K LMF	5/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	611 S MILPITAS BLVD	None	MILPITAS	CA	95035	5473	43	06085	37.4246225	-121.8944566	Santa Clara County
33633	Fee-for-Service	1346242906	1346242906	1	1	WIBBENMEYER, LUCY A	1/31/2023	2086S0102X	NA	General Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
33669	Fee-for-Service	1952316242	1952316242	1	1	WALGREEN CO.	1/22/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3630 SAN PABLO DAM RD	None	EL SOBRANTE	CA	94803	2730	07	06013	37.96423149	-122.317864	Contra Costa County
33701	Fee-for-Service	1922234798	1922234798	1	1	WONG, RYAN K MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125636	18	Ophthalmology	0	In state provider	None	100 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90095	0001	19	06037	34.06489065	-118.4443287	Los Angeles County
33708	Fee-for-Service	1376744268	1376744268	1	1	WETHERHOLT, KIMBERLY CRNA	7/11/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	25825 VERMONTE AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
33772	Fee-for-Service	1780670422	1780670422	1	1	WINCHESTER, MARK MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	34163	06	Cardiovascular Disease (M.D. only)	0	In state provider	SUTTER MEMORIAL HOSPITAL	5301 F ST	STE 117	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
33774	Fee-for-Service	1538363312	1538363312	1	1	WILCOX, DENNIS D MD INC	2/16/1988	208600000X	NA	General Surgery	026	PHYSICIANS	44471	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3800 JANES ROAD	None	ARCATA	CA	95521	4745	12	06023	40.89645172	-124.0930637	Humboldt County
33784	Fee-for-Service	1063762508	1063762508	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12270 PARAMOUNT BLVD	None	DOWNEY	CA	90242	3549	19	06037	33.92850727	-118.1485686	Los Angeles County
33828	Fee-for-Service	1356755532	1356755532	1	1	WANG, AILEEN X MD	6/9/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	161369	45	Nephrology (Renal-Kidney)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
33848	Fee-for-Service	1730328063	1730328063	1	2	WOLFF, LAUREN LMFT	10/18/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	409219	-	NOT APPLICABLE	0	In state provider	None	28632 ROADSIDE DR	210	AGOURA HILLS	CA	91301	6091	19	06037	34.14375168	-118.7497422	Los Angeles County
33855	Fee-for-Service	1770900359	1770900359	1	1	WAL-MART STORES, INC	6/12/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10470 TWIN CITIES ROAD	None	GALT	CA	95632	9032	34	06067	38.289996	-121.30488	Sacramento County
33867	Fee-for-Service	1386978658	1386978658	1	1	WALL, WENDIE K	12/2/2010	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11105 KNOTT AVE	STE A-B	CYPRESS	CA	90630	5137	30	06059	33.80083909	-118.0111199	Orange County
33877	Fee-for-Service	1720211824	1720211824	1	1	WALGREEN CO	11/5/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5001 W AVE N	None	LANCASTER	CA	93536	2989	19	06037	34.63089147	-118.219455	Los Angeles County
33920	Fee-for-Service	1619350311	1619350311	1	1	WILKINS, ASHLEY PSYD	5/18/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	39350 CIVIC CENTER DR	None	FREMONT	CA	94538	2343	01	06001	37.55399458	-121.9756047	Alameda County
34023	Fee-for-Service	1952404923	1952404923	1	1	WHITEHEAD, CHRIS L PT	10/22/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
34045	Fee-for-Service	1649266032	1649266032	1	1	WEISSIG, MARK D MD	9/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	49175	01	General Practice	0	In state provider	None	2675 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	19	06037	33.9892055	-118.2228885	Los Angeles County
34061	Fee-for-Service	1386969137	1386969137	1	1	WATSON, JOHN DEVIN B MD	7/13/2019	2086S0129X	NA	General Surgery	026	PHYSICIANS	158650	02	General Surgery	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
34064	Fee-for-Service	1538363312	1538363312	1	1	WILCOX, DENNIS D MD INC	2/16/1988	208600000X	NA	General Surgery	026	PHYSICIANS	44471	02	General Surgery	0	In state provider	None	3800 JANES ROAD	None	ARCATA	CA	95521	4745	12	06023	40.89645172	-124.0930637	Humboldt County
34081	Fee-for-Service	1447658695	1447658695	1	1	WILLAN, MAEGAN EMMA LMFT	6/25/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	610 16TH STREET	SUITE 504	OAKLAND	CA	94612	1286	01	06001	37.80722783	-122.2742936	Alameda County
34178	Fee-for-Service	1023412509	1023412509	2	1	WESTERN PHYSICAL THERAPY, IN	11/11/2020	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ORTS MEDICINE	6125 KING ROAD	102	LOOMIS	CA	95650	8809	31	06061	38.82513051	-121.189707	Placer County
34226	Fee-for-Service	1881990737	1881990737	1	1	WU, JOHN MD	1/10/2025	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	84002	01	General Practice	0	In state provider	None	19138 E WALNUT DR N	102	ROWLAND HEIGHTS	CA	91748	1432	19	06037	33.99570698	-117.8850338	Los Angeles County
34247	Fee-for-Service	1316013683	1316013683	1	1	WONG, SUSAN	1/16/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9201 BIG HORN BLVD	None	SACRAMENTO	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento
34294	Fee-for-Service	1720423791	1720423791	1	1	WESTBROEK, ERICK M MD	7/14/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	171937	None	None	0	In state provider	None	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	30	06059	33.89343304	-117.9279349	Orange County
34331	Fee-for-Service	1801153010	1801153010	1	1	WARUS, JONATHAN D MD	8/1/2018	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	136495	40	Pediatrics	0	In state provider	None	5000 W SUNSET BLVD	FL 4	LOS ANGELES	CA	90027	5861	19	06037	34.0981066	-118.2986382	Los Angeles County
34342	Fee-for-Service	1003851015	1003851015	1	1	WASHINGTON, SHARON D MD	4/12/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	70516	15	Obstetrics (D.O. only)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
34355	Fee-for-Service	1447344718	1447344718	1	1	WILLIAMS, RUSSELL A MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	33682	02	General Surgery	0	In state provider	None	101 CITY DR S	BLDG 10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
34414	Fee-for-Service	1124013966	1124013966	1	1	WEILBACKER, JOHN D	10/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 SOUTH AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
34429	Fee-for-Service	1326036260	1326036260	1	1	WANG, XIAOLIN MD	7/24/2023	207L00000X	NA	Other	026	PHYSICIANS	184184	None	None	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
34468	Fee-for-Service	1063710473	1063710473	1	2	WOLDENBERG, NINA R MD	10/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119261	30	Radiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
34474	Fee-for-Service	1205054236	1205054236	1	1	WATERS, LYNDSEY LMFT	6/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
34479	Fee-for-Service	1609988633	1609988633	1	1	WESSEL, LELAND G MD	7/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	55184	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
34520	Fee-for-Service	1710948112	1710948112	1	1	WANG, FANPING MD	4/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	56286	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2241 WANKEL WY	STE C	OXNARD	CA	93030	0191	56	06111	34.21679844	-119.1467863	Ventura County
34534	Fee-for-Service	1689170276	1689170276	1	1	WORTH, GLORIA E NP	10/18/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
34601	Fee-for-Service	1497308415	1497308415	1	1	WOODS, ALYSHA NP	9/11/2019	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
34615	Fee-for-Service	1437685815	1437685815	1	1	WU, KATHERINE C DO	8/6/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	17009	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
34660	Fee-for-Service	1275659773	1275659773	1	1	WRIGHT, YVONNE N LCSW	3/1/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3655 ALAMO ST	202	SIMI VALLEY	CA	93063	2187	56	06111	34.28646704	-118.7257456	Ventura County
34730	Fee-for-Service	1932227758	1932227758	1	1	WANG, RITA Y F MD	9/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113061	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3883 AIRWAY DR	STE 165	SANTA ROSA	CA	95403	1675	49	06097	38.483226	-122.739705	Sonoma County
34792	Fee-for-Service	1851513469	1851513469	1	9	WESTERN SIERRA MED CLINIC	10/31/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3257 PROFESSIONAL DR	STE C	AUBURN	CA	95602	2460	31	06061	38.943405	-121.1008195	Placer County
34807	Fee-for-Service	1710948112	1710948112	1	1	WANG, FANPING MD	4/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	56286	41	Internal Medicine	0	In state provider	None	2241 WANKEL WY	STE C	OXNARD	CA	93030	0191	56	06111	34.21679844	-119.1467863	Ventura County
34834	Fee-for-Service	1427704733	1427704733	1	1	WINDSOR FAMILY PRACTICE	4/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	2929 LOMA VISTA RD	STE F	VENTURA	CA	93003	2965	56	06111	34.27551157	-119.2569077	Ventura County
34868	Fee-for-Service	1205364148	1205364148	1	1	WILSEN, CRAIG B MD	7/1/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	159803	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
34886	Fee-for-Service	1558527952	1558527952	1	1	WENDLER, CARLAN B MD	7/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111063	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06238259	-118.2030986	Los Angeles County
34905	Fee-for-Service	1346336195	1346336195	2	1	WANG, DANIEL Y MD	4/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96792	None	None	0	In state provider	None	920 SUNNYSLOPE RD	None	HOLLISTER	CA	95023	5784	35	06069	36.83913141	-121.3857821	San Benito County
34949	Fee-for-Service	1023146891	1023146891	1	1	WILLIAMS, SHANNON E LMFT	10/4/2021	225400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	357 W 2ND ST	3	SAN BERNARDINO	CA	92401	1800	36	06071	34.10268251	-117.2909205	San Bernardino County
34963	Fee-for-Service	1609118736	1609118736	1	1	WERTZ, ANNA GARCIA MD	9/20/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	182061	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
34981	Fee-for-Service	1174076913	1174076913	1	1	WENTZEL, NICOLE E LCSW	2/2/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
34989	Fee-for-Service	1801263967	1801263967	1	1	WILLIAMS, AMY L PT	5/13/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
35001	Fee-for-Service	1063525715	1063525715	1	1	WILLIS, MARK G MD	4/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63295	66	Emergency Medicine (Urgent Care)	0	In state provider	None	347 ANDRIEUX ST	None	SONOMA	CA	95476	6811	49	06097	38.28843573	-122.4651035	Sonoma County
35032	Fee-for-Service	1003175738	1003175738	1	1	WALGREEN CO	7/27/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1175 COLUMBUS AVE	None	SAN FRANCISCO	CA	94133	1729	38	06075	37.80490869	-122.4168359	San Francisco County
35078	Fee-for-Service	1528262573	1528262573	1	1	WANG, KEVIN H MD	1/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118671	01	General Practice	0	In state provider	None	3779 PIEDMONT AVE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
35082	Fee-for-Service	1851513469	1851513469	1	9	WESTERN SIERRA MED CLINIC	10/31/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3257 PROFESSIONAL DR	STE C	AUBURN	CA	95602	2460	31	06061	38.943405	-121.1008195	Placer County
35130	Fee-for-Service	1326552902	1326552902	1	1	WILLIS, GREGORY LAC	12/13/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	127 HOSPITAL DR	SUITE #203	VALLEJO	CA	94589	2500	48	06095	38.13103371	-122.2387342	Solano County
35132	Fee-for-Service	1225114739	1225114739	1	1	WOLFE, DANNY A MD	9/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36706	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
35153	Fee-for-Service	1174743520	1174743520	1	1	WILLIAMS, MAUREEN A LCSW	7/21/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
35160	Fee-for-Service	1437128055	1437128055	1	1	WONG, SIU-PING CNP	12/4/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	987 E HILLSDALE BLVD	None	FOSTER CITY	CA	94404	2112	41	06081	37.55686846	-122.273705	San Mateo County
35208	Fee-for-Service	1558414193	1558414193	1	1	WAN, WEI L MD	12/1/1995	207W00000X	NA	Ophthalmology	026	PHYSICIANS	50251	18	Ophthalmology	0	In state provider	None	1700 N ROSE AVE	STE 200	OXNARD	CA	93030	3791	56	06111	34.21746	-119.155545	Ventura County
35231	Fee-for-Service	1720489503	1720489503	1	1	WALKER, JULIE C	6/15/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
35249	Fee-for-Service	1487188611	1487188611	1	1	WASSON, LARRY PSYD	5/13/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2131 CAPITOL AVE	SUITE 206	SACRAMENTO	CA	95816	5755	34	06067	38.573073	-121.4788005	Sacramento County
35256	Fee-for-Service	1528195450	1528195450	1	1	WELCOME,ANNA M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	ERIN	916 PACIFIC AVENUE	None	EVERETH	WA	98201	0000	00	None	47.97642669	-122.2166004	Snohomish County
35270	Fee-for-Service	1548240443	1548240443	1	2	WILLIAM NEAL EVANS MD LTD	11/9/2021	2080P0202X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	1	Border provider	A	85 KIRMAN AVE	SUITE 401	RENO	NV	89502	1360	00	None	39.52624763	-119.7984127	Washoe County
35375	Fee-for-Service	1932276243	1932276243	1	1	WILSON, LAURIE PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
35457	Fee-for-Service	1639667231	1639667231	1	1	WAGLE, SAGAR MD	6/23/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184916	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
35516	Fee-for-Service	1609089671	1609089671	1	1	WONG, ANNA M	5/3/2011	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
35546	Fee-for-Service	1811149131	1811149131	1	1	WATABE, MINAKO MD	11/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104073	None	None	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
35549	Fee-for-Service	1689691099	1689691099	1	1	WALMART INC.	4/13/1995	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	26502 TOWNE CENTRE DR	None	FOOTHILL RANCH	CA	92610	2417	30	06059	33.679782	-117.671256	Orange County
35573	Fee-for-Service	1134353444	1134353444	1	1	WINTER, TIMOTHY W DO	11/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	15051	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
35598	Fee-for-Service	1558542043	1558542043	1	1	WESLEY, JONATHAN LMFT	10/6/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
35600	Fee-for-Service	1730742586	1730742586	1	1	WEISER, CASEY E MD	10/23/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180259	08	Family Practice	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
35637	Fee-for-Service	1063597383	1063597383	1	1	WANG, SHAOJUN MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72571	41	Internal Medicine	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
35646	Fee-for-Service	1881671790	1881671790	1	1	WEAGANT, LANCE W MD	2/8/2015	207P00000X	NA	Other	026	PHYSICIANS	78798	66	Emergency Medicine (Urgent Care)	0	In state provider	None	43563 HWY 299 EAST	None	FALL RIVER MILLS	CA	96028	0459	45	06089	41.02401196	-121.4246219	Shasta County
35660	Fee-for-Service	1841307535	1841307535	1	1	WONG, DAVID T MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80664	02	General Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
35663	Fee-for-Service	1285649566	1285649566	1	1	WALGREEN CO	2/20/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3201 W 6TH ST	None	LOS ANGELES	CA	90020	5001	19	06037	34.0636545	-118.2922515	Los Angeles County
35673	Fee-for-Service	1851513469	1851513469	1	8	WESTERN SIERRA MED CLINIC	1/1/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	180 SIERRA COLLEGE DR	None	GRASS VALLEY	CA	95945	5768	29	06057	39.23235449	-121.0475561	Nevada County
35711	Fee-for-Service	1154411650	1154411650	3	2	WALKER PHYSICAL THERAPY INC	1/1/1994	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29650 BRADLEY RD	None	MENIFEE	CA	92586	6521	33	06065	33.6899672	-117.1885767	Riverside County
35718	Fee-for-Service	1841879889	1841879889	1	1	WINGER, ALLAN D MD	7/3/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
35725	Fee-for-Service	1437161346	1437161346	1	1	WADHWA, GURINDER S DO	1/28/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	9566	01	General Practice	0	In state provider	None	1450 TREAT BLVD	STE 160	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
35759	Fee-for-Service	1629279799	1629279799	1	1	WINN, BRYAN J MD	11/14/2018	207W00000X	NA	Ophthalmology	026	PHYSICIANS	90059	18	Ophthalmology	0	In state provider	None	1001 POTRERO AVE	RM 4M31	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
35797	Fee-for-Service	1689734428	1689734428	1	1	WU, YONGYI	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	835 CLAY ST	STE 102	SAN FRANCISCO	CA	94108	1639	38	06075	37.79415721	-122.4069755	San Francisco County
35806	Fee-for-Service	1538592407	1538592407	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	7677 CENTER AVE	STE 103	HUNTINGTON BEACH	CA	92647	3030	30	06059	33.736257	-117.995535	Orange County
35834	Fee-for-Service	1639278641	1639278641	1	1	WARSOWE, CARL MD	12/5/1996	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	20749	40	Pediatrics	0	In state provider	None	1160 CIRBY WAY	None	ROSEVILLE	CA	95661	4422	31	06061	38.72946765	-121.274199	Placer County
35869	Fee-for-Service	1356796254	1356796254	1	1	WU, MICHELLE S MD	7/8/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172614	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
35891	Fee-for-Service	1528073814	1528073814	1	1	WALGREEN CO.	1/7/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1028 S SAN FERNANDO BLVD	None	BURBANK	CA	91502	1537	19	06037	34.17397411	-118.2992136	Los Angeles County
35920	Fee-for-Service	1144229691	1144229691	1	1	WITHERS, CYNTHIA MD	12/31/1993	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	50781	30	Radiology	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4355	42	06083	34.42967671	-119.7228362	Santa Barbara County
35925	Fee-for-Service	1063597383	1063597383	1	1	WANG, SHAOJUN MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72571	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
35933	Fee-for-Service	1881671790	1881671790	1	1	WEAGANT, LANCE W MD	2/8/2015	207P00000X	NA	Other	026	PHYSICIANS	78798	08	Family Practice	0	In state provider	None	43563 HWY 299 EAST	None	FALL RIVER MILLS	CA	96028	0459	45	06089	41.02401196	-121.4246219	Shasta County
35961	Fee-for-Service	1851513469	1851513469	1	8	WESTERN SIERRA MED CLINIC	1/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	180 SIERRA COLLEGE DR	None	GRASS VALLEY	CA	95945	5768	29	06057	39.23235449	-121.0475561	Nevada County
35978	Fee-for-Service	1558406900	1558406900	1	1	WHITE, GREGORY W LCSW	1/2/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5053 LA MART DR	STE 105	RIVERSIDE	CA	92507	5993	33	06065	33.95818206	-117.3320081	Riverside County
36012	Fee-for-Service	1750887220	1750887220	1	1	WEISS, ANDREA MD	10/2/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
36013	Fee-for-Service	1356971550	1356971550	1	1	WESTERN HEALTH RESOURCES	8/24/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	500 ORIENT ST	STE 105	CHICO	CA	95928	5672	04	06007	39.72992759	-121.8349891	Butte County
36024	Fee-for-Service	1801322268	1801322268	1	1	WEIL, MICHAEL D MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	40152	78	Neoplastic Diseases/Oncology	0	In state provider	None	1165 S DORA ST	None	UKIAH	CA	95482	8325	23	06045	39.13602308	-123.2095502	Mendocino County
36053	Fee-for-Service	1811985542	1811985542	1	1	WINE, DAVID T MD	10/31/2022	207R00000X	NA	Other	026	PHYSICIANS	45531	None	None	0	In state provider	None	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	37	06073	32.99706	-117.05544	San Diego County
36063	Fee-for-Service	1619991510	1619991510	1	1	WANG, GINA R. MD	11/30/1993	207R00000X	NA	Other	026	PHYSICIANS	78096	41	Internal Medicine	0	In state provider	THREE RIVERS MEDICAL GR	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
36072	Fee-for-Service	1659337020	1659337020	1	1	WHITING, MICHAEL E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7920 CARMEL AVE NE	STE 1	ALBUQUERQUE	NM	87122	3056	00	None	35.17714152	-106.5574845	Bernalillo County
36094	Fee-for-Service	1982920666	1982920666	1	1	WHITE, CHRISTOPHER N LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
36097	Fee-for-Service	1891190831	1891190831	1	1	WALLACE, KATHERINE LMFT	12/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
36107	Fee-for-Service	1558628552	1558628552	1	1	WUNGWATTANA, MINKKWAN MD	4/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128717	40	Pediatrics	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
36113	Fee-for-Service	1346416112	1346416112	1	1	WINDSOR HALL CARE HOME, INC	10/3/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1415 JAMES M WOOD BLVD	None	LOS ANGELES	CA	90015	1209	19	06037	34.04955254	-118.2702322	Los Angeles County
36114	Fee-for-Service	1881236990	1881236990	1	1	WONG, STUART CRNA	2/20/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	8110 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21850103	-118.4310944	Los Angeles County
36160	Fee-for-Service	1750836573	1750836573	1	1	WILLIAMS, CAITLIN J LMFT	8/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
36206	Fee-for-Service	1366553984	1366553984	1	1	WEBSTER, ANN M NP	4/2/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3700 MALL VIEW RD	None	BAKERSFIELD	CA	93306	3050	15	06029	35.39462173	-118.9518506	Kern County
36258	Fee-for-Service	1740740042	1740740042	1	1	WU, DANWEI MD	2/2/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	180195	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
36276	Fee-for-Service	1558351536	1558351536	1	1	WEST PARK HOSPITAL	6/22/2007	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DISTRICT	707 SHERIDAN AVE	None	CODY	WY	82414	3409	00	None	44.52605901	-109.0732547	Park County
36300	Fee-for-Service	1356971550	1356971550	1	1	WESTERN HEALTH RESOURCES	8/24/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	500 ORIENT ST	STE 105	CHICO	CA	95928	5672	04	06007	39.72992759	-121.8349891	Butte County
36303	Fee-for-Service	1225292055	1225292055	1	1	WELLS, LINDSAY K MD	2/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112305	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
36316	Fee-for-Service	1801322268	1801322268	1	1	WEIL, MICHAEL D MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	40152	30	Radiology	0	In state provider	None	1165 S DORA ST	None	UKIAH	CA	95482	8325	23	06045	39.13602308	-123.2095502	Mendocino County
36346	Fee-for-Service	1902811284	1902811284	1	1	WALGREEN CO	2/16/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1574 E VALLEY PKWY	None	ESCONDIDO	CA	92027	2316	37	06073	33.13377959	-117.0599309	San Diego County
36423	Fee-for-Service	1326295288	1326295288	1	1	WANG, AI-JEN MD	8/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115003	41	Internal Medicine	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5795	36	06071	34.47092468	-117.2977236	San Bernardino County
36450	Fee-for-Service	1932346236	1932346236	1	1	WEST, MARVIN E LMFT	3/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
36458	Fee-for-Service	1568807774	1568807774	1	1	WU, GORDON Y MD	9/20/2018	207P00000X	NA	Other	026	PHYSICIANS	154994	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
36492	Fee-for-Service	1952490815	1952490815	1	1	WEINSTEIN, JAMIE S MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52926	01	General Practice	0	In state provider	None	5900 STATE FARM DR	None	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
36542	Fee-for-Service	1538138623	1538138623	1	1	WU, CYNTHIA S MD	10/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53381	40	Pediatrics	0	In state provider	None	401 BICENTENNIAL WY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
36563	Fee-for-Service	1558351536	1558351536	1	1	WEST PARK HOSPITAL	6/22/2007	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DISTRICT	707 SHERIDAN AVE	None	CODY	WY	82414	3409	00	None	44.52605901	-109.0732547	Park County
36651	Fee-for-Service	1083217376	1083217376	1	1	WAY MAKER HOME CARE INC	1/29/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5800 WINTER RIDGE DR	None	BAKERSFIELD	CA	93313	2701	15	06029	35.30228801	-119.0586776	Kern County
36654	Fee-for-Service	1124633953	1124633953	1	1	WALTERS, RHANDI A LMFT	11/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
36682	Fee-for-Service	1932506482	1932506482	1	1	WALSER, AMBER L PHD	3/13/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4700 SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
36709	Fee-for-Service	1134188543	1134188543	1	1	WADHAVKAR, GEETANJALI J MD	1/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	65929	41	Internal Medicine	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
36721	Fee-for-Service	1285894279	1285894279	1	1	WEYANDT, ADRIANA F PSYD	3/18/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7300 WYNDHAM DRIVE	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
36748	Fee-for-Service	1043449010	1043449010	1	1	WILLIAMS, NICOLE K LMFT	4/29/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	911 21ST ST	202	PASO ROBLES	CA	93446	1722	40	06079	35.63623522	-120.6893646	San Luis Obispo County
36779	Fee-for-Service	1376688457	1376688457	1	1	WALOT, IRWIN MD	12/31/1993	2085R0204X	NA	Other	026	PHYSICIANS	57034	30	Radiology	0	In state provider	None	21840 NORMANDIE AVE	STE 100	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
36842	Fee-for-Service	1659399079	1659399079	1	1	WEINBERG, MELISSA E MD	3/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89190	41	Internal Medicine	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
36874	Fee-for-Service	1679786693	1679786693	1	1	WARNER, SUSANNE G MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136276	02	General Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
36891	Fee-for-Service	1427320936	1427320936	1	1	WOLKIN, ALLISON CRNA	10/8/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
36892	Fee-for-Service	1164943569	1164943569	1	1	WALKER, CHRISTINA M CNP	12/2/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8101 GREENBACK LN	None	FAIR OAKS	CA	95628	2502	34	06067	38.679237	-121.261662	Sacramento County
36906	Fee-for-Service	1063543627	1063543627	1	1	WITMER NEONATOLOGY ASSOC	11/5/1990	2080N0001X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
36916	Fee-for-Service	1194873182	1194873182	1	1	WEST, GERALD I MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82598	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
36918	Fee-for-Service	1639381650	1639381650	1	1	WRIGHT, VALERIE L PHD	5/1/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
36964	Fee-for-Service	1790255214	1790255214	1	1	WARD, KENZIE LPCC	2/10/2025	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
36980	Fee-for-Service	1063948701	1063948701	1	1	WANG, ANNIE MD	10/18/2022	207L00000X	NA	Other	026	PHYSICIANS	159776	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
36992	Fee-for-Service	1104288356	1104288356	1	1	WEINER, ADAM B MD	3/16/2022	208800000X	NA	Other	026	PHYSICIANS	176647	None	None	0	In state provider	None	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
37016	Fee-for-Service	1972770899	1972770899	1	1	WEDEL, NEDA S PSYD	10/24/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	12522 MOORPARK ST	106	STUDIO CITY	CA	91604	1355	19	06037	34.15033253	-118.406061	Los Angeles County
37020	Fee-for-Service	1487920385	1487920385	1	1	WARM, HEATHER A MD	11/23/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	126922	None	None	0	In state provider	None	1001 POTRERO AVE	RM 7M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
37107	Fee-for-Service	1558700179	1558700179	1	1	WILLOW, EMILY MD	9/18/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	138947	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
37113	Fee-for-Service	1356631121	1356631121	1	1	WINTER, KATHERINE H MD	3/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129999	01	General Practice	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
37180	Fee-for-Service	1568401131	1568401131	1	1	WILSON, NEIL E MD	7/1/1993	207P00000X	NA	Other	026	PHYSICIANS	38073	08	Family Practice	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
37196	Fee-for-Service	1063543627	1063543627	1	1	WITMER NEONATOLOGY ASSOC	11/5/1990	2080N0001X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
37274	Fee-for-Service	1699714626	1699714626	1	1	WEHBE, SALIM A MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106873	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
37291	Fee-for-Service	1457369571	1457369571	1	1	WONG, SONNY JH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	25 MALUNIU AVE	STE 201	KAILUA	HI	96734	5807	00	None	21.39679234	-157.7413442	Honolulu County
37307	Fee-for-Service	1285839977	1285839977	1	1	WYNVEEN, KEVIN J	6/6/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 TRAVELODGE DR	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
37343	Fee-for-Service	1649798638	1649798638	1	1	WANDREY, LUKE D MD	2/12/2021	207P00000X	NA	Other	026	PHYSICIANS	169705	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
37370	Fee-for-Service	1487669578	1487669578	1	1	WALGREEN CO	8/19/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	670 4TH ST	None	SAN FRANCISCO	CA	94107	1618	38	06075	37.7773478	-122.3954502	San Francisco County
37373	Fee-for-Service	1205368370	1205368370	1	1	WOUND CARE CENTER OF INLAND	3/16/2018	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	INC	9481 PITTSBURGH AVE	STE 200	RANCHO CUCAMONGA	CA	91730	9007	36	06071	34.08094188	-117.5559944	San Bernardino County
37387	Fee-for-Service	1750018545	1750018545	1	1	WINDSCAPE SENIOR CARE INC	8/25/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7636 KENTLAND AVE	None	WEST HILLS	CA	91304	5406	19	06037	34.20947532	-118.6175957	Los Angeles County
37458	Fee-for-Service	1396851663	1396851663	1	1	WONG, STEPHANIE N MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76243	41	Internal Medicine	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
37479	Fee-for-Service	1033233168	1033233168	1	1	WEI, SHIANGYIN LMFT	5/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2100 E STREET	None	BAKERSFIELD	CA	93301	4703	15	06029	35.3781843	-119.0245697	Kern County
37563	Fee-for-Service	1134208358	1134208358	1	1	WILLIAM YS TOM & WESLEY	1/13/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	F TOM PTRS	942 N BROADWAY	STE 104	LOS ANGELES	CA	90012	1745	19	06037	34.06513536	-118.2368888	Los Angeles County
37633	Fee-for-Service	1942322821	1942322821	1	1	WILLIAMS, VICTOR G MD	7/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112306	14	Neurological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
37660	Fee-for-Service	1194897926	1194897926	1	1	WYATT, RONALD MD	8/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72284	20	Orthopedic Surgery	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
37725	Fee-for-Service	1598164089	1598164089	1	1	WELLSPRING HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	19730 VENTURA BLVD	#25	WOODLAND HILLS	CA	91364	2622	19	06037	34.17245599	-118.5633517	Los Angeles County
37772	Fee-for-Service	1407171903	1407171903	1	1	WALNUT CREEK ELEMENTARY	11/1/2009	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOL DISTRICT	960 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94596	3892	07	06013	37.909827	-122.055957	Contra Costa County
37904	Fee-for-Service	1437130804	1437130804	1	1	WHITTEMORE, DARREN E DO	2/9/2023	207ZP0102X	NA	Other	026	PHYSICIANS	16487	None	None	0	In state provider	None	7592 METROPOLITAN DR	STE 405-407	SAN DIEGO	CA	92108	4428	37	06073	32.77772014	-117.1575637	San Diego County
37921	Fee-for-Service	1346309697	1346309697	1	1	WILLATS, AMY M CNM	4/27/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
37957	Fee-for-Service	1033458161	1033458161	1	1	WINFIELD, EMMA H NP	12/22/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
37962	Fee-for-Service	1588979371	1588979371	1	1	WINTER, ROMAN A MD	11/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123848	41	Internal Medicine	0	In state provider	None	1400 E CHURCH STREET	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
37971	Fee-for-Service	1063855641	1063855641	1	1	WOODARD, JOSLYN I MD	6/15/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	136046	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
38009	Fee-for-Service	1598164089	1598164089	1	1	WELLSPRING HOSPICE	6/1/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	19730 VENTURA BLVD	#25	WOODLAND HILLS	CA	91364	2622	19	06037	34.17245599	-118.5633517	Los Angeles County
38029	Fee-for-Service	1780716472	1780716472	1	1	WANG, JENNIFER Y MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	85790	02	General Surgery	0	In state provider	None	280 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
38032	Fee-for-Service	1659314540	1659314540	1	1	WALDRON, KEVIN G MD	7/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147602	14	Neurological Surgery	0	In state provider	None	160 E ARTESIA ST	SUITE 220	POMONA	CA	91767	2900	19	06037	34.07556833	-117.7507835	Los Angeles County
38043	Fee-for-Service	1376881789	1376881789	1	1	WINDSOR, CAITLIN A	10/28/2013	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	802 MAGNOLIA AVE	STE 802	CORONA	CA	92879	3157	33	06065	33.8596449	-117.5529774	Riverside County
38055	Fee-for-Service	1982788006	1982788006	1	1	WOMACKS SIERRA VISTA PCY	1/26/1987	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	DOSE DRUGGISTS	650 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.29776196	-119.2013266	Tulare County
38070	Fee-for-Service	1750396032	1750396032	1	1	WALGREEN CO	7/14/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	60 N HIGHLAND SPRINGS AV	None	BANNING	CA	92220	3048	33	06065	33.92988307	-116.9468586	Riverside County
38077	Fee-for-Service	1679963276	1679963276	1	1	WU, JULIE H LCSW	10/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
38094	Fee-for-Service	1467682849	1467682849	1	1	WOEBKENBERG, HANNAH L MD	2/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119789	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
38145	Fee-for-Service	1952914681	1952914681	1	11	WEST COAST KIDNEY	12/29/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1999 MOWRY AVE	STE R	FREMONT	CA	94538	1723	01	06001	37.55783419	-121.9808484	Alameda County
38160	Fee-for-Service	1124027529	1124027529	1	1	WEST COVINA PLAN IPA INC	5/17/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	A MEDICAL GROUP INC	605 E BADILLO ST	STE 100	COVINA	CA	91723	2847	19	06037	34.08628747	-117.87903	Los Angeles County
38179	Fee-for-Service	1053389064	1053389064	1	1	WEST COAST RETINA MEDICAL	6/23/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	1445 BUSH ST	None	SAN FRANCISCO	CA	94109	5520	38	06075	37.78855318	-122.4211311	San Francisco County
38185	Fee-for-Service	1124218979	1124218979	1	1	WATT AVE MEDICAL CLINIC	10/11/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	5710 WATT AVE	None	NORTH HIGHLANDS	CA	95660	4752	34	06067	38.670723	-121.3823745	Sacramento County
38197	Fee-for-Service	1225393101	1225393101	1	1	WANG, JOYCE Z MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140282	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
38201	Fee-for-Service	1801963616	1801963616	1	1	WARNER, CATHERINE C MD	12/1/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	42846	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
38214	Fee-for-Service	1710064662	1710064662	1	1	WACHS, ROBERT V MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	21506	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
38230	Fee-for-Service	1366673568	1366673568	1	2	WAH, DESMOND J MD	12/9/2017	208M00000X	NA	Other	026	PHYSICIANS	143206	41	Internal Medicine	0	In state provider	None	300 CANAL ST	None	KING CITY	CA	93930	3431	27	06053	36.20653258	-121.1319345	Monterey County
38237	Fee-for-Service	1396791026	1396791026	1	1	WILLIAM R BENNETT MD	8/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 KOOTENAI HEALTH WAY	None	COEUR D ALENE	ID	83814	6051	00	None	47.695635	-116.792906	Kootenai County
38257	Fee-for-Service	1194185421	1194185421	2	1	WECARE SPECIALTY PHARMACY IN	12/28/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	198 N ARROWHEAD AVE	None	SAN BERNARDINO	CA	92408	1011	36	06071	34.102341	-117.2896785	San Bernardino County
38317	Fee-for-Service	1114006319	1114006319	1	1	WOFCHUCK JAY MO	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3179 HAMNER AVE	STE 1	NORCO	CA	92860	1983	33	06065	33.92804266	-117.558241	Riverside County
38322	Fee-for-Service	1063788255	1063788255	1	1	WANG, ANGELA L DO MD	8/9/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	15739	40	Pediatrics	0	In state provider	None	9939 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.91571158	-117.4549231	Riverside County
38361	Fee-for-Service	1285491936	1285491936	1	1	WALKING BY FAITH MINISTRIES	8/22/2024	171M00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	3191 M ST	STE B	MERCED	CA	95348	2405	24	06047	37.32176904	-120.4784343	Merced County
38408	Fee-for-Service	1043248990	1043248990	1	1	WONG, ELMER	9/15/1988	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6700 N 1ST ST	STE 103	FRESNO	CA	93710	3947	10	06019	36.83586697	-119.7721176	Fresno County
38446	Fee-for-Service	1043203730	1043203730	1	1	WILTCHIK, KERRI S MD	8/25/1999	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	55973	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	116 S PALISADE DR	STE 208	SANTA MARIA	CA	93454	8906	42	06083	34.9523869	-120.4120717	Santa Barbara County
38474	Fee-for-Service	1083773683	1083773683	1	1	WHITE, COURTENAY C MD	10/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83493	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
38499	Fee-for-Service	1750419560	1750419560	1	1	WOO, ANDREW H MD	8/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	78667	13	Neurology (M.D. only)	0	In state provider	None	2021 SANTA MONICA BLVD	STE 525E	SANTA MONICA	CA	90404	2208	19	06037	34.02922048	-118.4793681	Los Angeles County
38520	Fee-for-Service	1982166237	1982166237	1	1	WI, KRISTIANNA E MD	7/3/2023	390200000X	NA	Other	026	PHYSICIANS	180952	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
38544	Fee-for-Service	1891321204	1891321204	1	1	WEBERG, LENICE A OT	9/6/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
38610	Fee-for-Service	1134486004	1134486004	1	1	WANG, DAVID T	9/16/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
38667	Fee-for-Service	1447340336	1447340336	1	1	WOO, WARREN MD	4/22/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	40927	None	None	0	In state provider	None	12291 WASHINGTON BLVD	SUITE 500	WHITTIER	CA	90606	2500	19	06037	33.96734104	-118.0508773	Los Angeles County
38709	Fee-for-Service	1174292767	1174292767	1	1	WOLDESILASSE, ZEYERUSALEM T	1/13/2022	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	NP	8151 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	2300	34	06067	38.461554	-121.4167635	Sacramento County
38731	Fee-for-Service	1083003321	1083003321	1	4	WHITE MEMORIAL COMMUNITY	12/5/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1200 PLAZA DEL SOL E	None	LOS ANGELES	CA	90033	2730	19	06037	34.04877441	-118.2269065	Los Angeles County
38743	Fee-for-Service	1053389064	1053389064	1	4	WEST COAST RETINA MEDICAL	7/1/1989	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	101 S SAN MATEO DR	STE 306	SAN MATEO	CA	94401	3844	41	06081	37.56590481	-122.325549	San Mateo County
38763	Fee-for-Service	1427627884	1427627884	1	1	WILTON HAVEN INC	9/16/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	909 S WILTON PL	None	LOS ANGELES	CA	90019	2127	19	06037	34.05546447	-118.3142855	Los Angeles County
38787	Fee-for-Service	1902802168	1902802168	1	1	WELLS, JOSEPH J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4700 N 51ST AVE	None	PHOENIX	AZ	85031	1237	00	None	33.505722	-112.1690475	Maricopa County
38825	Fee-for-Service	1457856056	1457856056	1	1	WONG, BRIAN	2/25/2025	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
38831	Fee-for-Service	1760215263	1760215263	1	1	WILLIAM CURCI PSYCHOLOGY PRO	2/25/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	FESSIONAL CORPORATION	8950 VILLA LA JOLLA DR	STE B223	LA JOLLA	CA	92037	1715	37	06073	32.870934	-117.2338765	San Diego County
38849	Fee-for-Service	1972971299	1972971299	1	1	WONG, AMIE H NP	1/9/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
38863	Fee-for-Service	1366935215	1366935215	1	1	WANG, EVELYN MD	2/12/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	191815	None	None	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
38904	Fee-for-Service	1053389064	1053389064	1	3	WEST COAST RETINA MEDICAL	10/1/1988	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	400 29TH ST	STE 508	OAKLAND	CA	94609	3550	01	06001	37.81784861	-122.2652263	Alameda County
38943	Fee-for-Service	1508968074	1508968074	1	1	WHITTEN-VILE, SHELDON B	7/18/2007	2084P0800X	NA	Psychiatry	026	PHYSICIANS	64772	36	Psychiatry	0	In state provider	MD	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
39000	Fee-for-Service	1083003321	1083003321	1	4	WHITE MEMORIAL COMMUNITY	12/5/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1200 PLAZA DEL SOL E	None	LOS ANGELES	CA	90033	2730	19	06037	34.04877441	-118.2269065	Los Angeles County
39035	Fee-for-Service	1750943304	1750943304	1	1	WELLSTAR HOME HEALTH SERVICE	3/3/2022	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	S, INC	479 MASON ST	309	VACAVILLE	CA	95688	4542	48	06095	38.35495952	-121.9878135	Solano County
39088	Fee-for-Service	1689769309	1689769309	1	1	WENG, KIRSTI MD	12/1/1995	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	42867	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
39105	Fee-for-Service	1952734600	1952734600	1	2	WAY, SERENA MD	9/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127133	40	Pediatrics	0	In state provider	None	2500 MILVIA STREET	None	BERKELEY	CA	94705	2636	01	06001	37.86338897	-122.2698455	Alameda County
39122	Fee-for-Service	1215386248	1215386248	1	1	WILFONG, EDWARD J PHD	5/28/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
39193	Fee-for-Service	1730295049	1730295049	1	1	WATSON, RONALD R MD	1/29/1996	207R00000X	NA	Other	026	PHYSICIANS	37852	41	Internal Medicine	0	In state provider	None	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
39261	Fee-for-Service	1942968177	1942968177	1	1	WILSHIRE HEALTHCARE MANAGEME	12/28/2023	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CARE CENTER	1720 EL CAMINO REAL	STE 7	BURLINGAME	CA	94010	3226	41	06081	37.59341466	-122.381361	San Mateo County
39281	Fee-for-Service	1699708487	1699708487	1	1	WOLSZTEJN, JACOB MD	12/27/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	32006	40	Pediatrics	0	In state provider	None	1720 W BALL RD	STE 1	ANAHEIM	CA	92804	5585	30	06059	33.8178465	-117.9425115	Orange County
39315	Fee-for-Service	1992894539	1992894539	1	1	WRIGHT, BENNY L DO	4/3/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	13319	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	502 WASHINGTON AVE	None	LOS BANOS	CA	93635	3460	24	06047	37.05600223	-120.8529485	Merced County
39335	Fee-for-Service	1760626220	1760626220	1	1	WEBB, CHRISTOPHER A J MD	7/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124350	05	Anesthesiology	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
39356	Fee-for-Service	1447491501	1447491501	1	1	WESTCOM RADIOLOGY MEDICAL	1/25/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	1711 W TEMPLE STREET	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
39383	Fee-for-Service	1629796073	1629796073	1	1	WARDA, ERIC NP	2/25/2025	390200000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1120 WEST AVENUE M-4	None	PALMDALE	CA	93551	1432	19	06037	34.6457071	-118.155831	Los Angeles County
39403	Fee-for-Service	1801813928	1801813928	1	1	WESSLER, EMILY A	8/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91421	40	Pediatrics	0	In state provider	None	725 WELCH RD	MC5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
39422	Fee-for-Service	1831140938	1831140938	1	1	WASS, ADAM M MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87070	None	None	0	In state provider	None	638 LINDERO CANYON RD	STE 331	OAK PARK	CA	91377	5457	56	06111	34.1831578	-118.7860983	Ventura County
39458	Fee-for-Service	1316079619	1316079619	1	1	WIN, MIN S MD	12/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	92873	41	Internal Medicine	0	In state provider	None	290 N WAYTE LANE	None	FRESNO	CA	93701	2124	10	06019	36.74643429	-119.7837416	Fresno County
39468	Fee-for-Service	1588707384	1588707384	3	1	WARNOCK, IDEN J F RPT	10/31/1992	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7840 OLD REDWOOD HWY	None	COTATI	CA	94931	5106	49	06097	38.32994079	-122.7093541	Sonoma County
39473	Fee-for-Service	1497922694	1497922694	1	1	WORMAN, RACHEL S	4/10/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
39480	Fee-for-Service	1164073680	1164073680	1	1	WILSON, MARTENA R LMFT	3/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
39484	Fee-for-Service	1144258336	1144258336	1	1	WELCH, GEORGE N MD	6/15/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	88458	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2820 N ONTARIO ST	None	BURBANK	CA	91504	2015	19	06037	34.20335077	-118.3443845	Los Angeles County
39506	Fee-for-Service	1447324728	1447324728	1	1	WU, SHELLEY MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71092	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
39555	Fee-for-Service	1811175730	1811175730	1	1	WAN, CORDIA Y MD	5/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98109	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
39591	Fee-for-Service	1538350541	1538350541	2	1	WHOLERX INC	3/18/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19950 RINALD STREET	STE 102	PORTER RANCH	CA	91326	4141	19	06037	34.27560199	-118.5696701	Los Angeles County
39597	Fee-for-Service	1467619353	1467619353	1	1	WOZMAK, NICOLAS A MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	109605	None	None	0	In state provider	None	460 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13140416	-121.6141951	Sutter County
39609	Fee-for-Service	1861105819	1861105819	1	1	WIELAND, COLLEEN LCSW	1/25/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
39712	Fee-for-Service	1518494970	1518494970	1	1	WANG, SOPHIA S MD	7/16/2024	207P00000X	NA	Other	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
39744	Fee-for-Service	1316079619	1316079619	1	1	WIN, MIN S MD	12/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	92873	10	Gastroenterology (M.D. only)	0	In state provider	None	290 N WAYTE LANE	None	FRESNO	CA	93701	2124	10	06019	36.74643429	-119.7837416	Fresno County
39762	Fee-for-Service	1538374392	1538374392	1	1	WALGREEN CO	12/20/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5785 N FIRST ST	None	FRESNO	CA	93710	6203	10	06019	36.82255822	-119.7724051	Fresno County
39774	Fee-for-Service	1912186917	1912186917	1	2	WILLIAM F RESH MD, SKIN AND	2/9/2018	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	222 W MADISON AVE	None	EL CAJON	CA	92020	3406	37	06073	32.80071349	-116.964189	San Diego County
39792	Fee-for-Service	1366759904	1366759904	1	1	WILSHIRE CARDIOLOGY GROUP A	5/11/2011	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	42	Nuclear Medicine	0	In state provider	PROFESSIONAL CORPORATION	500 S VIRGIL AVE	STE 200	LOS ANGELES	CA	90020	1404	19	06037	34.064964	-118.2870335	Los Angeles County
39859	Fee-for-Service	1356847826	1356847826	1	1	WAKS, ASHTEN B MD	6/2/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	165053	None	None	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
39863	Fee-for-Service	1982995676	1982995676	1	1	WILLIAMS, LISA M MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126923	25	Physical Medicine and Rehabilitation	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
39907	Fee-for-Service	1639438500	1639438500	1	1	WONG, ZERLINA Z MD	8/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139368	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
39985	Fee-for-Service	1952495921	1952495921	1	1	WHITE, KEVIN G MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74767	40	Pediatrics	0	In state provider	None	451 W GONZALES RD	STE 340	OXNARD	CA	93036	0733	56	06111	34.21921445	-119.1816945	Ventura County
39997	Fee-for-Service	1518494970	1518494970	1	1	WANG, SOPHIA S MD	7/16/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
40014	Fee-for-Service	1033228739	1033228739	1	1	WARMERDAM, DOROTHEEA O MD	9/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96243	18	Ophthalmology	0	In state provider	None	1561 CREEKSIDE DR	STE 160	FOLSOM	CA	95630	3495	34	06067	38.668032	-121.150188	Sacramento County
40021	Fee-for-Service	1275377160	1275377160	1	1	WILLMENT, HALEY CCC-SLP	8/26/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	187 TANK FARM RD	STE 210	SAN LUIS OBISPO	CA	93401	7081	40	06079	35.24678151	-120.670299	San Luis Obispo County
40031	Fee-for-Service	1538210208	1538210208	1	1	WHITTIER KIDNEY DIALYSIS	6/5/2002	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	16417 WHITTIER BLVD	None	WHITTIER	CA	90603	3044	19	06037	33.93998653	-117.980136	Los Angeles County
40053	Fee-for-Service	1871507962	1871507962	1	1	WANG, NATALIE Y MD	5/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	80797	None	None	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
40083	Fee-for-Service	1366759904	1366759904	1	1	WILSHIRE CARDIOLOGY GROUP A	5/11/2011	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PROFESSIONAL CORPORATION	500 S VIRGIL AVE	STE 200	LOS ANGELES	CA	90020	1404	19	06037	34.064964	-118.2870335	Los Angeles County
40119	Fee-for-Service	1174802599	1174802599	1	1	WENDT, RICHARD LMFT	10/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
40141	Fee-for-Service	1427350156	1427350156	1	1	WANG, YUH-HUEY MD INC	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55694	41	Internal Medicine	0	In state provider	None	1106 S DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	4447	19	06037	34.00226972	-117.8102362	Los Angeles County
40175	Fee-for-Service	1356344758	1356344758	1	8	WEST COUNTY HEALTH CENTERS	8/5/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	6800 PALM AVE	SUITE C	SEBASTOPOL	CA	95472	4269	49	06097	38.39602719	-122.8185446	Sonoma County
40179	Fee-for-Service	1700109204	1700109204	1	1	WON, ALBERT U MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116666	None	None	0	In state provider	None	3801 HOWE STREET	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
40210	Fee-for-Service	1386063212	1386063212	1	1	WONG, LAURA C MD	10/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139164	41	Internal Medicine	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
40255	Fee-for-Service	1093770919	1093770919	1	1	WALTUCH, JEAN K MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	60642	41	Internal Medicine	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
40290	Fee-for-Service	1558376830	1558376830	1	1	WALGREEN CO.	3/23/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2801 ADELINE ST	None	BERKELEY	CA	94703	2204	01	06001	37.85820135	-122.2676316	Alameda County
40347	Fee-for-Service	1720346083	1720346083	1	1	WARDI, GABRIEL MD	7/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124468	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
40371	Fee-for-Service	1366759904	1366759904	1	1	WILSHIRE CARDIOLOGY GROUP A	5/11/2011	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	PROFESSIONAL CORPORATION	500 S VIRGIL AVE	STE 200	LOS ANGELES	CA	90020	1404	19	06037	34.064964	-118.2870335	Los Angeles County
40449	Fee-for-Service	1457883696	1457883696	1	1	WEED, CHRISTINA N MD	12/8/2022	208600000X	NA	General Surgery	026	PHYSICIANS	175742	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
40464	Fee-for-Service	1356344758	1356344758	1	8	WEST COUNTY HEALTH CENTERS	8/5/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	6800 PALM AVE	SUITE C	SEBASTOPOL	CA	95472	4269	49	06097	38.39602719	-122.8185446	Sonoma County
40469	Fee-for-Service	1922183094	1922183094	1	1	WILLIAMS, SELEDA A MD	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	69665	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
40489	Fee-for-Service	1760652713	1760652713	1	1	WEBER, AKILAH F MD	12/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56035	15	Obstetrics (D.O. only)	0	In state provider	None	3020 CHILDRENS WAY	MC5003	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
40490	Fee-for-Service	1477749752	1477749752	1	1	WHEELER, AMANDA JANE MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	87298	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
40566	Fee-for-Service	1609802842	1609802842	1	1	WEST RAD MEDICAL GROUP	9/30/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1100 N TUSTIN AVE	None	SANTA ANA	CA	92705	3509	30	06059	33.754707	-117.8342455	Orange County
40617	Fee-for-Service	1437656980	1437656980	1	1	WONG, GORDON X	7/28/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	164070	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
40623	Fee-for-Service	1083146468	1083146468	1	1	WELLMAN, TYLER MD	9/11/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169735	08	Family Practice	0	In state provider	None	115 LOCUST ST	None	SANTA CRUZ	CA	95060	3907	44	06087	36.97519309	-122.027024	Santa Cruz County
40645	Fee-for-Service	1003301581	1003301581	1	1	WALKER FURMAN SPEECH PATHOLO	6/2/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	600 N MOUNTAIN AVE	A201	UPLAND	CA	91786	4331	36	06071	34.10094187	-117.6700806	San Bernardino County
40674	Fee-for-Service	1912004755	1912004755	1	1	WELL CARE PHARMACY	1/8/2009	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1108 1/2 W GLENOAKS BLVD	None	GLENDALE	CA	91202	2628	19	06037	34.16425012	-118.2804619	Los Angeles County
40704	Fee-for-Service	1851785042	1851785042	1	1	WESTCO DRUGS INC	11/13/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1217 N CENTRAL AVE	UNIT AA	GLENDALE	CA	91202	3160	19	06037	34.16438552	-118.2568837	Los Angeles County
40752	Fee-for-Service	1700909215	1700909215	1	1	WHITE, RUTH D	4/4/2006	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1234 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3911	38	06075	37.781144	-122.4390035	San Francisco County
40772	Fee-for-Service	1982250916	1982250916	1	2	WINDSOR PHARMACY INC	2/5/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6411 SEPULVEDA BLVD	SUITE 2A	VAN NUYS	CA	91411	1304	19	06037	34.187067	-118.4662155	Los Angeles County
40806	Fee-for-Service	1508286089	1508286089	1	1	WILTON, PETER J MD	6/4/2020	390200000X	NA	Other	026	PHYSICIANS	137884	20	Orthopedic Surgery	0	In state provider	None	15325 FAIRFIELD RANCH RD	STE. 150	CHINO HILLS	CA	91709	8834	36	06071	33.9729714	-117.6918388	San Bernardino County
40872	Fee-for-Service	1285749648	1285749648	1	1	WEINSTEIN, DONALD	6/30/1984	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	41132	01	General Practice	0	In state provider	None	2301 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1735	19	06037	34.17252521	-118.3332018	Los Angeles County
40880	Fee-for-Service	1306130380	1306130380	1	1	WEST, BRIAN MD	1/20/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	136225	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
40889	Fee-for-Service	1457550246	1457550246	1	1	WU, PAULINE DO	5/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10890	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
40894	Fee-for-Service	1235194879	1235194879	1	1	WIXOM, CHRISTOPHER R MD	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74676	None	None	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
40952	Fee-for-Service	1114222791	1114222791	1	1	WALSH, KRISTEN L CRNA	11/7/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
40984	Fee-for-Service	1932284817	1932284817	1	1	WONG, WINSTON C MD	10/1/1994	207R00000X	NA	Other	026	PHYSICIANS	45020	40	Pediatrics	0	In state provider	None	6900 LINCOLN AVE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
40995	Fee-for-Service	1649423732	1649423732	1	1	WU, ANGELA P Y LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
40998	Fee-for-Service	1134440613	1134440613	1	1	WILSON, KATHERINE L PSYD	4/17/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5750 SUNRISE BLVD	130-F	CITRUS HEIGHTS	CA	95610	7634	34	06067	38.670858	-121.271049	Sacramento County
41007	Fee-for-Service	1982600342	1982600342	1	1	WELSH, GREGORY M MD	7/9/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	167888	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
41029	Fee-for-Service	1659393759	1659393759	1	1	WENNER, KARL C MD	12/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	1	Border provider	KLAMATH ORTHOPEDIC CLN	2200 BRYANT WILLIAMS DR	FL 1	KLAMATH FALLS	OR	97601	1121	00	None	42.25198664	-121.7841082	Klamath County
41031	Fee-for-Service	1568514925	1568514925	1	1	WONG, ANGELA V MD	10/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65146	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
41043	Fee-for-Service	1558508887	1558508887	1	1	WURM, ALEX M MD	11/15/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	103180	None	None	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
41059	Fee-for-Service	1114933066	1114933066	1	1	WATSON, ROBERT D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	60038	05	Anesthesiology	0	In state provider	GILLE CALUIM ANESTESIA	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
41078	Fee-for-Service	1457527236	1457527236	1	1	WELDON, BRITTANY C MD	11/5/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	97717	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
41112	Fee-for-Service	1992718811	1992718811	1	1	WILLIAMS, BRIE A MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75299	41	Internal Medicine	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
41152	Fee-for-Service	1245965508	1245965508	1	1	WHELEN, COLLEEN H NP	3/14/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1355 EAST ST	SUITE 200	REDDING	CA	96001	0801	45	06089	40.58628506	-122.3887911	Shasta County
41173	Fee-for-Service	1578577805	1578577805	1	1	WALGREEN CO.	1/9/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3098 G ST	None	MERCED	CA	95340	2137	24	06047	37.31800248	-120.4692105	Merced County
41201	Fee-for-Service	1619192200	1619192200	1	1	WARE, KAREN LMFT	1/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
41232	Fee-for-Service	1851355622	1851355622	1	1	WASHINGTON RADIOLOGISTS	9/25/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
41249	Fee-for-Service	1710412085	1710412085	1	1	WANG, LIN MD	11/5/2020	208M00000X	NA	Other	026	PHYSICIANS	159290	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
41260	Fee-for-Service	1912254749	1912254749	1	1	WEST, ELIZABETH H MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128459	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
41264	Fee-for-Service	1386097798	1386097798	1	1	WILLIAMS, TYLER CSW	3/1/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3111 LOS FELIZ BLVD	106	LOS ANGELES	CA	90039	1599	19	06037	34.12432566	-118.2669792	Los Angeles County
41272	Fee-for-Service	1932284817	1932284817	1	1	WONG, WINSTON C MD	10/1/1994	207R00000X	NA	Other	026	PHYSICIANS	45020	41	Internal Medicine	0	In state provider	None	6900 LINCOLN AVE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
41306	Fee-for-Service	1447660055	1447660055	1	1	WILLIAMS, ELLIOT C MD	8/5/2022	2086S0102X	NA	General Surgery	026	PHYSICIANS	140929	None	None	0	In state provider	None	1450 SAN PABLO ST	STE 4000	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
41358	Fee-for-Service	1033116223	1033116223	1	1	WANG, WILLIAM G MD	5/30/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	62529	02	General Surgery	0	In state provider	None	1 SHRADER ST	STE 600	SAN FRANCISCO	CA	94117	1018	38	06075	37.77467326	-122.4529451	San Francisco County
41371	Fee-for-Service	1992193353	1992193353	1	1	WANG, QIANWEI OT	11/9/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
41394	Fee-for-Service	1336661461	1336661461	1	1	WAL-MART STORES INC	11/1/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8270 DELTA SHORES	CIRCLE S	SACRAMENTO	CA	95832	9101	34	06067	38.45952	-121.493052	Sacramento County
41403	Fee-for-Service	1083261846	1083261846	1	1	WOODWARD, JESSIKA R	10/11/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
41483	Fee-for-Service	1730472507	1730472507	1	1	WALKER DIALYSIS LLC	2/9/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	39355 CALIFORNIA ST	1ST FLOOR	FREMONT	CA	94538	1447	01	06001	37.54733091	-121.9819574	Alameda County
41488	Fee-for-Service	1346285780	1346285780	1	1	WENGER, ELLIOTT L DPM	7/31/1987	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	DBA SENIOR SVS MED GRP	6425 OAKWOOD DR	None	OAKLAND	CA	94611	1350	01	06001	37.84007472	-122.2026311	Alameda County
41517	Fee-for-Service	1174675417	1174675417	1	2	WASHINGTON TOWNSHIP MED	12/31/2007	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	46690 MOHAVE DRIVE	None	FREMONT	CA	94539	7001	01	06001	37.49166118	-121.9261313	Alameda County
41598	Fee-for-Service	1346353737	1346353737	1	1	WEITZ,J DAVID MD	8/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	19829 N 27TH AVE	None	PHOENIX	AZ	85027	0000	00	None	33.665616	-112.116267	Maricopa County
41644	Fee-for-Service	1063494474	1063494474	1	1	WALLACE, PAUL W MD	5/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	49918	07	Dermatology	0	In state provider	WALLACE MEDICAL GRP INC	8920 WILSHIRE BLVD	STE 327	BEVERLY HILLS	CA	90211	2007	19	06037	34.06703599	-118.3863456	Los Angeles County
41645	Fee-for-Service	1033116223	1033116223	1	1	WANG, WILLIAM G MD	5/30/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	62529	33	Thoracic Surgery	0	In state provider	None	1 SHRADER ST	STE 600	SAN FRANCISCO	CA	94117	1018	38	06075	37.77467326	-122.4529451	San Francisco County
41660	Fee-for-Service	1912667213	1912667213	1	1	WARD, LA VIOLA A LPCC	5/23/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
41682	Fee-for-Service	1932276243	1932276243	1	2	WILSON, LAURIE PHD	3/30/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1177 WILLOW AVE	None	NAPA	CA	94559	2101	28	06055	38.30322197	-122.2758695	Napa County
41723	Fee-for-Service	1598927261	1598927261	1	1	WESTHOFF, GINA L MD	10/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122645	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
41724	Fee-for-Service	1376063461	1376063461	1	1	WOUND MASTERS MEDICAL GROUP	8/25/2017	193200000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	4506 W 166TH STREET	None	LOS ANGELES	CA	90260	2809	19	06037	33.88011554	-118.355112	Los Angeles
41729	Fee-for-Service	1255493136	1255493136	1	1	WAKIM, EMILE P MD	10/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94520	20	Orthopedic Surgery	0	In state provider	None	18800 DELAWARE ST	STE 1100	HUNTINGTON BEACH	CA	92648	1959	30	06059	33.68911733	-117.9931535	Orange County
41748	Fee-for-Service	1639669450	1639669450	1	1	WEIGAND, JESSICA CCC-SLP	3/24/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
41752	Fee-for-Service	1609807049	1609807049	1	1	WOZNIAK, SHANNON M NP	9/14/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	630 DRAKE AVE	None	SAUSALITO	CA	94965	1107	21	06041	37.87340883	-122.515085	Marin County
41793	Fee-for-Service	1245338508	1245338508	1	1	WALTERS, PRISCILLA P	12/21/2010	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1902 ROYALTY DRIVE	SUITE 220	POMONA	CA	91767	3056	19	06037	34.07791925	-117.746146	Los Angeles County
41794	Fee-for-Service	1487956934	1487956934	1	1	WOLF, STACY CNP	4/23/2019	363LP0222X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
41797	Fee-for-Service	1730661521	1730661521	1	1	WHITE, KATELYN S NP	5/16/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
41849	Fee-for-Service	1669832507	1669832507	1	1	WAGNER, RACHEL	2/5/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	STE 120/110	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
41864	Fee-for-Service	1578680435	1578680435	1	1	WURSTLE, SUZANNE G N MD	2/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	842 E MAIN ST	None	MEDFORD	OR	97504	7155	00	None	42.32787853	-122.863311	Jackson County
41866	Fee-for-Service	1841259751	1841259751	1	1	WHITE, DAVID DO	2/12/2024	207L00000X	NA	Other	026	PHYSICIANS	22128	None	None	0	In state provider	None	1150 INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
41882	Fee-for-Service	1710037197	1710037197	1	2	WEE, ERIC L	7/20/1998	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7334 TOPANGA CANYON BLVD	STE 109	CANOGA PARK	CA	91303	3345	19	06037	34.203861	-118.6059315	Los Angeles County
41961	Fee-for-Service	1437505393	1437505393	1	1	WOUND INSTITUTE OF AMERICA,	12/10/2020	208200000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC.	250 N ROBERTSON BLVD	STE 106	BEVERLY HILLS	CA	90211	1767	19	06037	34.0696407	-118.3836988	Los Angeles County
41981	Fee-for-Service	1619474657	1619474657	1	1	WU, GEORGE	8/19/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	21206	30	Radiology	0	In state provider	None	24411 HEALTH CENTER DR	STE 680	LAGUNA HILLS	CA	92653	3692	30	06059	33.6087201	-117.7076948	Orange County
42020	Fee-for-Service	1134330855	1134330855	1	1	WINETZKY, RICHARD M LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	777 DAVIS ST	None	SAN LEANDRO	CA	94577	6923	01	06001	37.72317409	-122.162925	Alameda County
42071	Fee-for-Service	1043225378	1043225378	1	1	WALGREEN CO	7/26/1989	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1763 SANTA RITA RD	None	PLEASANTON	CA	94566	5657	01	06001	37.67630688	-121.8739119	Alameda County
42073	Fee-for-Service	1740391069	1740391069	1	1	WATFORD, VIRGINIA L	2/8/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	27405 PUERTA REAL	STE 150	MISSION VIEJO	CA	92691	6366	30	06059	33.56491134	-117.6715558	Orange County
42128	Fee-for-Service	1144272881	1144272881	1	1	WESTERN TUMOR MED GRP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	INC	5522 SEPULVEDA BLVD	None	SHERMAN OAKS	CA	91411	3437	19	06037	34.171092	-118.466131	Los Angeles County
42163	Fee-for-Service	1093723306	1093723306	1	1	WONG, WILLIAM G MD	2/20/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	34456	41	Internal Medicine	0	In state provider	None	10234 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2602	19	06037	33.90197379	-118.1144208	Los Angeles County
42164	Fee-for-Service	1942390596	1942390596	1	1	WILLBANKS, KELLY J PT	3/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29650 BRADLEY RD	None	MENIFEE	CA	92586	6521	33	06065	33.6899672	-117.1885767	Riverside County
42184	Fee-for-Service	1063475242	1063475242	1	1	WANG, PETER C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	84367	02	General Surgery	0	In state provider	None	1501 SUPERIOR AVE	STE 212	NEWPORT BEACH	CA	92663	3640	30	06059	33.62918676	-117.9305675	Orange County
42185	Fee-for-Service	1881967180	1881967180	1	1	WALGREEN CO	3/20/2013	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#15296	2262 MARKET ST	None	SAN FRANCISCO	CA	94114	1508	38	06075	37.76498914	-122.4322587	San Francisco County
42249	Fee-for-Service	1275319469	1275319469	1	1	WESTERN COMPREHENSIVE CARE C	1/24/2024	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LINIC PC	830 MAGNOLIA AVE	None	CORONA	CA	92879	3128	33	06065	33.86017131	-117.5520534	Riverside County
42270	Fee-for-Service	1609589860	1609589860	1	1	WAXMAN, TESS CD	1/3/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
42273	Fee-for-Service	1376597575	1376597575	1	1	WALSH,DANIEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK	None	BOISE	ID	83712	0000	00	None	43.6124738	-116.1926844	Ada County
42283	Fee-for-Service	1740232529	1740232529	1	1	WILLIAM L CRUMP, III, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3090 E GENTRY WAY	STE 200	MERIDIAN	ID	83642	3550	00	None	43.598448	-116.355951	Ada County
42306	Fee-for-Service	1467401521	1467401521	1	1	WOODS, GINA N MD	2/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	81848	67	Endocrinology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
42366	Fee-for-Service	1548205537	1548205537	1	1	WITUCKI, PETER J MD	9/16/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75302	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
42388	Fee-for-Service	1245266873	1245266873	1	1	WOHLGEMUTH, MARK A MD	11/16/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	39796	04	Otology, Laryngology, Rhinology	0	In state provider	None	27800 MEDICAL CENTER RD	STE 324	MISSION VIEJO	CA	92691	6409	30	06059	33.55952733	-117.6645199	Orange County
42403	Fee-for-Service	1366616997	1366616997	1	1	WILSON, DAVID M MD	5/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95997	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
42415	Fee-for-Service	1144272881	1144272881	1	1	WESTERN TUMOR MED GRP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	INC	5522 SEPULVEDA BLVD	None	SHERMAN OAKS	CA	91411	3437	19	06037	34.171092	-118.466131	Los Angeles County
42430	Fee-for-Service	1659501708	1659501708	1	1	WISNIEWSKA, AGNIESZKA MD	11/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129876	36	Psychiatry	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
42450	Fee-for-Service	1700384096	1700384096	1	1	WILLIAMS, ALISON LMFT	5/28/2024	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11870 PIERCE ST	SUITE 150	RIVERSIDE	CA	92505	4402	33	06065	33.90095662	-117.4936969	Riverside County
42453	Fee-for-Service	1093723306	1093723306	1	1	WONG, WILLIAM G MD	2/20/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	34456	01	General Practice	0	In state provider	None	10234 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2602	19	06037	33.90197379	-118.1144208	Los Angeles County
42456	Fee-for-Service	1417735580	1417735580	1	1	WANJIKU, LOISE MUTHONI	3/26/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	8264 GRAND CRU DR	None	SACRAMENTO	CA	95829	9515	34	06067	38.457468	-121.362291	Sacramento County
42478	Fee-for-Service	1821066887	1821066887	1	1	WESLEY, SHARON MD	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50498	08	Family Practice	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
42482	Fee-for-Service	1164792321	1164792321	1	1	WASSEI, JOSEPH J MD	10/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135627	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
42502	Fee-for-Service	1043669989	1043669989	1	1	WRIGHT, DAVID J MD	9/12/2023	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	152439	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
42596	Fee-for-Service	1467401521	1467401521	1	1	WOODS, GINA N MD	2/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	81848	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
42617	Fee-for-Service	1568641298	1568641298	1	1	WILSON, BARRY K MD	1/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103336	05	Anesthesiology	0	In state provider	None	975 SOUTH FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
42656	Fee-for-Service	1386481299	1386481299	1	1	WATTERS, LINDSEY B NP	11/14/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1 MARCELA DR	None	WILLITS	CA	95490	5769	23	06045	39.3901086	-123.339055	Mendocino County
42704	Fee-for-Service	1144272881	1144272881	1	1	WESTERN TUMOR MED GRP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	42	Nuclear Medicine	0	In state provider	INC	5522 SEPULVEDA BLVD	None	SHERMAN OAKS	CA	91411	3437	19	06037	34.171092	-118.466131	Los Angeles County
42722	Fee-for-Service	1346267572	1346267572	1	1	WAL-MART STORES INC	6/14/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 105338	4840 SHAWLINE ST	None	SAN DIEGO	CA	92111	1400	37	06073	32.829579	-117.1638065	San Diego County
42743	Fee-for-Service	1417735580	1417735580	1	1	WANJIKU, LOISE MUTHONI	3/26/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	8264 GRAND CRU DR	None	SACRAMENTO	CA	95829	9515	34	06067	38.457468	-121.362291	Sacramento County
42769	Fee-for-Service	1053750240	1053750240	1	1	WHITEHEAD, SARA J MD	5/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	91423	02	General Surgery	0	In state provider	None	4333 TORRANCE BLVD	None	TORRANCE	CA	90503	4401	19	06037	33.83759353	-118.360089	Los Angeles County
42867	Fee-for-Service	1043652829	1043652829	1	1	WOOD, KELSEY LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	43	06085	37.26846327	-121.9547306	Santa Clara County
42875	Fee-for-Service	1508919051	1508919051	1	1	WINTERFELT, NANETTE H LCSW	12/16/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
42876	Fee-for-Service	1255443545	1255443545	1	1	WEN, CHRISTOPHER H MD	6/30/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71576	30	Radiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
42943	Fee-for-Service	1144209586	1144209586	1	1	WILLIAM C FINNERAN III M.D.	11/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	301 S 7TH AVE	STE 2020	WEST READING	PA	19611	1495	00	None	40.3314109	-75.95209897	Berks County
42952	Fee-for-Service	1497741128	1497741128	1	1	WHITE, GAIL M	7/18/1986	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4700 SPRING ST	STE 306	LA MESA	CA	91942	2294	37	06073	32.76503682	-117.0203822	San Diego County
42962	Fee-for-Service	1609824408	1609824408	1	1	WELLS, JOHN W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	64524	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
42972	Fee-for-Service	1083355879	1083355879	1	1	WILLIAMS, JAMES A MD	11/28/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
42978	Fee-for-Service	1144326752	1144326752	1	1	WALTERS, JOSEPH J MD	6/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	84144	08	Family Practice	0	In state provider	None	12961 VILLAGE DRIVE	STE A	SARATOGA	CA	95070	4158	43	06085	37.28089196	-122.0049522	Santa Clara County
42996	Fee-for-Service	1023015484	1023015484	1	1	WU, DAVID W MD	1/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83347	83	Rheumatology	0	In state provider	None	120 LA CASA VIA	STE 204	WALNUT CREEK	CA	94598	3007	07	06013	37.91202407	-122.0419227	Contra Costa County
42999	Fee-for-Service	1912913252	1912913252	1	1	WATSON, JAMES P MD	12/1/1993	2086S0122X	NA	General Surgery	026	PHYSICIANS	79375	24	Plastic Surgery	0	In state provider	None	10833 LE CONTE AVE	RM 64140	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
43001	Fee-for-Service	1932396116	1932396116	1	1	WANG, DAVID S MD	8/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97040	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94035	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
43058	Fee-for-Service	1356344758	1356344758	1	9	WEST COUNTY HEALTH CENTERS	4/18/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	652 PETALUMA AVENUE	SUITE H	SEBASTOPOL	CA	95472	0000	49	06097	38.39662494	-122.8201368	Sonoma County
43071	Fee-for-Service	1679677033	1679677033	1	1	WOLFF, BRIAN E OD	6/2/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
43073	Fee-for-Service	1013136399	1013136399	1	1	WILLIAMS, CARL DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	THE BACK DOCTORS	1992 MAIN ST	None	WATSONVILLE	CA	95076	3066	44	06087	36.91850314	-121.7825983	Santa Cruz County
43088	Fee-for-Service	1720180847	1720180847	2	1	WHITTIER PHARMACY, INC.	6/1/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	MACY	12291 WASHINGTON BLVD	STE 101	WHITTIER	CA	90606	2500	19	06037	33.96734104	-118.0508773	Los Angeles County
43160	Fee-for-Service	1548440365	1548440365	1	1	WHITE TIGER ENTERPRISES	6/27/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FRONTERA EQUIPO MEDICO	302 E 3RD ST	None	CALEXICO	CA	92231	2760	13	06025	32.66772464	-115.4946189	Imperial County
43167	Fee-for-Service	1366000143	1366000143	1	2	WEL-MOR PSYCHOLOGY GROUP, IN	3/16/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	C	415 N STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	2917	30	06059	33.844635	-117.889318	Orange County
43187	Fee-for-Service	1780015438	1780015438	1	1	WAI, CHIT S MD	11/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127042	41	Internal Medicine	0	In state provider	None	17360 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	3720	30	06059	33.71141952	-117.9542482	Orange County
43201	Fee-for-Service	1902961907	1902961907	1	1	WOOD, CHARLES M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	LEGACY EMANUAL HOSPITAL	2801 N. GANTENBEIN AVE.	None	PORTLAND	OR	97208	0000	00	None	45.54387841	-122.6696022	Multnomah County
43205	Fee-for-Service	1376601245	1376601245	1	1	WORDEN, BRIAN F MD	10/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92320	04	Otology, Laryngology, Rhinology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
43233	Fee-for-Service	1568528784	1568528784	1	1	WOJCZYK, TOMASZ CRNA	11/10/2005	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
43261	Fee-for-Service	1083355879	1083355879	1	1	WILLIAMS, JAMES A MD	11/28/2024	207P00000X	NA	Other	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
43346	Fee-for-Service	1356344758	1356344758	1	9	WEST COUNTY HEALTH CENTERS	4/18/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	652 PETALUMA AVENUE	SUITE H	SEBASTOPOL	CA	95472	0000	49	06097	38.39662494	-122.8201368	Sonoma County
43377	Fee-for-Service	1356344758	1356344758	1	7	WEST COUNTY HEALTH CENTERS	7/4/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	652 PETALUMA AVE	SUITES C-F	SEBASTOPOL	CA	95472	4256	49	06097	38.39662494	-122.8201368	Sonoma County
43413	Fee-for-Service	1891974655	1891974655	1	1	WILLNER, JULIA B MD	8/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96859	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
43436	Fee-for-Service	1023326485	1023326485	1	1	WALTHALL GENERAL HOSPITAL	10/1/2023	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	100 HOSPITAL DR	None	TYLERTOWN	MS	39667	2022	00	None	31.12025857	-90.15694983	Walthall County
43437	Fee-for-Service	1427746312	1427746312	1	1	WOMACK, BETHANY BIRTH DOULA	7/1/2024	174N00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
43459	Fee-for-Service	1851306120	1851306120	1	1	WALGREENS 02770	7/14/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7929 LOWER SACRAMENTO RD	None	STOCKTON	CA	95210	3723	39	06077	38.021913	-121.3230885	San Joaquin County
43507	Fee-for-Service	1952914681	1952914681	1	5	WEST COAST KIDNEY	9/27/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	2250 HAYES ST	STE 612	SAN FRANCISCO	CA	94117	1078	38	06075	37.77302042	-122.45342	San Francisco County
43515	Fee-for-Service	1811970049	1811970049	1	1	WILLIAMS, MEREDITH K MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91961	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
43526	Fee-for-Service	1083612824	1083612824	1	1	WOODHOUSE, ERNIE S MD	2/1/1984	207P00000X	NA	Other	026	PHYSICIANS	33613	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
43536	Fee-for-Service	1851513469	1851513469	1	3	WESTERN SIERRA MED CLINIC	9/26/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	12183 LOCKSLEY LANE	SUITE 107	AUBURN	CA	95602	2050	31	06061	38.9503293	-121.0966898	Placer County
43590	Fee-for-Service	1003311572	1003311572	1	1	WANG, ANNIE Y MD	5/13/2021	207R00000X	NA	Other	026	PHYSICIANS	166430	None	None	0	In state provider	None	100 MED PLAZA	100, 755	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
43595	Fee-for-Service	1285138834	1285138834	1	1	WU, GLORIA MD	6/10/2024	207R00000X	NA	Other	026	PHYSICIANS	164161	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
43606	Fee-for-Service	1497141659	1497141659	1	1	WERGER, NICHOLE M NP	8/1/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
43620	Fee-for-Service	1275738049	1275738049	1	1	WEN, ERNESTINE M MD	9/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106114	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
43634	Fee-for-Service	1881896082	1881896082	1	1	WALTON, PAULETTE L NP	6/9/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95010139	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	WARD 93, WARD 95 3RD FL	SAN FRANCISCO	CA	94110	3185	38	06075	37.75548534	-122.4065362	San Francisco County
43659	Fee-for-Service	1508145772	1508145772	1	1	WILLARD, MELISSA LMFT	4/21/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	106 POLLASKY AVE	SUITE D	CLOVIS	CA	93612	1159	10	06019	36.828954	-119.7020255	Fresno County
43667	Fee-for-Service	1356344758	1356344758	1	7	WEST COUNTY HEALTH CENTERS	7/4/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	652 PETALUMA AVE	SUITES C-F	SEBASTOPOL	CA	95472	4256	49	06097	38.39662494	-122.8201368	Sonoma County
43685	Fee-for-Service	1205811007	1205811007	1	1	WARNER, NANCY M MD	7/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104314	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.049547	-117.264078	San Bernardino County
43687	Fee-for-Service	1467772152	1467772152	1	1	WIRENGARD, YANA R MD	12/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135278	02	General Surgery	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94555	4633	07	06013	38.00771973	-122.1331484	Contra Costa County
43688	Fee-for-Service	1922462183	1922462183	1	1	WAHL, CHRISTOPHER S DO	8/30/2021	207P00000X	NA	Other	026	PHYSICIANS	18813	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
43724	Fee-for-Service	1023326485	1023326485	1	1	WALTHALL GENERAL HOSPITAL	10/1/2023	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	100 HOSPITAL DR	None	TYLERTOWN	MS	39667	2022	00	None	31.12025857	-90.15694983	Walthall County
43729	Fee-for-Service	1417275959	1417275959	1	1	WINDSOR HAYWARD ESTATES LLC	6/1/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	25919 GADING ROAD	None	HAYWARD	CA	94544	2725	01	06001	37.64778968	-122.0814136	Alameda County
43786	Fee-for-Service	1720412828	1720412828	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	7677 CENTER AVE	STE 212	HUNTINGTON BEACH	CA	92647	3030	30	06059	33.736257	-117.995535	Orange County
43822	Fee-for-Service	1851513469	1851513469	1	3	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	12183 LOCKSLEY LANE	SUITE 107	AUBURN	CA	95602	2050	31	06061	38.9503293	-121.0966898	Placer County
43841	Fee-for-Service	1689711608	1689711608	1	1	WEBBER, AMANDA	1/19/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7293 DUMOSA AVE	SUITE 5, 7 & 8	YUCCA VALLEY	CA	92284	3700	36	06071	34.12094334	-116.4177385	San Bernardino County
43846	Fee-for-Service	1083755680	1083755680	1	1	WASHINGTON, JOSCELYN C.	10/30/2009	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	140 W SAN JOSE AVE	UNIT A	CLAREMONT	CA	91711	5204	19	06037	34.08314253	-117.7159185	Los Angeles County
43861	Fee-for-Service	1467835207	1467835207	1	1	WIMER, ANN M LCSW	5/28/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
43881	Fee-for-Service	1285138834	1285138834	1	1	WU, GLORIA MD	6/10/2024	207R00000X	NA	Other	026	PHYSICIANS	164161	41	Internal Medicine	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
43902	Fee-for-Service	1710657325	1710657325	1	1	WILSON, KESHA R LCSW	12/4/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
43960	Fee-for-Service	1063167740	1063167740	1	1	WANG, JING MD	6/7/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	176086	None	None	0	In state provider	None	1300 N VERMONT AVE	SUITE 101	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
44008	Fee-for-Service	1144555343	1144555343	1	1	WILLIAMS, JESSICA J PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1660 E ROSEVILLE PARKWAY	BUILDING C	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
44111	Fee-for-Service	1851513469	1851513469	1	3	WESTERN SIERRA MED CLINIC	7/20/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	12183 LOCKSLEY LANE	SUITE 107	AUBURN	CA	95602	2050	31	06061	38.9503293	-121.0966898	Placer County
44170	Fee-for-Service	1336171404	1336171404	2	1	WANG, ZHIJUN MD	3/26/2013	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	72665	40	Pediatrics	0	In state provider	None	4950 BARRANCA PKWY	SUITE 210	IRVINE	CA	92604	8648	30	06059	33.67620851	-117.7948348	Orange County
44213	Fee-for-Service	1912046947	1912046947	1	1	WILLIAM H WHEIR, MD	5/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1460 NE MEDICAL CENTER D	None	BEND	OR	97701	6061	00	None	44.064765	-121.2666635	Deschutes County
44236	Fee-for-Service	1750423620	1750423620	1	1	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	218 E COMMONWEALTH AVE	None	FULLERTON	CA	92832	1911	30	06059	33.87035552	-117.9211545	Orange County
44267	Fee-for-Service	1437992070	1437992070	1	1	WALKER, BILLY NP	8/1/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
44271	Fee-for-Service	1437164720	1437164720	1	1	WALGREENS CO	1/22/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #04516	745 E DUNNE AVE	None	MORGAN HILL	CA	95037	4601	43	06085	37.12976072	-121.6383326	Santa Clara County
44372	Fee-for-Service	1699937417	1699937417	1	1	WRIGHT, GARY L MD INC	8/13/2014	207N00000X	NA	Dermatology	026	PHYSICIANS	39395	07	Dermatology	0	In state provider	None	664 PAULINE COURT	SUITE G	SONORA	CA	95370	5210	55	06109	37.97881031	-120.3721608	Tuolumne County
44378	Fee-for-Service	1912165358	1912165358	1	1	WAHLSTROM, JUSTIN T MD	5/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113418	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.7634502	-122.4579779	San Francisco County
44461	Fee-for-Service	1336171404	1336171404	2	1	WANG, ZHIJUN MD	3/26/2013	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	72665	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4950 BARRANCA PKWY	SUITE 210	IRVINE	CA	92604	8648	30	06059	33.67620851	-117.7948348	Orange County
44473	Fee-for-Service	1578611554	1578611554	1	1	WAALEN, JILL MD	3/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	69683	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
44523	Fee-for-Service	1750423620	1750423620	1	1	WESTERN PACIFIC MED-CORP	3/1/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	218 E COMMONWEALTH AVE	None	FULLERTON	CA	92832	1911	30	06059	33.87035552	-117.9211545	Orange County
44559	Fee-for-Service	1861569758	1861569758	1	1	WANG, GUIXI MD	2/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76068	25	Physical Medicine and Rehabilitation	0	In state provider	MGA OFFICE	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
44657	Fee-for-Service	1134262850	1134262850	1	1	WHITE, CAROL ANN	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8540 S SEPULVEDA BLVD	STE 906	LOS ANGELES	CA	90045	3828	19	06037	33.96022076	-118.3961982	Los Angeles County
44659	Fee-for-Service	1194205617	1194205617	1	1	WYSOCKA, IWONA K RCP	10/19/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	13640 ROSCOE BLVD	None	PANORAMA CITY	CA	91402	3904	19	06037	34.22164249	-118.4299965	Los Angeles County
44664	Fee-for-Service	1912165358	1912165358	1	1	WAHLSTROM, JUSTIN T MD	5/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113418	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.7634502	-122.4579779	San Francisco County
44686	Fee-for-Service	1932370384	1932370384	1	2	WELSH, RAYMOND H MD	12/16/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	104153	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
44706	Fee-for-Service	1942308903	1942308903	1	1	WALKER, GEORGANNE NP	8/17/2020	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
44715	Fee-for-Service	1104183508	1104183508	1	1	WILLIAMS, NICOLE K MD	5/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129119	41	Internal Medicine	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
44716	Fee-for-Service	1356344758	1356344758	1	6	WEST COUNTY HEALTH CENTERS	8/5/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLNC BLDG 2	16312 3RD ST	None	GUERNEVILLE	CA	95446	0000	49	06097	38.5025889	-122.9985795	Sonoma County
44727	Fee-for-Service	1235348228	1235348228	1	1	WILKINS, KIP R MD	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107219	20	Orthopedic Surgery	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
44763	Fee-for-Service	1003939133	1003939133	1	1	WILLIAMS, TERENCE MD	3/4/2021	2085R0001X	NA	Other	026	PHYSICIANS	171532	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
44769	Fee-for-Service	1922093053	1922093053	1	1	WHEELER, MICHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8TH AVE & C ST	None	SLC	UT	84143	0001	00	None	40.778496	-111.8805615	Salt Lake County
44797	Fee-for-Service	1770585473	1770585473	1	1	WILSON, ANDREW J MD	11/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36682	22	Pathology (M.D. only)	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
44807	Fee-for-Service	1437291937	1437291937	1	1	WEBB, DEBRA A LCSW	5/23/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	801 E CHAPMAN AVE	STE 215	FULLERTON	CA	92831	3847	30	06059	33.87407517	-117.9110814	Orange County
44819	Fee-for-Service	1720469638	1720469638	1	1	WINDON, CHARLES C MD	6/4/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	146407	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
44830	Fee-for-Service	1215563994	1215563994	1	1	WILLIAMS ANESTHESIOLOGY, INC	9/8/2020	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	.	100 S RAYMOND AVE	None	ALHAMBRA	CA	91801	3166	19	06037	34.09027878	-118.1450083	Los Angeles County
44832	Fee-for-Service	1588972293	1588972293	1	1	WAY, RENATA O PSYD	12/20/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
44853	Fee-for-Service	1104517846	1104517846	1	1	WAMBAA, ALICE MUMBI	6/7/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	11906 SILVERCREST STREET	None	MOORPARK	CA	93021	3186	56	06111	34.26138555	-118.8972413	Ventura County
44888	Fee-for-Service	1477639771	1477639771	1	1	WANG, AGNES J MD	1/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122837	34	Urology and Urological Surgery	0	In state provider	None	1789 W YOSEMITE AVE	None	MANTECA	CA	95337	5160	39	06077	37.79964	-121.246425	San Joaquin County
44958	Fee-for-Service	1912165358	1912165358	1	1	WAHLSTROM, JUSTIN T MD	5/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113418	78	Neoplastic Diseases/Oncology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.7634502	-122.4579779	San Francisco County
44961	Fee-for-Service	1518283167	1518283167	1	1	WYNNE, ANNETTE M LMFT	11/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
45000	Fee-for-Service	1356344758	1356344758	1	6	WEST COUNTY HEALTH CENTERS	8/5/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLNC BLDG 2	16312 3RD ST	None	GUERNEVILLE	CA	95446	0000	49	06097	38.5025889	-122.9985795	Sonoma County
45075	Fee-for-Service	1871786558	1871786558	1	1	WEAVER, MARINEL LCSW	11/29/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
45141	Fee-for-Service	1104517846	1104517846	1	1	WAMBAA, ALICE MUMBI	6/7/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	11906 SILVERCREST STREET	None	MOORPARK	CA	93021	3186	56	06111	34.26138555	-118.8972413	Ventura County
45177	Fee-for-Service	1548378086	1548378086	1	1	WALTERS, DAVID T MD	3/31/1996	207P00000X	NA	Other	026	PHYSICIANS	60752	66	Emergency Medicine (Urgent Care)	0	In state provider	None	AIRPORT ROAD	None	HOOPA	CA	95546	0000	12	06023	41.04526615	-123.6661741	Humboldt County
45203	Fee-for-Service	1972380475	1972380475	1	1	WHOLESOME ELDERLY CARE HOMES	2/4/2025	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	7401 MAR VISTA WY	None	CITRUS HEIGHTS	CA	95621	1724	34	06067	38.700369	-121.3186005	Sacramento County
45205	Fee-for-Service	1548396898	1548396898	2	1	WINTER, MARGARET E	7/1/1993	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	806 W ADAMS BLVD	None	LOS ANGELES	CA	90007	2505	19	06037	34.02989008	-118.2799804	Los Angeles County
45222	Fee-for-Service	1821102922	1821102922	1	1	WULFSBERG, RICHARD L MD	12/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	20755	41	Internal Medicine	0	In state provider	None	16030 VENTURA BLVD	STE 680	ENCINO	CA	91436	4443	19	06037	34.15615339	-118.4824038	Los Angeles County
45287	Fee-for-Service	1205036316	1205036316	1	1	WALKER, JEFFREY MD	10/16/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183048	None	None	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
45342	Fee-for-Service	1316229222	1316229222	1	1	WIRTH, WHITNEY W LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
45372	Fee-for-Service	1932194586	1932194586	1	1	WILMINGTON COMMUNITY CLN	8/1/2004	261QP2300X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1009 N AVALON BLVD	None	WILMINGTON	CA	90744	4505	19	06037	33.78320457	-118.2627263	Los Angeles County
45435	Fee-for-Service	1952749996	1952749996	1	1	WHITLOW, SHANNA M LMFT	5/24/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	11643 GLENOAKS BLVD	None	PACOIMA	CA	91331	1050	19	06037	34.28133474	-118.4198166	Los Angeles County
45438	Fee-for-Service	1073537536	1073537536	1	1	WILLIAMS, DON T MD	6/30/1988	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	57667	20	Orthopedic Surgery	0	In state provider	None	17762 MORO RD	None	SALINAS	CA	93907	8965	27	06053	36.80289533	-121.6644191	Monterey County
45441	Fee-for-Service	1457512584	1457512584	1	1	WU, JACK J MD	7/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93228	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	7001	19	06037	34.07067	-118.4432445	Los Angeles County
45453	Fee-for-Service	1083146286	1083146286	1	1	WANG, ANDREW	7/7/2022	208800000X	NA	Other	026	PHYSICIANS	177402	None	None	0	In state provider	None	2545 W HAMMER LN	None	STOCKTON	CA	95209	2839	39	06077	38.0214303	-121.3461515	San Joaquin County
45465	Fee-for-Service	1548378086	1548378086	1	1	WALTERS, DAVID T MD	3/31/1996	207P00000X	NA	Other	026	PHYSICIANS	60752	01	General Practice	0	In state provider	None	AIRPORT ROAD	None	HOOPA	CA	95546	0000	12	06023	41.04526615	-123.6661741	Humboldt County
45505	Fee-for-Service	1518225960	1518225960	1	1	WEISS, NICOLE M MD	6/3/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	128844	40	Pediatrics	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
45527	Fee-for-Service	1205380227	1205380227	1	1	WALGREEN CO	2/16/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16490	4130 LA JOLLA VILLAGE DR	SUITE 103	LA JOLLA	CA	92037	1480	37	06073	32.87194345	-117.2173414	San Diego County
45557	Fee-for-Service	1669482576	1669482576	1	1	WEXLER, ANN M MD	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96244	68	Hematology	0	In state provider	None	100 HOSPITAL DRIVE	SUITE 110	VALLEJO	CA	94589	2577	48	06095	38.13100118	-122.2403008	Solano County
45594	Fee-for-Service	1881642155	1881642155	1	1	WIN, HTAY	3/30/2007	207R00000X	NA	Other	026	PHYSICIANS	88638	41	Internal Medicine	0	In state provider	None	3550 MOWRY AVE	STE 101	FREMONT	CA	94538	1716	01	06001	37.55129671	-121.9861157	Alameda County
45651	Fee-for-Service	1881996692	1881996692	1	1	WANG, CHENG YU OD	9/3/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15908 BEAR VALLEY RD	SUITE A	VICTORVILLE	CA	92395	9547	36	06071	34.4709788	-117.316553	San Bernardino County
45661	Fee-for-Service	1932194586	1932194586	1	1	WILMINGTON COMMUNITY CLN	8/1/2004	261QP2300X	NA	Other	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1009 N AVALON BLVD	None	WILMINGTON	CA	90744	4505	19	06037	33.78320457	-118.2627263	Los Angeles County
45669	Fee-for-Service	1730267543	1730267543	1	1	WONG, JULIA L MD	9/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87571	40	Pediatrics	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
45701	Fee-for-Service	1578724639	1578724639	1	1	WING, AIMEE MD	8/16/2018	208M00000X	NA	Other	026	PHYSICIANS	109399	41	Internal Medicine	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
45808	Fee-for-Service	1821265802	1821265802	1	1	WONG, BECKY J MD	10/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109578	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
45842	Fee-for-Service	1558894741	1558894741	1	1	WONG, LAI MAN NP	5/12/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1893 W MALVERN AVE	None	FULLERTON	CA	92833	2403	30	06059	33.87987	-117.9611415	Orange County
45843	Fee-for-Service	1669482576	1669482576	1	1	WEXLER, ANN M MD	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96244	78	Neoplastic Diseases/Oncology	0	In state provider	None	100 HOSPITAL DRIVE	SUITE 110	VALLEJO	CA	94589	2577	48	06095	38.13100118	-122.2403008	Solano County
45846	Fee-for-Service	1477727121	1477727121	1	1	WALLS, SARAH	2/10/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3737 MORAGA AVE	A203	SAN DIEGO	CA	92117	5491	37	06073	32.8086683	-117.2109991	San Diego County
45865	Fee-for-Service	1932635281	1932635281	1	1	WANG, KEVIN	11/15/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158708	None	None	0	In state provider	None	223 N GARFIELD AVE	#208	MONTEREY PARK	CA	91754	1700	19	06037	34.0646166	-118.1228948	Los Angeles County
45911	Fee-for-Service	1144641994	1144641994	1	1	WAL-MART STORES INC	3/14/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3255 MISSION COLLEGE	None	SANTA CLARA	CA	95054	1829	43	06085	37.389987	-121.9863945	Santa Clara County
45950	Fee-for-Service	1932194586	1932194586	1	1	WILMINGTON COMMUNITY CLN	8/1/2004	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1009 N AVALON BLVD	None	WILMINGTON	CA	90744	4505	19	06037	33.78320457	-118.2627263	Los Angeles County
45986	Fee-for-Service	1912186917	1912186917	1	1	WILLIAM F RESH MD, SKIN AND	8/22/2005	193400000X	NA	Other	026	PHYSICIANS	34661	None	None	0	In state provider	SKIN CANCER MEDICAL GROU	1625 E MAIN ST	#103	EL CAJON	CA	92021	5211	37	06073	32.80969963	-116.9203429	San Diego County
45995	Fee-for-Service	1649347642	1649347642	1	1	WALDRON, JOHN D MD	7/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	64615	08	Family Practice	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
46008	Fee-for-Service	1447514658	1447514658	1	1	WESTERCAMP, NICOLE S MD	9/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126639	36	Psychiatry	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
46024	Fee-for-Service	1801891130	1801891130	1	1	WILSON, DAVID P MD	8/13/1995	207R00000X	NA	Other	026	PHYSICIANS	37216	01	General Practice	0	In state provider	None	11219 N HWY 3	None	FORT JONES	CA	96032	0458	47	06093	41.60015699	-122.847467	Siskiyou County
46045	Fee-for-Service	1538401856	1538401856	1	1	WIN, THERESA MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138793	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
46062	Fee-for-Service	1518008630	1518008630	1	1	WOLFSON, JOHANNA C PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	820 LAS GALLINAS	None	SAN RAFAEL	CA	94903	3410	21	06041	38.00702954	-122.5471567	Marin County
46078	Fee-for-Service	1689156895	1689156895	1	1	WRIGHT, MICHAEL LMFT	1/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
46089	Fee-for-Service	1871740654	1871740654	1	1	WALGREEN CO.	12/16/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2020 W CLEVELAND AVE	None	MADERA	CA	93637	8759	20	06039	36.97450854	-120.0811275	Madera County
46105	Fee-for-Service	1518378256	1518378256	1	1	WU, KATHERINE Y MD	12/2/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	148302	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
46182	Fee-for-Service	1861598526	1861598526	1	1	WIKHOLM, GARY D MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	41000	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	247 W HARVARD BLVD	None	SANTA PAULA	CA	93060	3223	56	06111	34.34517723	-119.0758733	Ventura County
46212	Fee-for-Service	1043924079	1043924079	1	2	WTL TRANSPORT CORP	1/30/2023	172A00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	154 JUNIPERO SERRA DR	None	SAN GABRIEL	CA	91776	1209	19	06037	34.10130845	-118.1029825	Los Angeles County
46231	Fee-for-Service	1992883581	1992883581	1	1	WANG, JUSTIN Y MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85122	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
46237	Fee-for-Service	1932194586	1932194586	1	1	WILMINGTON COMMUNITY CLN	7/28/2004	261QP2300X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1009 N AVALON BLVD	None	WILMINGTON	CA	90744	4505	19	06037	33.78320457	-118.2627263	Los Angeles County
46293	Fee-for-Service	1336354059	1336354059	1	1	WEISS, FREDRIC E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29963	10	Gastroenterology (M.D. only)	0	In state provider	None	16311 VENTURA BLVD	STE 1175	ENCINO	CA	91436	4359	19	06037	34.15706864	-118.4885978	Los Angeles County
46310	Fee-for-Service	1801891130	1801891130	1	1	WILSON, DAVID P MD	8/13/1995	207R00000X	NA	Other	026	PHYSICIANS	37216	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11219 N HWY 3	None	FORT JONES	CA	96032	0458	47	06093	41.60015699	-122.847467	Siskiyou County
46313	Fee-for-Service	1275840050	1275840050	1	1	WALGREEN CO	11/29/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1640 LINCOLN RD	None	YUBA CITY	CA	95993	6061	51	06101	39.11269554	-121.645017	Sutter County
46341	Fee-for-Service	1609293968	1609293968	1	1	WALMART INC	7/17/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4080 STEVENS CREEK BLVD	None	SAN JOSE	CA	95129	1334	43	06085	37.32313108	-121.9732347	Santa Clara County
46352	Fee-for-Service	1508465873	1508465873	2	1	WHITECROSS APOTHECARY LLC	3/26/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6780 INDIANA AVE	145	RIVERSIDE	CA	92506	4270	33	06065	33.94341303	-117.3913377	Riverside County
46391	Fee-for-Service	1104200880	1104200880	1	1	WIJESEKERA, KANCHANA DS PHD	10/6/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	8631	19	06037	34.07067	-118.4432445	Los Angeles County
46392	Fee-for-Service	1689682015	1689682015	1	2	WESTPHALEN, ANTONIO C A MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	104825	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
46415	Fee-for-Service	1942473442	1942473442	1	1	WANG, MICHELE MD	11/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115102	36	Psychiatry	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
46437	Fee-for-Service	1275599375	1275599375	1	1	WU, HUI-HSIN MD FAAP	5/31/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	42343	None	None	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
46463	Fee-for-Service	1588865521	1588865521	1	1	WONG, VICTOR W D MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140472	24	Plastic Surgery	0	In state provider	None	3333 MENDOCINO AVE	None	SANTA ROSA	CA	95403	2261	49	06097	38.469825	-122.723145	Sonoma County
46470	Fee-for-Service	1861598526	1861598526	1	1	WIKHOLM, GARY D MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	41000	08	Family Practice	0	In state provider	None	247 W HARVARD BLVD	None	SANTA PAULA	CA	93060	3223	56	06111	34.34517723	-119.0758733	Ventura County
46478	Fee-for-Service	1336170356	1336170356	1	1	WIX, MARK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	250 E DUNLAP AVE	None	PHOENIX	AZ	85020	2825	00	None	33.568947	-112.0712985	Maricopa County
46512	Fee-for-Service	1902071715	1902071715	1	1	WENG, LINDA YU-HWA	1/1/2009	1041C0700X	NA	Mental Health Outpatient Services	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2055 FLETCHER AVE	None	SOUTH PASADENA	CA	91030	4626	19	06037	34.09950784	-118.1424896	Los Angeles County
46532	Fee-for-Service	1821003195	1821003195	1	1	WALGREEN CO	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3382 CASTRO VALLEY BLVD	None	CASTRO VALLEY	CA	94546	5623	01	06001	37.69560262	-122.0767052	Alameda County
46584	Fee-for-Service	1013919752	1013919752	1	2	WHEELER, JONATHAN W MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	68184	01	General Practice	0	In state provider	None	1127 POPE ST	None	SAINT HELENA	CA	94574	1280	28	06055	38.50358554	-122.4663764	Napa County
46591	Fee-for-Service	1962602771	1962602771	1	3	WALTER, NICHOLAS D MD	1/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
46599	Fee-for-Service	1801891130	1801891130	1	1	WILSON, DAVID P MD	8/13/1995	207R00000X	NA	Other	026	PHYSICIANS	37216	41	Internal Medicine	0	In state provider	None	11219 N HWY 3	None	FORT JONES	CA	96032	0458	47	06093	41.60015699	-122.847467	Siskiyou County
46601	Fee-for-Service	1851372874	1851372874	1	1	WILLIAMS, BRYAN E	7/7/2006	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 N MARKET BLVD	STE 20	SACRAMENTO	CA	95834	1986	34	06067	38.646531	-121.484331	Sacramento County
46603	Fee-for-Service	1295269025	1295269025	1	1	WHITBY, AARON MD	7/31/2023	207L00000X	NA	Other	026	PHYSICIANS	172822	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
46609	Fee-for-Service	1700507266	1700507266	1	1	WELL CARE PHYSICAL THERAPY I	10/8/2024	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	NC.	1722 DESIRE AVE	STE 207	ROWLAND HEIGHTS	CA	91748	2970	19	06037	33.98725948	-117.8963129	Los Angeles County
46621	Fee-for-Service	1669672770	1669672770	1	1	WARD, JENNIFER D MD	9/1/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	98548	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
46661	Fee-for-Service	1215488770	1215488770	1	1	WILLE, CECILIA L CNP	2/21/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
46683	Fee-for-Service	1043493026	1043493026	1	1	WEIDMANN, CHARLES	7/2/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	APMC	15243 VANOWNEN ST	STE 306	VAN NUYS	CA	91405	3649	19	06037	34.19394848	-118.4654115	Los Angeles County
46712	Fee-for-Service	1164950762	1164950762	1	1	WAY, ESTEFANIA S	8/31/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	166907	None	None	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
46724	Fee-for-Service	1952586323	1952586323	1	1	WALGREEN CO	6/11/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11983 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	3015	19	06037	33.924132	-118.3527075	Los Angeles County
46791	Fee-for-Service	1932260205	1932260205	1	1	WEBB, KIMBERLY L	5/20/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
46799	Fee-for-Service	1689931818	1689931818	1	1	WISEL, STEVEN A MD	8/7/2019	208600000X	NA	General Surgery	026	PHYSICIANS	128350	89	Surgery-Traumatic	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
46834	Fee-for-Service	1154492056	1154492056	1	1	WALKER, SUSAN L MD	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71748	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
46867	Fee-for-Service	1336145184	1336145184	1	1	WOOD, JAMES B MD	11/1/1998	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	22858	40	Pediatrics	0	In state provider	None	572 RIO LINDO AVE	SUITE 203	CHICO	CA	95926	1851	04	06007	39.75508407	-121.8487933	Butte County
46923	Fee-for-Service	1639397961	1639397961	1	1	WONG, BRIAN B MD	12/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	99050	30	Radiology	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
46937	Fee-for-Service	1104570803	1104570803	1	1	WEISENBERGER, KELI-RAE LCSW	4/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2373 COLORADO BLVD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
46959	Fee-for-Service	1477589570	1477589570	1	1	WILCOX, ALISON G MD	4/1/1998	2085B0100X	NA	MRI Provider	026	PHYSICIANS	77491	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
46968	Fee-for-Service	1043493026	1043493026	1	1	WEIDMANN, CHARLES	7/2/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	83	Rheumatology	0	In state provider	APMC	15243 VANOWNEN ST	STE 306	VAN NUYS	CA	91405	3649	19	06037	34.19394848	-118.4654115	Los Angeles County
47099	Fee-for-Service	1245641869	1245641869	1	1	WILLIAMS, ANDREW R MD	11/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135707	41	Internal Medicine	0	In state provider	None	375 HUNTINGTON DR	STE G	SAN MARINO	CA	91108	2357	19	06037	34.1067704	-118.1349621	Los Angeles County
47172	Fee-for-Service	1730356882	1730356882	1	1	WONG, CONSTANCE MD	6/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100514	41	Internal Medicine	0	In state provider	None	450 STANYAN STREET	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
47174	Fee-for-Service	1730391764	1730391764	1	1	WOLLASTON, MATTHEW T PT	1/29/2020	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
47182	Fee-for-Service	1538122734	1538122734	1	1	WEAVER, BENJAMIN D CRNA	1/9/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
47208	Fee-for-Service	1598210601	1598210601	1	1	WILWERDING, STACEY LMFT	5/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SELING SERVICES	6444 MYRTLE AVE	None	EUREKA	CA	95503	0908	12	06023	40.7917989	-124.0865972	Humboldt County
47217	Fee-for-Service	1346826070	1346826070	1	1	WEBB, ERYCKA A MD	9/16/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
47220	Fee-for-Service	1316968282	1316968282	1	2	WEHRLE, MALCOLM J MD	4/21/2020	207LA0401X	NA	Other	086	MEDICAL DIRECTORS	64523	-	NOT APPLICABLE	0	In state provider	None	48745 THREE POINTS RD	None	LAKE HUGHES	CA	93532	1122	19	06037	34.7661184	-118.5914416	Los Angeles County
47280	Fee-for-Service	1487669768	1487669768	1	1	WALGREEN CO	3/1/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20901 DEVONSHIRE ST	None	CHATSWORTH	CA	91311	2313	19	06037	34.25728053	-118.589265	Los Angeles County
47324	Fee-for-Service	1952148363	1952148363	1	1	WELLINGTON, ALISON DOULA	8/2/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	12	06023	0	0	None
47325	Fee-for-Service	1144497926	1144497926	1	1	WONG, TONY	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
47363	Fee-for-Service	1144381609	1144381609	1	1	WISEMAN-KELLY, CYNTHIA B LCS	6/23/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LY	1947 DIVISADERO ST	SUITE 2	SAN FRANCISCO	CA	94115	2532	38	06075	37.78777198	-122.4404105	San Francisco County
47370	Fee-for-Service	1770670127	1770670127	1	1	WRIGHT, KENNETH W MD A	9/27/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	PROFESSIONAL CORPORATION	520 S SAN VICENTE BLVD	None	LOS ANGELES	CA	90048	4616	19	06037	34.06814789	-118.3742916	Los Angeles County
47371	Fee-for-Service	1629379169	1629379169	1	1	WHITE, DOUGLAS W MD	12/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109829	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20103 LAKE CHABOT ROAD	None	CASTRO VALLEY	CA	94546	5306	01	06001	37.698264	-122.090112	Alameda County
47376	Fee-for-Service	1073879490	1073879490	1	1	WAL-MART STORES, INC	8/8/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1550 LEUCADIA BLVD	None	ENCINITAS	CA	92024	2371	37	06073	33.0685625	-117.2666115	San Diego County
47410	Fee-for-Service	1548243413	1548243413	1	1	WITT,THERESA C PHD	7/1/1998	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
47495	Fee-for-Service	1508493107	1508493107	1	1	WILLINGER, CHRISTINE M MD	6/5/2023	207R00000X	NA	Other	026	PHYSICIANS	186307	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
47516	Fee-for-Service	1235794009	1235794009	1	1	WAN, PHILIP K DO	7/1/2022	207R00000X	NA	Other	026	PHYSICIANS	19665	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
47518	Fee-for-Service	1487641957	1487641957	1	1	WONG, LESLIE P MD	11/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54492	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
47530	Fee-for-Service	1447339189	1447339189	1	1	WANG, CHRISTINA Y MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77722	41	Internal Medicine	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
47536	Fee-for-Service	1124551817	1124551817	1	1	WANG, YANNING MD	9/20/2021	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
47568	Fee-for-Service	1235361528	1235361528	1	1	WALSHAW, PATRICIA D PHD	9/21/2009	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	RM C8-746	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
47572	Fee-for-Service	1295358919	1295358919	1	1	WANCZYK, EMILY LMFT	9/27/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
47608	Fee-for-Service	1093153629	1093153629	1	1	WAL-MART STORES, INC	6/16/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2480 GEER RD	None	TURLOCK	CA	95382	1426	50	06099	37.515618	-120.8487915	Stanislaus County
47695	Fee-for-Service	1073967204	1073967204	1	1	WANG, CONNIE W MD	9/25/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	155220	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
47728	Fee-for-Service	1003645979	1003645979	1	1	WALTERMAN, ELENA NP	10/31/2024	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
47744	Fee-for-Service	1306004007	1306004007	1	1	WU, YUPING DO	12/9/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19036	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
47767	Fee-for-Service	1679590921	1679590921	1	1	WAL-MART STORES, INC	4/26/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-2951	1731 E AVENUE J	None	LANCASTER	CA	93535	6928	19	06037	34.691724	-118.097766	Los Angeles County
47804	Fee-for-Service	1487641957	1487641957	1	1	WONG, LESLIE P MD	11/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54492	45	Nephrology (Renal-Kidney)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
47840	Fee-for-Service	1942782982	1942782982	1	1	WONG, WILLIAM PT	3/1/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
47847	Fee-for-Service	1861899205	1861899205	1	1	WEINBERG, ZEV A LCSW	12/17/2023	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
47860	Fee-for-Service	1174100143	1174100143	1	1	WU, ARIEL MD	4/25/2024	207P00000X	NA	Other	026	PHYSICIANS	182710	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
47907	Fee-for-Service	1154653699	1154653699	1	1	WOLFE, JENNIFER G LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	51630	-	NOT APPLICABLE	0	In state provider	None	370 S CRENSHAW BLVD	SUITE E-100	TORRANCE	CA	90503	1727	19	06037	33.84549	-118.3287415	Los Angeles County
47946	Fee-for-Service	1629204599	1629204599	1	1	WADELL, PAULA M	6/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113733	None	None	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
47952	Fee-for-Service	1083651087	1083651087	1	1	WATABE,JOHN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL STREET	None	HONOLULU	HI	96813	2499	00	None	21.30800017	-157.8550765	Honolulu County
47958	Fee-for-Service	1215166335	1215166335	1	1	WONG, DEBRA A MD	6/23/2020	207RX0202X	NA	Oncology	026	PHYSICIANS	117617	41	Internal Medicine	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
47996	Fee-for-Service	1871159962	1871159962	1	1	WONG, LARRY B DO	11/2/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20090	None	None	0	In state provider	None	12761 SCHABARUM AVE	None	BALDWIN PARK	CA	91706	6807	19	06037	34.08060971	-117.9958001	Los Angeles County
47998	Fee-for-Service	1942571047	1942571047	1	1	WASHINGTON MEDICAL GROUP	6/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	None	None	0	In state provider	None	2544 E WASHINGTON BLVD	SUITE C	PASADENA	CA	91107	1465	19	06037	34.16911248	-118.097577	Los Angeles County
48009	Fee-for-Service	1174918460	1174918460	1	1	WHITE, DAVID W MD	8/1/2021	207P00000X	NA	Other	026	PHYSICIANS	146498	None	None	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
48013	Fee-for-Service	1861457632	1861457632	1	1	WARE, DANA S MD	7/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	55407	08	Family Practice	0	In state provider	None	130 BRENTWOOD DR	None	CHESTER	CA	96020	0000	32	06063	40.30535806	-121.2340359	Plumas County
48022	Fee-for-Service	1801801188	1801801188	1	1	WALGREEN CO	5/1/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9180 FRANKLIN BLVD	None	ELK GROVE	CA	95758	9501	34	06067	38.424204	-121.4485965	Sacramento County
48103	Fee-for-Service	1548240443	1548240443	1	1	WILLIAM NEAL EVANS MD LTD	2/1/2000	2080P0202X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	1	Border provider	None	3131 LA CANADA STREET	SUITE 230	LAS VEGAS	NV	89169	2551	00	None	36.13267814	-115.132162	Clark County
48129	Fee-for-Service	1164464731	1164464731	1	1	WILLE, ROZANNE H MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	86546	08	Family Practice	0	In state provider	None	2071 E HERNDON	None	CLOVIS	CA	93611	6101	10	06019	36.8375685	-119.6781105	Fresno County
48142	Fee-for-Service	1528179058	1528179058	1	1	WAGGONER, WILLIAM H MD	3/1/1993	207P00000X	NA	Other	026	PHYSICIANS	70189	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
48200	Fee-for-Service	1477500965	1477500965	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	43200 STATE HIGHWAY 74	None	HEMET	CA	92544	5142	33	06065	33.74788146	-116.905905	Riverside County
48233	Fee-for-Service	1811920093	1811920093	1	1	WEPMAN, KENNETH J DPM	5/31/1989	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3816 WOODRUFF AVE	STE 207	LONG BEACH	CA	90808	2145	19	06037	33.828102	-118.1165525	Los Angeles County
48263	Fee-for-Service	1770780157	1770780157	1	1	WILSON, CAMERON W MD	8/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121921	34	Urology and Urological Surgery	0	In state provider	None	8851 CENTER DR	SUITE 208	LA MESA	CA	91942	3189	37	06073	32.78189749	-117.0075062	San Diego County
48323	Fee-for-Service	1265743595	1265743595	1	1	WALLACE, DAVID R JR MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136122	30	Radiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
48362	Fee-for-Service	1205209137	1205209137	1	1	WOLFSWINKEL, ERIK M MD	7/9/2020	208200000X	NA	General Surgery	026	PHYSICIANS	141291	24	Plastic Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
48371	Fee-for-Service	1083127906	1083127906	1	1	WETTSTEIN, EVE L LCSW	12/26/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11303 WASHINGTON BLVD	SUITE 100	LOS ANGELES	CA	90066	6003	19	06037	34.00408212	-118.4147433	Los Angeles County
48387	Fee-for-Service	1154959781	1154959781	1	1	WEE, CINDY S NP	12/7/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
48432	Fee-for-Service	1528179058	1528179058	1	1	WAGGONER, WILLIAM H MD	3/1/1993	207P00000X	NA	Other	026	PHYSICIANS	70189	01	General Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
48491	Fee-for-Service	1912981788	1912981788	1	1	WEDDERBURN, LAURA L MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74957	41	Internal Medicine	0	In state provider	None	3883 AIRWAY DRIVE	SUITE 165	SANTA ROSA	CA	95403	1675	49	06097	38.483226	-122.739705	Sonoma County
48505	Fee-for-Service	1346295052	1346295052	1	1	WEIDNER, NOEL MD	9/1/1999	207ZP0102X	NA	Other	026	PHYSICIANS	72066	22	Pathology (M.D. only)	0	In state provider	None	200 W ARBOR DR	DEPT 8201	SAN DIEGO	CA	92103	8201	37	06073	32.7537975	-117.1658298	San Diego County
48548	Fee-for-Service	1174152128	1174152128	1	1	WONG, IAN G DO	9/6/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	22519	40	Pediatrics	0	In state provider	None	11943 EL CAMINO REAL	210	SAN DIEGO	CA	92130	2597	37	06073	32.93583421	-117.2376593	San Diego County
48592	Fee-for-Service	1861122889	1861122889	1	1	WORK, ROSEANNE OD	8/1/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1721 WESTWIND DR	STE B	BAKERSFIELD	CA	93301	3026	15	06029	35.37519935	-119.0425415	Kern County
48637	Fee-for-Service	1346809316	1346809316	1	1	WATTS, SHERRY H	1/14/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95011981	-	NOT APPLICABLE	0	In state provider	None	838 BEACH COURT	None	COLOMA	CA	95613	0437	09	06017	38.80779414	-120.9070843	El Dorado County
48702	Fee-for-Service	1083884480	1083884480	1	1	WILSON HANNAY, SARAH B MD	5/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102909	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3779 PIEDMONT AVENUE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
48765	Fee-for-Service	1801813043	1801813043	1	1	WAL-MART STORES INC	3/7/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-5193	12721 MORENO BEACH DR	None	MORENO VALLEY	CA	92555	4411	33	06065	33.935742	-117.1819035	Riverside County
48796	Fee-for-Service	1093024572	1093024572	1	1	WANG, CINDY OD	12/16/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4405 VANDEVER AVE	None	SAN DIEGO	CA	92120	3315	37	06073	32.78765609	-117.09908	San Diego County
48838	Fee-for-Service	1831130574	1831130574	1	1	WOAN, JINMEI MD APC	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69222	13	Neurology (M.D. only)	0	In state provider	INC	530 W EATON AVE	SUITE M	TRACY	CA	95376	3455	39	06077	37.74328351	-121.433886	San Joaquin County
48839	Fee-for-Service	1851587398	1851587398	1	1	WILLIAMS, TIMOTHY K MD	7/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120818	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
48852	Fee-for-Service	1356344758	1356344758	1	3	WEST COUNTY HEALTH CENTERS	8/17/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7050 COVEY RD	None	FORESTVILLE	CA	95436	9642	49	06097	38.48148427	-122.8901284	Sonoma County
48856	Fee-for-Service	1043487101	1043487101	1	1	WEN, ANDY Y	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107599	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
48942	Fee-for-Service	1003821380	1003821380	1	1	WALGREEN CO	11/17/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	24930 WESTERN AVE	None	HARBOR CITY	CA	90710	2029	19	06037	33.7981282	-118.3074768	Los Angeles County
48965	Fee-for-Service	1124117593	1124117593	1	1	WILLEN, JON F MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	37023	77	Infectious Disease	0	In state provider	None	7230 MEDICAL CENTER DR	STE 203	WEST HILLS	CA	91307	4007	19	06037	34.20172814	-118.6294322	Los Angeles County
48978	Fee-for-Service	1437520715	1437520715	1	1	WALLS, CANDACE S LMFT	5/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
48990	Fee-for-Service	1821223389	1821223389	1	1	WING, LAUREN L PHD	1/30/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
48997	Fee-for-Service	1659489268	1659489268	1	1	WU, HENRY HORNG-YIH MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84427	34	Urology and Urological Surgery	0	In state provider	SOUTHERN CA UROLOGY, INC	3801 KATELLA AVE	STE 320	LOS ALAMITOS	CA	90720	3338	30	06059	33.80318951	-118.066068	Orange County
49001	Fee-for-Service	1992864839	1992864839	1	1	WONG, MARY J NP	8/19/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
49024	Fee-for-Service	1043520216	1043520216	1	1	WESTERN PHYSICAL THERAPY INC	3/2/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1516 STATE HWY 99	STE G	GRIDLEY	CA	95948	3130	04	06007	39.35988	-121.6878825	Butte County
49042	Fee-for-Service	1053416461	1053416461	1	1	WANG, PING H MD	11/1/1993	207RE0101X	NA	Endocrinology	026	PHYSICIANS	53392	67	Endocrinology	0	In state provider	None	1 MEDICAL PLAZA	None	IRVINE	CA	92602	0000	30	06059	33.64705191	-117.8514749	Orange County
49080	Fee-for-Service	1932466950	1932466950	1	1	WITKOWSKI, JESSICA C MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128131	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
49118	Fee-for-Service	1235293648	1235293648	1	1	WANG, ROBERT T MD	12/1/1987	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	40989	None	None	0	In state provider	#1410	2080 CENTURY PARK E	None	LOS ANGELES	CA	90067	2001	19	06037	34.05887194	-118.4122914	Los Angeles County
49137	Fee-for-Service	1356344758	1356344758	1	3	WEST COUNTY HEALTH CENTERS	8/17/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7050 COVEY RD	None	FORESTVILLE	CA	95436	9642	49	06097	38.48148427	-122.8901284	Sonoma County
49149	Fee-for-Service	1003234501	1003234501	1	1	WADHWA, SANYA MD	8/3/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	145736	10	Gastroenterology (M.D. only)	0	In state provider	None	2222 EAST ST	STE 300	CONCORD	CA	94520	2066	07	06013	37.98125538	-122.0329375	Contra Costa County
49155	Fee-for-Service	1871540948	1871540948	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12109 APPLE VALLEY RD	None	APPLE VALLEY	CA	92308	6702	36	06071	34.47176263	-117.2423444	San Bernardino County
49164	Fee-for-Service	1316238835	1316238835	1	1	WESTSIDE HOSPICE COMFORTCARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INCORPORATION	9555 W PICO BLVD	STE B	LOS ANGELES	CA	90035	1215	19	06037	34.0552853	-118.397067	Los Angeles County
49247	Fee-for-Service	1396935979	1396935979	1	1	WAINESS, REID M MD	10/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108766	18	Ophthalmology	0	In state provider	None	17833 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	1729	19	06037	33.99017251	-117.9153748	Los Angeles County
49317	Fee-for-Service	1285371872	1285371872	1	1	WHITE CURTIS, FELICIA BIRTH	6/28/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
49324	Fee-for-Service	1982967188	1982967188	1	1	WOODRUFF, JENNIFER PT	4/11/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
49376	Fee-for-Service	1043708811	1043708811	1	1	WU, CHUNG-AN M MD	6/16/2023	207L00000X	NA	Other	026	PHYSICIANS	165773	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
49382	Fee-for-Service	1922264522	1922264522	1	1	WAN, JENNIFER MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100066	33	Thoracic Surgery	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
49452	Fee-for-Service	1316238835	1316238835	1	1	WESTSIDE HOSPICE COMFORTCARE	4/15/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INCORPORATION	9555 W PICO BLVD	STE B	LOS ANGELES	CA	90035	1215	19	06037	34.0552853	-118.397067	Los Angeles County
49481	Fee-for-Service	1083813638	1083813638	1	1	WEISSMANN, ANNA M MD	11/23/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	148986	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
49505	Fee-for-Service	1851178313	1851178313	1	1	WANG, HONG QIN LAC	3/12/2025	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
49507	Fee-for-Service	1508064387	1508064387	1	1	WILKINSON, KATIE E MD	8/17/2022	207ZP0102X	NA	Other	026	PHYSICIANS	100684	None	None	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	4045	30	06059	33.62421676	-117.9309656	Orange County
49519	Fee-for-Service	1538232137	1538232137	1	1	WANG, SHUO S MD	7/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	76144	41	Internal Medicine	0	In state provider	None	711 W COLLEGE ST	STE 210	LOS ANGELES	CA	90012	1092	19	06037	34.06541412	-118.2414102	Los Angeles County
49580	Fee-for-Service	1942761572	1942761572	1	1	WILLIAMS, SAMANTHA L DPM	7/11/2022	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
49607	Fee-for-Service	1811339641	1811339641	1	1	WILLIAMS, NOLAN MD	1/28/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	159440	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
49671	Fee-for-Service	1972988624	1972988624	1	1	WILLIS-AKINS, MARLENE L LMFT	2/10/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8300 UTICA AVE	STE 245	RANCHO CUCAMONGA	CA	91730	3852	36	06071	34.10227306	-117.5715643	San Bernardino County
49730	Fee-for-Service	1982269593	1982269593	1	1	WONG, KAREN D DO	1/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20429	None	None	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
49786	Fee-for-Service	1841470267	1841470267	1	1	WOOLSEY, JANICE D CCC-SLP	7/23/2009	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18111 NORDHOFF STREET	None	NORTHRIDGE	CA	91330	8288	19	06037	34.239213	-118.527768	Los Angeles County
49788	Fee-for-Service	1932145067	1932145067	1	1	WILLOCK, GRETCHEN S MD	11/2/2022	207P00000X	NA	Other	026	PHYSICIANS	175540	None	None	0	In state provider	None	6001 NORRIS CANYON RD.	None	SAN RAMON	CA	94583	5400	07	06013	37.7755858	-121.958923	Contra Costa County
49789	Fee-for-Service	1962516245	1962516245	1	1	WONG, DAVID MD	11/20/2018	207R00000X	NA	Other	026	PHYSICIANS	85258	01	General Practice	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
49824	Fee-for-Service	1962449660	1962449660	1	1	WU, VICTOR H MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62392	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
49874	Fee-for-Service	1730175449	1730175449	1	1	WALTER, DAVID H PHD	9/1/1995	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1840 N HACIENDA BLVD	STE 2	LA PUENTE	CA	91744	1143	19	06037	34.05164127	-117.9426446	Los Angeles County
49923	Fee-for-Service	1164502076	1164502076	1	1	WEINBERG,DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N MEDICAL DRIVE	None	SALT LAKE CITY	UT	84132	0000	00	None	40.77197161	-111.8352608	Salt Lake County
49957	Fee-for-Service	1992114383	1992114383	1	1	WOOD, EMILY T MD	4/6/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	144603	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
50047	Fee-for-Service	1417156829	1417156829	1	1	WALTON, JOHN W MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103406	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
50050	Fee-for-Service	1609804426	1609804426	1	1	WEINBERG PAUL SM	4/30/1989	207P00000X	NA	Other	026	PHYSICIANS	27031	08	Family Practice	0	In state provider	None	27100 EUCLID	None	FOUNTAIN VALLEY	CA	92706	0000	30	06059	33.69492344	-117.9358945	Orange County
50057	Fee-for-Service	1346508918	1346508918	1	1	WOODWARD, ELLIOTT L MD	8/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148021	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
50086	Fee-for-Service	1316400559	1316400559	1	1	WIN, KHIN S DO	9/26/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19622	None	None	0	In state provider	None	1000 FRANKLIN PARKWAY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
50127	Fee-for-Service	1497078877	1497078877	1	1	WINDSOR CT ASST LIVING	1/24/2011	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	OWNER/ADMINISTRATOR	201 SOUTH SUNRISE WAY	None	PALM SPRINGS	CA	92262	6738	33	06065	33.820812	-116.5282555	Riverside County
50135	Fee-for-Service	1659409456	1659409456	1	1	WU, ALICEA X MD	3/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	96542	08	Family Practice	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
50139	Fee-for-Service	1194178640	1194178640	1	1	WESTERN PHYSICAL THERAPY INC	8/30/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1031 VILLAGE LN	None	CHICO	CA	95926	2812	04	06007	39.74903547	-121.8249236	Butte County
50181	Fee-for-Service	1649349192	1649349192	1	1	WOEHRLE, THERESA A MD	6/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	46577	08	Family Practice	0	In state provider	None	501 N MACLAY AVE	None	SAN FERNANDO	CA	91340	2424	19	06037	34.28782178	-118.4351701	Los Angeles County
50190	Fee-for-Service	1063590883	1063590883	1	1	WIENS, JONATHAN G MD	1/30/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	68592	25	Physical Medicine and Rehabilitation	0	In state provider	None	4785 N 1ST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
50202	Fee-for-Service	1154717338	1154717338	1	1	WILNER, JOSHUA I MD	1/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144076	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
50267	Fee-for-Service	1154313963	1154313963	1	1	WALDMIRE, MARK W OD	12/1/2012	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4633 WHITNEY AVE	STE A	SACRAMENTO	CA	95821	4100	34	06067	38.628873	-121.356198	Sacramento County
50269	Fee-for-Service	1952530438	1952530438	1	1	WATSON, BETYSHIA J MD	9/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120734	08	Family Practice	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
50280	Fee-for-Service	1538334289	1538334289	1	1	WON K YU MD MPH INC	5/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	77275	None	None	0	In state provider	None	230 S MAIN ST	STE 215	ORANGE	CA	92868	3851	30	06059	33.785154	-117.867318	Orange County
50337	Fee-for-Service	1609804426	1609804426	1	1	WEINBERG PAUL SM	4/30/1989	207P00000X	NA	Other	026	PHYSICIANS	27031	01	General Practice	0	In state provider	None	27100 EUCLID	None	FOUNTAIN VALLEY	CA	92706	0000	30	06059	33.69492344	-117.9358945	Orange County
50394	Fee-for-Service	1093866063	1093866063	1	1	WHITE, O.C. MD	10/18/2018	2084P0804X	NA	Psychiatry	026	PHYSICIANS	87429	36	Psychiatry	0	In state provider	None	4300 LONG BEACH BLVD	STE 340	LONG BEACH	CA	90807	2011	19	06037	33.83662572	-118.1900605	Los Angeles County
50395	Fee-for-Service	1275875965	1275875965	1	1	WATSON, TRACIE DO	2/5/2021	207RH0003X	NA	Oncology	026	PHYSICIANS	18558	None	None	0	In state provider	None	500 LENNON LANE	None	WALNUT CREEK	CA	94598	2415	07	06013	37.92948868	-122.0315914	Contra Costa County
50419	Fee-for-Service	1992123210	1992123210	1	1	WHYNOTT, RACHEL M	12/10/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
50430	Fee-for-Service	1609051549	1609051549	1	2	WANG JENNIFER ZHENG MD INC	3/3/2022	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
50437	Fee-for-Service	1285637652	1285637652	2	1	WINICK, JEFFREY P MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	46812	18	Ophthalmology	0	In state provider	None	1517 E KNICKERBOCKER DR	None	STOCKTON	CA	95210	3119	39	06077	38.02415455	-121.2934722	San Joaquin County
50499	Fee-for-Service	1679515217	1679515217	1	1	WESTERN UNIVERSITY OF	4/24/1996	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	HEALTH SCIENCES	795 E SECOND ST	STE 5	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
50506	Fee-for-Service	1134711682	1134711682	1	1	WIENS, LANA N CCC-SLP	8/13/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
50525	Fee-for-Service	1306839568	1306839568	1	1	WALLER, TODD S MD	5/7/2012	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	39474	04	Otology, Laryngology, Rhinology	0	In state provider	None	1700 WESTWOOD BLVD	None	LOS ANGELES	CA	90024	5608	19	06037	34.05159882	-118.4385447	Los Angeles County
50554	Fee-for-Service	1275898371	1275898371	1	1	WRIGHT, PATRICIA K PSYD	4/17/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
50583	Fee-for-Service	1952914681	1952914681	1	14	WEST COAST KIDNEY	3/2/2023	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	13851 E 14TH ST	STE 206	SAN LEANDRO	CA	94578	2627	01	06001	37.71458918	-122.1418781	Alameda County
50647	Fee-for-Service	1548319924	1548319924	1	1	WONG, ALEXANDER D MD	2/20/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	84071	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
50692	Fee-for-Service	1790827657	1790827657	1	1	WESTERN PACIFIC MED-CORP	9/1/1988	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	45335 SIERRA HWY	None	LANCASTER	CA	93534	1611	19	06037	34.7068568	-118.1383834	Los Angeles County
50717	Fee-for-Service	1609051549	1609051549	1	2	WANG JENNIFER ZHENG MD INC	3/3/2022	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
50737	Fee-for-Service	1689741506	1689741506	1	1	WONG, LINDA MD	8/21/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69603	07	Dermatology	0	In state provider	ATTN MGA OFFICE	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
50750	Fee-for-Service	1518358480	1518358480	1	1	WONG, MELISSA C MD INC	5/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110373	01	General Practice	0	In state provider	None	1842 NORIEGA ST	None	SAN FRANCISCO	CA	94122	4324	38	06075	37.75395567	-122.4837142	San Francisco County
50880	Fee-for-Service	1942671615	1942671615	1	1	WAHLIN, KARA L LMFT	9/16/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CES	74075 EL PASEO	A2A	PALM DESERT	CA	92260	2645	33	06065	33.71971253	-116.3724764	Riverside County
50930	Fee-for-Service	1386273027	1386273027	1	1	WATSON, AARON MD	2/20/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178832	36	Psychiatry	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
50978	Fee-for-Service	1790827657	1790827657	1	1	WESTERN PACIFIC MED-CORP	9/30/2016	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	45335 SIERRA HWY	None	LANCASTER	CA	93534	1611	19	06037	34.7068568	-118.1383834	Los Angeles County
50990	Fee-for-Service	1558865865	1558865865	1	1	WILSON, SHATIRA MD	9/21/2023	207L00000X	NA	Other	026	PHYSICIANS	176169	None	None	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
51007	Fee-for-Service	1871138529	1871138529	1	1	WONG, NORMAN PT	12/6/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1017 S FAIR OAKS AVE	None	PASADENA	CA	91105	2621	19	06037	34.12830178	-118.1503497	Los Angeles County
51042	Fee-for-Service	1578135323	1578135323	1	1	WILEY, TURNER J NP	11/9/2021	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
51050	Fee-for-Service	1265912562	1265912562	1	1	WU, YU NP	3/13/2020	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
51077	Fee-for-Service	1912320698	1912320698	1	1	WYNKS CORPORATION	12/12/2022	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1788 S SAN GABRIEL BLVD	STE 101	SAN GABRIEL	CA	91776	3930	19	06037	34.077438	-118.0907035	Los Angeles County
51098	Fee-for-Service	1518189604	1518189604	1	1	WANG, KATHLEEN M MD	9/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103000	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
51141	Fee-for-Service	1114424447	1114424447	1	1	WANG, LUCY	8/23/2024	207ZP0105X	NA	Other	026	PHYSICIANS	22602	22	Pathology (M.D. only)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
51156	Fee-for-Service	1205076379	1205076379	1	1	WASHBURN, ELISA E DO	6/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10454	08	Family Practice	0	In state provider	None	1100 BUTTE STREET	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
51161	Fee-for-Service	1952914681	1952914681	1	6	WEST COAST KIDNEY	9/27/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	87 FENTON ST	STE 210	LIVERMORE	CA	94550	4100	01	06001	37.676565	-121.7834555	Alameda County
51301	Fee-for-Service	1740274760	1740274760	2	1	WALSH, CHANTAL G MD	5/4/2023	207R00000X	NA	Other	026	PHYSICIANS	171983	None	None	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
51307	Fee-for-Service	1114933512	1114933512	1	1	WALGREEN CO	6/4/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1042 NORD AVE	None	CHICO	CA	95926	4308	04	06007	39.73168861	-121.8607504	Butte County
51356	Fee-for-Service	1639986045	1639986045	1	1	WILSON, BRITANNY CNP	1/29/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
51365	Fee-for-Service	1912320698	1912320698	1	1	WYNKS CORPORATION	12/11/2015	251K00000X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	1788 S SAN GABRIEL BLVD	STE 101	SAN GABRIEL	CA	91776	3930	19	06037	34.077438	-118.0907035	Los Angeles County
51405	Fee-for-Service	1588681811	1588681811	1	1	WAL-MART STORES INC	12/5/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10355 WICKLOW WAY	None	JACKSON	CA	95642	9324	03	06005	38.35909526	-120.8047262	Amador County
51406	Fee-for-Service	1720250186	1720250186	1	1	WITTELES, WESLEY H MD	9/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88702	41	Internal Medicine	0	In state provider	None	2940 WHIPPLE AVE	#B	REDWOOD CITY	CA	94062	2856	41	06081	37.47840623	-122.2549871	San Mateo County
51417	Fee-for-Service	1336309897	1336309897	1	1	WATTERS, EMILY R MD	5/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112057	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
51438	Fee-for-Service	1053541862	1053541862	1	1	WEISS, KATHERINE J MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154876	01	General Practice	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
51458	Fee-for-Service	1306000757	1306000757	1	1	WOODWORTH, AMANDA M MD	2/9/2022	2086X0206X	NA	General Surgery	026	PHYSICIANS	122229	None	None	0	In state provider	None	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
51513	Fee-for-Service	1770928483	1770928483	1	1	WONG, BRIAN H DPM	8/13/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	11332 MOUNTAIN VIEW AVE	STE A	LOMA LINDA	CA	92354	3854	36	06071	34.04709935	-117.2436936	San Bernardino County
51581	Fee-for-Service	1013305341	1013305341	1	1	WU, ADELA MD	5/13/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	164144	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
51593	Fee-for-Service	1649242678	1649242678	1	1	WRIGHT, MICHAEL H MD	12/15/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	67365	20	Orthopedic Surgery	0	In state provider	None	25455 BARTON RD	101B 102B 104B 106B 108B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
51611	Fee-for-Service	1386650349	1386650349	1	1	WILSON, LOU E MD	4/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76107	41	Internal Medicine	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
51643	Fee-for-Service	1275552580	1275552580	1	1	WOODMANSEE, SUSAN MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55503	66	Emergency Medicine (Urgent Care)	0	In state provider	CENTRAL CALIF FAC MED GR	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
51691	Fee-for-Service	1720250186	1720250186	1	1	WITTELES, WESLEY H MD	9/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88702	78	Neoplastic Diseases/Oncology	0	In state provider	None	2940 WHIPPLE AVE	#B	REDWOOD CITY	CA	94062	2856	41	06081	37.47840623	-122.2549871	San Mateo County
51727	Fee-for-Service	1053541862	1053541862	1	1	WEISS, KATHERINE J MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154876	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
51755	Fee-for-Service	1306863725	1306863725	1	1	WAL-MART STORES, INC	12/10/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101859	2540 ROCKWOOD AVE	None	CALEXICO	CA	92231	4406	13	06025	32.697594	-115.496577	Imperial County
51759	Fee-for-Service	1679106926	1679106926	1	1	WALKER, DANA S CMF	8/25/2020	224900000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	9033 BASELINE RD	C	RIVERSIDE	CA	91730	1214	33	06065	34.12151248	-117.6080805	San Bernardino County
51885	Fee-for-Service	1144841735	1144841735	1	1	WOO LEE, YESSIKA DPM	5/22/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	750 LAS GALLINAS AVE	#115	SAN RAFAEL	CA	94903	3431	21	06041	38.00688138	-122.5463961	Marin County
51889	Fee-for-Service	1538520457	1538520457	1	1	WEATHERLY, JACOB A MD	4/19/2019	390200000X	NA	Other	026	PHYSICIANS	150920	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
51890	Fee-for-Service	1104976174	1104976174	1	1	WOLF, AMY M MD	6/11/2008	207R00000X	NA	Other	026	PHYSICIANS	96860	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
51967	Fee-for-Service	1962423590	1962423590	2	1	WASSILY, VICTOR M MD	11/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53474	45	Nephrology (Renal-Kidney)	0	In state provider	None	111 W BEVERLY BLVD	STE 217	MONTEBELLO	CA	90640	4320	19	06037	34.01572372	-118.0991599	Los Angeles County
51979	Fee-for-Service	1720250186	1720250186	1	1	WITTELES, WESLEY H MD	9/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88702	68	Hematology	0	In state provider	None	2940 WHIPPLE AVE	#B	REDWOOD CITY	CA	94062	2856	41	06081	37.47840623	-122.2549871	San Mateo County
52117	Fee-for-Service	1740446335	1740446335	1	1	WILLIAMSON, CHARLES E CNP	12/9/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
52137	Fee-for-Service	1295752541	1295752541	1	1	WAL-MART STORES, INC	7/14/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101700	13425 COMMUNITY RD	None	POWAY	CA	92064	4723	37	06073	32.95923464	-117.0404669	San Diego County
52154	Fee-for-Service	1871172023	1871172023	1	1	WHALL, JAMES MD	8/23/2023	207P00000X	NA	Other	026	PHYSICIANS	183045	None	None	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
52194	Fee-for-Service	1942384946	1942384946	1	1	WEITZENBERG,TODD W MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64341	25	Physical Medicine and Rehabilitation	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
52241	Fee-for-Service	1366707648	1366707648	1	1	WAL-MART STORES, INC	12/28/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9100 ALCOSTA BLVD	None	SAN RAMON	CA	94583	3857	07	06013	37.73039746	-121.9301944	Contra Costa County
52254	Fee-for-Service	1962423590	1962423590	2	1	WASSILY, VICTOR M MD	11/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53474	41	Internal Medicine	0	In state provider	None	111 W BEVERLY BLVD	STE 217	MONTEBELLO	CA	90640	4320	19	06037	34.01572372	-118.0991599	Los Angeles County
52289	Fee-for-Service	1821099953	1821099953	1	1	WOODRUFF, CHRISTY A MD	7/21/2021	174400000X	NA	Other	026	PHYSICIANS	170033	None	None	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
52343	Fee-for-Service	1982098380	1982098380	1	1	WALKER, EVAN J MD	9/23/2021	207RH0003X	NA	Oncology	026	PHYSICIANS	147886	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
52354	Fee-for-Service	1942342811	1942342811	1	1	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	10751 DALE AVE	None	STANTON	CA	90680	2604	30	06059	33.8063153	-117.9845625	Orange County
52388	Fee-for-Service	1578634929	1578634929	1	1	WYTRZES, LYDIA MARIA	8/31/1988	2084S0012X	NA	Neurology	026	PHYSICIANS	60213	13	Neurology (M.D. only)	0	In state provider	None	87 SCRIPPS DR	STE 318	SACRAMENTO	CA	95825	6305	34	06067	38.572092	-121.410261	Sacramento County
52414	Fee-for-Service	1962472464	1962472464	1	1	WILLEY, RICHARD M. DO	5/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1800 E FLORENCE BLVD	None	CASA GRANDE	AZ	85122	5303	00	None	32.881311	-111.7096155	Pinal County
52469	Fee-for-Service	1013094127	1013094127	1	1	WONG, ROBIN C RPT	10/31/1986	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	818 JACKSON ST	STE 201	SAN FRANCISCO	CA	94133	4849	38	06075	37.79580797	-122.4086365	San Francisco County
52483	Fee-for-Service	1518220722	1518220722	1	1	WALLACE, LORIEN R DO	7/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13168	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
52516	Fee-for-Service	1558467787	1558467787	1	1	WANG, ANDREW MD	1/1/1997	207R00000X	NA	Other	026	PHYSICIANS	43341	01	General Practice	0	In state provider	None	197 ARNEILL RD	None	CAMARILLO	CA	93010	6401	56	06111	34.218459	-119.0390355	Ventura County
52528	Fee-for-Service	1023330719	1023330719	1	1	WRIGHT-GIBSON, SANDRA K	10/29/2009	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2000 N SCHNOOR AVE	STE 102	MADERA	CA	93637	5051	20	06039	36.97844086	-120.085895	Madera County
52544	Fee-for-Service	1962423590	1962423590	2	1	WASSILY, VICTOR M MD	11/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53474	04	Otology, Laryngology, Rhinology	0	In state provider	None	111 W BEVERLY BLVD	STE 217	MONTEBELLO	CA	90640	4320	19	06037	34.01572372	-118.0991599	Los Angeles County
52561	Fee-for-Service	1790107829	1790107829	1	1	WILSON, BARRY K MD INC	1/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	103336	05	Anesthesiology	0	In state provider	None	800 S LOWER SACRAMENTO	ROAD	LODI	CA	95242	3635	39	06077	38.12374272	-121.3065139	San Joaquin County
52596	Fee-for-Service	1093999104	1093999104	1	1	WEI, PEILIN MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	45	Nephrology (Renal-Kidney)	1	Border provider	None	2420 PROFESSIONAL COURT	SUITE 400	LAS VEGAS	NV	89128	0837	00	None	36.203769	-115.2550845	Clark County
52642	Fee-for-Service	1942342811	1942342811	1	1	WESTERN PACIFIC MED-CORP	3/1/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	10751 DALE AVE	None	STANTON	CA	90680	2604	30	06059	33.8063153	-117.9845625	Orange County
52680	Fee-for-Service	1639305576	1639305576	1	1	WILLIAM CAMPBELL M.D.	12/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5361 REYNOLDS ST	None	SAVANNAH	GA	31405	6014	00	None	32.02724772	-81.10182503	Chatham County
52702	Fee-for-Service	1225185242	1225185242	1	1	WHELAN, HEATHER A MD	5/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	76343	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
52709	Fee-for-Service	1356584007	1356584007	1	1	WONG, WENDY W MD	8/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114159	20	Orthopedic Surgery	0	In state provider	None	2405 SHADELANDS DR	None	WALNUT CREEK	CA	94598	2444	07	06013	37.92615477	-122.0259459	Contra Costa County
52717	Fee-for-Service	1326009655	1326009655	1	1	WESTCOM RADIOLOGY MEDICAL	1/25/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	4081 E OLYMPIC BLVD	None	LOS ANGELES	CA	90023	3330	19	06037	34.01891346	-118.186614	Los Angeles County
52723	Fee-for-Service	1962849646	1962849646	1	1	WAL-MART STORES INC	8/15/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14061 W WHITESBRIDGE AVE	None	KERMAN	CA	93630	9297	10	06019	36.732699	-120.044187	Fresno County
52741	Fee-for-Service	1891911202	1891911202	1	1	WONG, ANDREW S MD	6/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107338	20	Orthopedic Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
52749	Fee-for-Service	1669744751	1669744751	1	1	WAL-MART STORES, INC	5/3/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5095 ALMADEN EXPY	None	SAN JOSE	CA	95118	2051	43	06085	37.255446	-121.8801645	Santa Clara County
52758	Fee-for-Service	1053428698	1053428698	1	1	WILSON, LUCAS B	11/7/2006	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	405 REDCLIFF DR	STE 100	REDDING	CA	96002	0160	45	06089	40.57465323	-122.3639452	Shasta County
52761	Fee-for-Service	1184641326	1184641326	1	1	WAL-MART STORES, INC	8/23/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-5394	770 W EL MONTE WAY	None	DINUBA	CA	93618	3493	54	06107	36.543339	-119.4023205	Tulare County
52803	Fee-for-Service	1558467787	1558467787	1	1	WANG, ANDREW MD	1/1/1997	207R00000X	NA	Other	026	PHYSICIANS	43341	41	Internal Medicine	0	In state provider	None	197 ARNEILL RD	None	CAMARILLO	CA	93010	6401	56	06111	34.218459	-119.0390355	Ventura County
52845	Fee-for-Service	1447586904	1447586904	1	1	WONG, JARED S	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137345	None	None	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
52886	Fee-for-Service	1093999104	1093999104	1	1	WEI, PEILIN MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2420 PROFESSIONAL COURT	SUITE 400	LAS VEGAS	NV	89128	0837	00	None	36.203769	-115.2550845	Clark County
52927	Fee-for-Service	1639849284	1639849284	1	1	WONGK, BELEN A NP	7/22/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
52980	Fee-for-Service	1437320561	1437320561	1	1	WILLIAMSON, ANDREW M LMFT	4/17/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45589	-	NOT APPLICABLE	0	In state provider	None	251 GEORGIA STREET	None	VALLEJO	CA	94590	5905	48	06095	38.10111026	-122.2588175	Solano County
52982	Fee-for-Service	1417188871	1417188871	1	1	WAKING UP ON THE TOILET	7/25/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1126 NORTH 2ND STREET	None	EL CAJON	CA	92021	5008	37	06073	32.81016488	-116.9358667	San Diego County
52996	Fee-for-Service	1912239203	1912239203	1	1	WALTON, VICKIE A MD INC	8/10/2010	2084N0400X	NA	Neurology	026	PHYSICIANS	58237	13	Neurology (M.D. only)	0	In state provider	None	1313 E HERNDON	STE 205	FRESNO	CA	93720	3306	10	06019	36.834984	-119.7641925	Fresno County
52997	Fee-for-Service	1578932653	1578932653	1	1	WYCHE, PETRA	1/24/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
53074	Fee-for-Service	1619474616	1619474616	1	1	WU, MARK MD	9/1/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
53103	Fee-for-Service	1033313143	1033313143	1	1	WARUINGI, WAMBUI MD	7/22/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	MERCY MEDICAL CENTER	2175 ROSALINE AVE	REDDING	CA	96001	2509	45	06089	40.62534625	-122.4599915	Shasta County
53149	Fee-for-Service	1295779940	1295779940	1	1	WERNER, JOCELYN P MD	2/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	76891	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
53173	Fee-for-Service	1629299029	1629299029	1	1	WIESE, JANET M MD	1/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90792	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
53189	Fee-for-Service	1013247246	1013247246	2	2	WILSON, PAUL J OD FAAO	3/29/2022	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	36330 HIDDEN SPRINGS RD.	SUITE A	WILDOMAR	CA	92595	5804	33	06065	33.59339735	-117.2454691	Riverside County
53221	Fee-for-Service	1720584253	1720584253	1	1	WHIPPLE, CASEY MD	3/25/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	174604	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
53225	Fee-for-Service	1033267356	1033267356	1	1	WOODLAND JOINT USD	8/1/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	435 6TH ST	None	WOODLAND	CA	95695	4109	57	06113	38.67611288	-121.7671382	Yolo County
53233	Fee-for-Service	1043381023	1043381023	1	1	WESLEY, PATRICIA F MD	9/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	56188	26	Psychiatry (child)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
53235	Fee-for-Service	1750313359	1750313359	1	2	WESSON, DOUGLAS B	1/21/2021	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1079 EUCALYPTUS	STE B	MANTECA	CA	95337	4317	39	06077	37.80126585	-121.2326114	San Joaquin County
53269	Fee-for-Service	1669644514	1669644514	1	1	WALLACH, SABINA R MD AMC	12/5/2008	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	9850 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1212	37	06073	32.882913	-117.226341	San Diego County
53290	Fee-for-Service	1205149440	1205149440	1	1	WRIGHT, ANNA MD	6/10/2022	207L00000X	NA	Other	026	PHYSICIANS	176384	None	None	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
53295	Fee-for-Service	1184898355	1184898355	1	1	WILLIAMS, RENEE D LMFT	1/17/2017	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1620 CENTINELA AVE	SUITE 201A, 204	INGLEWOOD	CA	90302	1093	19	06037	33.97711068	-118.3677329	Los Angeles County
53311	Fee-for-Service	1285889923	1285889923	1	1	WOO, KAREN MD	7/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81758	None	None	0	In state provider	None	200 UCLA MEDICAL PLAZA	SUITE 526	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
53356	Fee-for-Service	1124895164	1124895164	1	1	WILCOX, ISABELLE R CNP	7/19/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	703 E E ST	None	ONTARIO	CA	91764	3820	36	06071	34.068429	-117.6411555	San Bernardino County
53362	Fee-for-Service	1689127722	1689127722	1	1	WINTER, COLLEEN D LMFT	2/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	906 G ST	None	SACRAMENTO	CA	95814	1800	34	06067	38.583468	-121.49289	Sacramento County
53373	Fee-for-Service	1477588432	1477588432	1	1	WILSON, JENNIFER M MD	2/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	235 W 6TH ST	None	RENO	NV	89503	4548	00	None	39.53165987	-119.8181899	Washoe County
53410	Fee-for-Service	1295094167	1295094167	1	1	WU, SUSANA MD	1/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127948	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
53423	Fee-for-Service	1326265893	1326265893	1	1	WANI, OMAR R MD	1/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73464	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
53444	Fee-for-Service	1871695551	1871695551	1	1	WOODLEY, DAVID T MD	8/31/1989	207N00000X	NA	Dermatology	026	PHYSICIANS	67324	07	Dermatology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
53453	Fee-for-Service	1447338256	1447338256	1	1	WERBLIN, ALAN MD	7/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	45529	08	Family Practice	0	In state provider	None	333 ESTUDILLO AVE	None	SAN LEANDRO	CA	94577	4717	01	06001	37.72569478	-122.1533134	Alameda County
53492	Fee-for-Service	1386845162	1386845162	1	1	WASHINGTON, SIERRA L	7/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99781	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
53508	Fee-for-Service	1194898023	1194898023	1	1	WILLIAMS, STEVENS H MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92181	24	Plastic Surgery	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
53516	Fee-for-Service	1043381023	1043381023	1	1	WESLEY, PATRICIA F MD	9/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	56188	36	Psychiatry	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
53526	Fee-for-Service	1346434891	1346434891	1	1	WERNER, HEIDI MD DO	11/3/2017	2080P0204X	NA	Other	026	PHYSICIANS	150511	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
53556	Fee-for-Service	1669644514	1669644514	1	1	WALLACH, SABINA R MD AMC	12/5/2008	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	9850 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1212	37	06073	32.882913	-117.226341	San Diego County
53573	Fee-for-Service	1215498720	1215498720	1	1	WIN, SUSAN MD	4/2/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	177613	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
53628	Fee-for-Service	1154477560	1154477560	1	1	WERBLIN, GAIL F LMFT	3/16/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27595	-	NOT APPLICABLE	0	In state provider	None	5451 LEMON HILL AVE	None	SACRAMENTO	CA	95824	1529	34	06067	38.517192	-121.441284	Sacramento County
53657	Fee-for-Service	1851642565	1851642565	1	1	WILLMON, LISA A LMFT	12/12/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
53689	Fee-for-Service	1881134393	1881134393	1	1	WANG, SICONG MD	6/28/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
53712	Fee-for-Service	1699854554	1699854554	1	1	WOLKE, MICHAEL M MD	1/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	51248	40	Pediatrics	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
53715	Fee-for-Service	1003523614	1003523614	1	1	WELLBEING CARE MANAGEMENT	3/13/2024	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	602 FALCON WAY	None	ROSEVILLE	CA	95661	3606	31	06061	38.73904333	-121.2552592	Placer County
53717	Fee-for-Service	1013247246	1013247246	3	1	WILSON, PAUL J OD	10/11/2021	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	36330 HIDDEN SPRINGS RD.	SUITE A	WILDOMAR	CA	92595	5804	33	06065	33.59339735	-117.2454691	Riverside County
53722	Fee-for-Service	1073510590	1073510590	1	1	WEBSTER, LUCIA R CRNA	12/15/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
53769	Fee-for-Service	1588927602	1588927602	1	1	WYLIE GOMEZ	12/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
53770	Fee-for-Service	1336608603	1336608603	1	1	WALKER, NAOMI E MD	4/5/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182436	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
53790	Fee-for-Service	1821054305	1821054305	1	1	WATUMULL, LORI MERIIL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
53804	Fee-for-Service	1992722128	1992722128	1	1	WAL-MART STORES INC	8/20/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHRMCY 10-3587	1400 LEAD HILL BLVD	None	ROSEVILLE	CA	95661	2949	31	06061	38.7483256	-121.256596	Placer County
53809	Fee-for-Service	1083629091	1083629091	1	1	WALGREEN CO	1/14/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1400 BEAUMONT AVE	None	BEAUMONT	CA	92223	4704	33	06065	33.947496	-116.977181	Riverside County
53820	Fee-for-Service	1023025020	1023025020	1	1	WALGREEN CO	2/7/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9200 ELK GROVE FLORIN RD	None	ELK GROVE	CA	95624	0000	34	06067	38.423097	-121.372128	Sacramento County
53845	Fee-for-Service	1669644514	1669644514	1	1	WALLACH, SABINA R MD AMC	12/5/2008	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	9850 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1212	37	06073	32.882913	-117.226341	San Diego County
53878	Fee-for-Service	1457697963	1457697963	1	1	WILSON, DIANA C LCSW	4/18/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	28156	-	NOT APPLICABLE	0	In state provider	None	950 W JULIAN ST	None	SAN JOSE	CA	95126	2719	43	06085	37.33352455	-121.9089111	Santa Clara County
53910	Fee-for-Service	1285726216	1285726216	1	1	WOLFE, ROBERT N MD	8/1/1993	207RP1001X	NA	Pulmonology	026	PHYSICIANS	32286	01	General Practice	0	In state provider	None	8635 W 3RD ST	STE 475W	LOS ANGELES	CA	90048	6121	19	06037	34.07361928	-118.3803143	Los Angeles County
53919	Fee-for-Service	1285668905	1285668905	1	1	WINOKUR, ROBIN F MD	10/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	47950	40	Pediatrics	0	In state provider	None	1744 ALCATRAZ AVE	None	BERKELEY	CA	94703	2713	01	06001	37.84860565	-122.2722184	Alameda County
53924	Fee-for-Service	1497173389	1497173389	1	1	WIESNER, THEODORE MD	9/18/2018	207P00000X	NA	Other	026	PHYSICIANS	155718	66	Emergency Medicine (Urgent Care)	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
53950	Fee-for-Service	1487669727	1487669727	1	1	WALGREEN CO	3/5/1990	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1138 W TENNYSON RD	None	HAYWARD	CA	94544	4422	01	06001	37.63123947	-122.076639	Alameda County
54028	Fee-for-Service	1336130350	1336130350	1	1	WOODMAN, ROB ROY PHD	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2322 BUTANO DR	STE 108	SACRAMENTO	CA	95825	0687	34	06067	38.606373	-121.3814655	Sacramento County
54044	Fee-for-Service	1164460226	1164460226	1	1	WASHINGTON NEWARK	3/1/1999	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP INC	35500 DUMBARTON CT	None	NEWARK	CA	94560	1127	01	06001	37.54845303	-122.0528	Alameda County
54046	Fee-for-Service	1932691151	1932691151	1	1	WENDT, JOSHUA E MD	9/1/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	163480	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
54111	Fee-for-Service	1366609042	1366609042	1	1	WEISENBERG, SCOTT A MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	60307	77	Infectious Disease	0	In state provider	None	350 30TH STREET	SUITE 320	OAKLAND	CA	94609	3424	01	06001	37.81892183	-122.2640154	Alameda County
54146	Fee-for-Service	1568407427	1568407427	1	2	WILMES-REITZ, MARC E PHD	6/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23945 CALABASAS RD	#202	CALABASAS	CA	91302	1552	19	06037	34.15340482	-118.6490978	Los Angeles County
54189	Fee-for-Service	1780755686	1780755686	1	1	WANG, WILLIAM J MD	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75124	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
54200	Fee-for-Service	1528075389	1528075389	1	1	WILLIAMS, ANDREW S MD	9/30/1988	207W00000X	NA	Ophthalmology	026	PHYSICIANS	56863	18	Ophthalmology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
54218	Fee-for-Service	1558499079	1558499079	1	1	WAGNER, ROBERT G MD	12/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	41235	41	Internal Medicine	0	In state provider	None	2850 SEVENTH ST	STE 100	BERKELEY	CA	94710	2703	01	06001	37.85385944	-122.2920618	Alameda County
54347	Fee-for-Service	1104482132	1104482132	1	1	WORRALL, GARYN MD	10/4/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176742	None	None	0	In state provider	None	2240 MERCURY WAY	None	SANTA ROSA	CA	95407	5413	49	06097	38.421135	-122.752008	Sonoma County
54363	Fee-for-Service	1639177355	1639177355	1	1	WIN, SAN S MD	4/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	77815	41	Internal Medicine	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
54402	Fee-for-Service	1699794602	1699794602	1	1	WATERS, GARY M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	22087	18	Ophthalmology	0	In state provider	None	1122 S ST	None	FRESNO	CA	93721	1430	10	06019	36.74185388	-119.7823667	Fresno County
54403	Fee-for-Service	1740295021	1740295021	1	1	WALGREEN CO.	10/27/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	27951 BASELINE ST	None	HIGHLAND	CA	92346	3346	36	06071	34.12120447	-117.194688	San Bernardino County
54411	Fee-for-Service	1467499145	1467499145	1	1	WANG, WENG-LIH	5/1/1996	207RN0300X	NA	Nephrology	026	PHYSICIANS	48180	45	Nephrology (Renal-Kidney)	0	In state provider	SUITE E	1398 S STATE ST	None	SAN JACINTO	CA	92583	4934	33	06065	33.77367	-116.9719155	Riverside County
54448	Fee-for-Service	1164476198	1164476198	1	1	WONG, ARTHUR MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50295	05	Anesthesiology	0	In state provider	None	301 E 13TH ST	None	MERCED	CA	95340	6211	24	06047	37.29248035	-120.4730619	Merced County
54483	Fee-for-Service	1033267935	1033267935	1	1	WESLEY, JAMES J MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	55937	01	General Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
54529	Fee-for-Service	1053470781	1053470781	1	1	WILKINSON, SANDRA J CNM	12/2/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	13640 ROSCOE BLVD	None	PANORAMA CITY	CA	91402	3904	19	06037	34.22164249	-118.4299965	Los Angeles County
54539	Fee-for-Service	1043260904	1043260904	1	1	WOOD, ROBERT J MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50963	05	Anesthesiology	0	In state provider	None	400 E MAIN ST	STE 200	STOCKTON	CA	95202	3000	39	06077	37.95344497	-121.2852303	San Joaquin County
54564	Fee-for-Service	1962500223	1962500223	1	1	WAN, CHEUNG S MD	1/1/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	34199	18	Ophthalmology	0	In state provider	None	121 S 7TH AVE	STE B	BARSTOW	CA	92311	3036	36	06071	34.89777162	-117.019628	San Bernardino County
54586	Fee-for-Service	1609843259	1609843259	1	1	WOODARD, RONALD D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51835	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1808 VERDUGO BLVD	STE 408	GLENDALE	CA	91208	1488	19	06037	34.2056211	-118.2154553	Los Angeles County
54602	Fee-for-Service	1245686419	1245686419	1	1	WILCOX, MELISSA	9/2/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	151436	08	Family Practice	0	In state provider	None	2210 DEL PASO RD	None	SACRAMENTO	CA	95834	9671	34	06067	38.655189	-121.5091575	Sacramento County
54677	Fee-for-Service	1992142277	1992142277	1	1	WEST SIDE HEALTH CARE	1/12/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	100 E NORTH ST	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
54682	Fee-for-Service	1740369677	1740369677	1	1	WAGNER, LILI Z PSYD	7/14/2003	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	25031 W AVE STANFORD ST	STE 100	VALENCIA	CA	91355	0000	19	06037	34.4377567	-118.5737287	Los Angeles County
54694	Fee-for-Service	1902227192	1902227192	1	1	WINICK, CARA PT	5/15/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	STE 306	SAN DIEGO	CA	92108	4404	37	06073	32.77677653	-117.1592911	San Diego County
54696	Fee-for-Service	1508055948	1508055948	1	1	WEBBER, PAUL T CPO	4/14/2014	222Z00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2012 5TH AVENUE	None	OROVILLE	CA	95965	5815	04	06007	39.50339416	-121.5647848	Butte County
54743	Fee-for-Service	1952914681	1952914681	1	7	WEST COAST KIDNEY	11/23/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1320 EL CAPITAN DR	STE 220	DANVILLE	CA	94526	6260	07	06013	37.78476866	-121.9658691	Contra Costa County
54752	Fee-for-Service	1689691909	1689691909	1	1	WAL-MART STORES INC	1/26/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102697	4893 LONE TREE WAY	None	ANTIOCH	CA	94531	8553	07	06013	37.96179547	-121.761648	Contra Costa County
54771	Fee-for-Service	1033267935	1033267935	1	1	WESLEY, JAMES J MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	55937	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
54815	Fee-for-Service	1508944265	1508944265	1	1	WANG, STEPHEN E MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61029	41	Internal Medicine	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
54855	Fee-for-Service	1669609681	1669609681	1	1	WANG, AUDREY S MD	7/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113188	07	Dermatology	0	In state provider	None	3301 C STREET	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
54920	Fee-for-Service	1568541829	1568541829	1	1	WEST CORNER MED SUPLY	11/26/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	WEST CORNER MED SUPLY	905 D.S. PRAIRIE AVE	None	INGLEWOOD	CA	90301	4118	19	06037	33.9523167	-118.3440211	Los Angeles County
54964	Fee-for-Service	1992142277	1992142277	1	1	WEST SIDE HEALTH CARE	2/1/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	100 E NORTH ST	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
55010	Fee-for-Service	1235391863	1235391863	1	1	WERHO, DAVID K MD	7/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135895	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
55034	Fee-for-Service	1174538458	1174538458	1	1	WALGREEN CO	7/27/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1300 W YOSEMITE AVE	None	MADERA	CA	93637	6320	20	06039	36.95272804	-120.0737193	Madera County
55081	Fee-for-Service	1891795092	1891795092	1	1	WICK, JEFFREY S MD	8/1/2016	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	74695	25	Physical Medicine and Rehabilitation	0	In state provider	None	5001 COMMERCE DR	None	BAKERSFIELD	CA	93309	0648	15	06029	35.36784468	-119.0578744	Kern County
55104	Fee-for-Service	1508944265	1508944265	1	1	WANG, STEPHEN E MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61029	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
55146	Fee-for-Service	1184663650	1184663650	1	1	WOESSNER, KATHARINE M MD	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81801	01	General Practice	0	In state provider	None	10666 N TORREY PINES RD	STE MS317	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
55196	Fee-for-Service	1942296934	1942296934	1	1	WEISS, BENNETT T MD	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	51045	05	Anesthesiology	0	In state provider	None	12101 W WASHINGTON BLVD	None	CULVER CITY	CA	90231	2787	19	06037	33.99745323	-118.4244846	Los Angeles County
55241	Fee-for-Service	1003100306	1003100306	1	1	WLODARCZYK, SUSAN M MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123305	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
55243	Fee-for-Service	1104165224	1104165224	1	1	WYSOCKI, JACEK B MFT	7/8/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	101799	-	NOT APPLICABLE	0	In state provider	None	3580 WILSHIRE BLVD	2000	LOS ANGELES	CA	90010	2521	19	06037	34.06170677	-118.302787	Los Angeles County
55251	Fee-for-Service	1992142277	1992142277	1	1	WEST SIDE HEALTH CARE	1/12/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	100 E NORTH ST	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
55256	Fee-for-Service	1093894883	1093894883	1	1	WHITMORE, RONALD T MD	4/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	57745	08	Family Practice	0	In state provider	None	2580 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	52	06103	40.14842672	-122.2180085	Tehama County
55284	Fee-for-Service	1669412714	1669412714	1	1	WEBSTER, WILLIAM M MD	10/1/1998	207P00000X	NA	Other	026	PHYSICIANS	66945	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4747 ENGLE RD	None	CARMICHAEL	CA	95608	2223	34	06067	38.6320173	-121.3545928	Sacramento County
55299	Fee-for-Service	1235391863	1235391863	1	1	WERHO, DAVID K MD	7/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135895	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
55343	Fee-for-Service	1710035605	1710035605	1	1	WILKS, ARLENE J CRNA	4/20/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
55353	Fee-for-Service	1689920944	1689920944	1	1	WILLIS, ALISON B CNM	2/8/2022	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
55397	Fee-for-Service	1194728451	1194728451	1	1	WRIGHT, B CODY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	BEHAVIORAL HEALTH FMC	1201 N BEAVER ST	None	FLAGSTAFF	AZ	86001	0000	00	None	35.2080984	-111.6455525	Coconino County
55414	Fee-for-Service	1669906897	1669906897	1	1	WORD, SABRINA LCSW	11/14/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
55426	Fee-for-Service	1568803013	1568803013	1	1	WEHBI, ELIAS MD	7/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126481	34	Urology and Urological Surgery	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
55469	Fee-for-Service	1073994463	1073994463	1	1	WEI, DONGGUANG MD	6/24/2021	390200000X	NA	Other	026	PHYSICIANS	150884	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
55494	Fee-for-Service	1457439275	1457439275	1	1	WILEY, WILLIAM L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41206	01	General Practice	0	In state provider	None	3284 JEFFERSON ST	None	NAPA	CA	94558	3436	28	06055	38.32147532	-122.2994954	Napa County
55495	Fee-for-Service	1205126505	1205126505	1	1	WEN, AKI Y DO	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12555	01	General Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
55542	Fee-for-Service	1992142277	1992142277	1	1	WEST SIDE HEALTH CARE	12/19/2017	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	100 E NORTH ST	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
55572	Fee-for-Service	1528327566	1528327566	1	1	WOO, SUNEE S MD	12/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123566	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
55623	Fee-for-Service	1215321591	1215321591	1	1	WOOD, SAMANTHA LMFT	7/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
55687	Fee-for-Service	1780914093	1780914093	1	1	WILSON, TOSCA L LCSW	12/7/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
55695	Fee-for-Service	1154911014	1154911014	1	1	WATERS, KARRIE NP	3/18/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	19	06037	34.18784988	-118.6427021	Los Angeles County
55743	Fee-for-Service	1598843070	1598843070	1	1	WEN, HUI-SHAN A MD	10/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9083	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
55746	Fee-for-Service	1407130602	1407130602	1	1	WALKER DIALYSIS LLC	4/10/2012	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2599 STEVENSON STREET	None	FREMONT	CA	94538	2315	01	06001	37.55077762	-121.9723823	Alameda County
55754	Fee-for-Service	1043686744	1043686744	1	1	WALKER, STACIE L CNM	3/22/2023	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1095 MARSHALL WAY	2N FL	PLACERVILLE	CA	95667	5722	09	06017	38.7257686	-120.7910663	El Dorado County
55818	Fee-for-Service	1407625734	1407625734	1	1	WRIGHT, NYEEMA DOULA	1/17/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
55850	Fee-for-Service	1093895724	1093895724	1	1	WIMBERLY, ROBERT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
55870	Fee-for-Service	1356646178	1356646178	1	1	WALGREEN CO.	4/4/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14280 SAN PABLO BLVD	None	SAN PABLO	CA	94806	3328	07	06013	37.96470576	-122.3451289	Contra Costa County
55938	Fee-for-Service	1699833012	1699833012	1	1	WEISS, JEFFREY S MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138264	02	General Surgery	0	In state provider	None	4077 FIFTH AVENUE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
56039	Fee-for-Service	1407161920	1407161920	1	1	WALKER DIALYSIS LLC	4/28/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1661 INDUSTRIAL PKWY W	None	HAYWARD	CA	94544	7046	01	06001	37.61768736	-122.0681226	Alameda County
56090	Fee-for-Service	1447483540	1447483540	1	1	WILLIAMS, TREVOR R MD	9/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122117	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
56130	Fee-for-Service	1871814558	1871814558	1	1	WONG, PETER B MD	11/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129279	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
56142	Fee-for-Service	1316072788	1316072788	1	1	WANG, LUCASE H MD	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91742	40	Pediatrics	0	In state provider	None	2450 SISTER MARY COLUMBA	None	RED BLUFF	CA	91754	1746	52	06103	40.14921426	-122.2216794	Tehama County
56143	Fee-for-Service	1770658346	1770658346	1	1	WEST EAST ADVANCED CARE	1/4/2016	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER	8341 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92844	1145	30	06059	33.7739121	-117.9872532	Orange County
56194	Fee-for-Service	1346505625	1346505625	1	1	WAL-MART STORES INC	6/12/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	255 LINCOLN BLVD	None	LINCOLN	CA	95648	1880	31	06061	38.88863771	-121.2927826	Placer County
56242	Fee-for-Service	1568694735	1568694735	1	1	WALZ, MICHELLE L LMFT	8/29/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8037 FAIR OAKS BLVD	STE 112	CARMICHAEL	CA	95608	6742	34	06067	38.63691	-121.3149555	Sacramento County
56276	Fee-for-Service	1871584227	1871584227	1	1	WONG, DAVID W MD	3/1/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	40576	None	None	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
56298	Fee-for-Service	1326054370	1326054370	1	1	WU, HELEN M MD	11/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87788	None	None	0	In state provider	None	607 N CENTRAL AVE	STE 105	GLENDALE	CA	91203	1804	19	06037	34.153974	-118.2579675	Los Angeles County
56303	Fee-for-Service	1144583444	1144583444	1	1	WEST, RYENN L MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128534	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
56388	Fee-for-Service	1265787972	1265787972	1	1	WALLS, JAMES E MD	10/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122114	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
56399	Fee-for-Service	1972185098	1972185098	1	1	WILKINS, ALLISON	11/22/2022	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	SUITE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
56408	Fee-for-Service	1114300548	1114300548	1	1	WANG, JEFFREY	8/17/2023	207R00000X	NA	Other	026	PHYSICIANS	20772	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
56431	Fee-for-Service	1558681213	1558681213	1	1	WANG, JEFFREY S MD	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129356	77	Infectious Disease	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
56504	Fee-for-Service	1801562426	1801562426	1	1	WELLSPRING SENIOR HOME CARE	5/22/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7261 SUNBREEZE DRIVE	None	HUNTINGTON BEACH	CA	92647	6270	30	06059	33.70923186	-118.001063	Orange County
56505	Fee-for-Service	1871987156	1871987156	1	1	WHISENHUNT, JAMES D MD	4/7/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	141180	-	NOT APPLICABLE	0	In state provider	None	1002 PICO BLVD	None	SANTA MONICA	CA	90405	1326	19	06037	34.01333344	-118.4809119	Los Angeles County
56527	Fee-for-Service	1528108834	1528108834	1	1	WAHL, LAURA A LMFT	1/31/2019	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
56528	Fee-for-Service	1285708024	1285708024	1	1	WONG, MIMI K PHD	4/8/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1411 EAST 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
56592	Fee-for-Service	1942215231	1942215231	1	1	WALGREEN CO	3/5/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4200 ARDEN WAY	None	SACRAMENTO	CA	95864	3021	34	06067	38.595015	-121.365306	Sacramento County
56604	Fee-for-Service	1558803650	1558803650	1	1	WELKER, KATHERINE G	10/14/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1300 SHAW	SUITE 109	FRESNO	CA	93710	7917	10	06019	36.80872147	-119.765979	Fresno County
56617	Fee-for-Service	1184933418	1184933418	1	1	WESTON, STEPHEN D MD	7/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121350	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
56685	Fee-for-Service	1902149271	1902149271	1	1	WU, PENG MD	7/22/2019	2080P0207X	NA	Hematology	026	PHYSICIANS	137127	68	Hematology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
56740	Fee-for-Service	1780759449	1780759449	1	1	WALTER, FRANK G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
56741	Fee-for-Service	1417205527	1417205527	1	1	WHITESIDE, BRIAN J NP	12/7/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	23511	-	NOT APPLICABLE	0	In state provider	None	1400 EMELINE AVENUE	BUILDING K	SANTA CRUZ	CA	95060	1976	44	06087	36.99276804	-122.0178271	Santa Cruz County
56772	Fee-for-Service	1033136361	1033136361	1	1	WAL-MART STORES INC.	3/15/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY10-2479	3412 COLLEGE AVE	None	SAN DIEGO	CA	92115	7134	37	06073	32.741586	-117.0536265	San Diego County
56781	Fee-for-Service	1538186770	1538186770	1	1	WAL-MART STORES INC	5/3/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHRMCY 10-3523	26471 CARL BOYER DR	None	SANTA CLARITA	CA	91350	2996	19	06037	34.41445746	-118.5047459	Los Angeles County
56787	Fee-for-Service	1124045547	1124045547	1	1	WAL-MART STORES, INC	12/14/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101903	935 THARP RD	None	YUBA CITY	CA	95993	8998	51	06101	39.138921	-121.6485045	Sutter County
56801	Fee-for-Service	1689109274	1689109274	1	1	WILHELM, KELSEY E MD	10/13/2021	207P00000X	NA	Other	026	PHYSICIANS	158152	None	None	0	In state provider	None	13100 STUDEBAKER ROAD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
56884	Fee-for-Service	1700398641	1700398641	1	1	WILCOX, COLLEEN M LPCC	10/1/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
56913	Fee-for-Service	1972669919	1972669919	1	1	WONG, SUNNY MD	5/29/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	52331	10	Gastroenterology (M.D. only)	0	In state provider	None	328 S. FIRST ST	F	ALHAMBRA	CA	91801	3790	19	06037	34.09104553	-118.1252904	Los Angeles County
56932	Fee-for-Service	1932114261	1932114261	1	1	WALGREEN CO	7/5/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5467 WILSHIRE BLVD	None	LOS ANGELES	CA	90036	4219	19	06037	34.06233905	-118.3479771	Los Angeles County
56957	Fee-for-Service	1821611724	1821611724	1	1	WOO, JESSICA G NP	2/5/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 ESCUELA DRIVE	None	DALY CITY	CA	94015	4003	41	06081	37.67441047	-122.4762435	San Mateo County
56972	Fee-for-Service	1902149271	1902149271	1	1	WU, PENG MD	7/22/2019	2080P0207X	NA	Hematology	026	PHYSICIANS	137127	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
57054	Fee-for-Service	1598134843	1598134843	1	1	WARSH, JOEL M MD	6/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136175	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
57079	Fee-for-Service	1558624072	1558624072	1	1	WANG, GLORIA Y MD	8/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140555	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
57107	Fee-for-Service	1477768455	1477768455	1	1	WEBSTER, CHRISTOPHER P	10/27/2014	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
57139	Fee-for-Service	1942460217	1942460217	1	1	WALGREEN CO.	9/17/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11930 STUDEBAKER RD	None	NORWALK	CA	90650	7548	19	06037	33.92251077	-118.0991696	Los Angeles County
57151	Fee-for-Service	1295758399	1295758399	1	1	WALZ, WILLIAM C MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80113	05	Anesthesiology	0	In state provider	None	2701 W ALAMEDA AVE	STE 203	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
57156	Fee-for-Service	1649352675	1649352675	1	1	WOHLERT, LIBIA E MD	5/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101093	08	Family Practice	0	In state provider	None	1770 N ORANGE GROVE AVE	STE 101	POMONA	CA	91767	3027	19	06037	34.07637624	-117.7492622	Los Angeles County
57210	Fee-for-Service	1932247400	1932247400	1	1	WELCH, JOHN R MD	9/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97609	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
57212	Fee-for-Service	1639260649	1639260649	1	1	WILLIAM N HAGEN	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1200 S COLUMBIA RD	None	GRAND FORKS	ND	58201	4036	00	None	47.910609	-97.06647551	Grand Forks County
57217	Fee-for-Service	1962417246	1962417246	1	1	WALGREEN CO.	8/30/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2995 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3535	07	06013	37.92663556	-122.0164121	Contra Costa County
57237	Fee-for-Service	1225182181	1225182181	1	1	WHITE, DAVID N MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39211	01	General Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
57246	Fee-for-Service	1861229411	1861229411	1	1	WEST, DYLAN NP	1/2/2025	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
57429	Fee-for-Service	1316150717	1316150717	1	1	WEINER, JERROLD LCSW	4/16/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	330 FLUME ST	STE 110	CHICO	CA	95928	5400	04	06007	39.73048207	-121.8372333	Butte County
57441	Fee-for-Service	1265525935	1265525935	1	1	WESTERN MEDICAL CENTER	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	TRAUMA GROUP INC	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3577	30	06059	33.75363187	-117.8341886	Orange County
57470	Fee-for-Service	1104115294	1104115294	1	1	WALTMAN, BELINDA A MD	5/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122907	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
57485	Fee-for-Service	1538606736	1538606736	1	1	WOUBESHET, RAHEL LMFT	6/1/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
57495	Fee-for-Service	1689061400	1689061400	1	1	WAILES, DUSTIN H MD	9/9/2022	207L00000X	NA	Other	026	PHYSICIANS	144788	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
57501	Fee-for-Service	1184041360	1184041360	1	1	WOODS, JEREMY D MD	12/5/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	141789	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
57523	Fee-for-Service	1225182181	1225182181	1	1	WHITE, DAVID N MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39211	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
57543	Fee-for-Service	1467740571	1467740571	1	1	WELCH, DAVID L PHD	10/13/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	17646	-	NOT APPLICABLE	0	In state provider	None	2900 BRISTOL STREET	SUITE E103	COSTA MESA	CA	92626	7906	30	06059	33.67689875	-117.8872016	Orange County
57588	Fee-for-Service	1568787026	1568787026	1	1	WALL, EMMA K MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137109	36	Psychiatry	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	8631	19	06037	34.07067	-118.4432445	Los Angeles County
57595	Fee-for-Service	1750319273	1750319273	1	1	WELLS, JESSE A MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84768	66	Emergency Medicine (Urgent Care)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
57621	Fee-for-Service	1932146719	1932146719	1	1	WATKINS, CHAWN L MD	10/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	53380	40	Pediatrics	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
57633	Fee-for-Service	1437113313	1437113313	1	1	WILLIAMS, VERNON B MD	4/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84209	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
57641	Fee-for-Service	1043362015	1043362015	1	1	WU, PEARL GRACE	8/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77630	01	General Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
57678	Fee-for-Service	1750308094	1750308094	1	1	WAL-MART STORES INC	2/23/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-2925	681 LINCOLN AVE	None	NAPA	CA	94558	3612	28	06055	38.31021155	-122.283477	Napa County
57687	Fee-for-Service	1932590957	1932590957	1	1	WIDULE, CLAIRE C MD	9/7/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
57690	Fee-for-Service	1790793289	1790793289	1	1	WANG, MAY LI MD	1/3/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	64130	40	Pediatrics	0	In state provider	None	11245 LOWER AZUSA RD	None	EL MONTE	CA	91731	1411	19	06037	34.09163095	-118.0213554	Los Angeles County
57728	Fee-for-Service	1265525935	1265525935	1	1	WESTERN MEDICAL CENTER	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	89	Surgery-Traumatic	0	In state provider	TRAUMA GROUP INC	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3577	30	06059	33.75363187	-117.8341886	Orange County
57778	Fee-for-Service	1609079664	1609079664	1	1	WADE AUSTIN-GETSFRID MD	3/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	530 BOGACHIEL WAY	None	FORKS	WA	98331	9120	00	None	47.946141	-124.3931915	Clallam County
57854	Fee-for-Service	1326277385	1326277385	1	1	WALIA, SALONI MD	7/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	134118	22	Pathology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06269295	-118.2030006	Los Angeles County
57862	Fee-for-Service	1265456636	1265456636	1	2	WINKLER, HEIDI A MD	3/12/2021	208000000X	NA	Pediatric Primary Care	086	MEDICAL DIRECTORS	50311	-	NOT APPLICABLE	0	In state provider	None	10210 ORR AND DAY RD	STE B	SANTA FE SPRINGS	CA	90670	3581	19	06037	33.94432489	-118.090377	Los Angeles County
57877	Fee-for-Service	1851306146	1851306146	1	1	WALGREEN CO	5/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #06017	2840 W AVENUE L	None	LANCASTER	CA	93536	4006	19	06037	34.6602533	-118.1827153	Los Angeles County
57880	Fee-for-Service	1467547398	1467547398	1	1	WAKABAYASHI, MARK MD	5/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	71305	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
57881	Fee-for-Service	1861551350	1861551350	1	1	WIDTFELDT, ARTHUR F JR DPM	7/20/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
57896	Fee-for-Service	1013951524	1013951524	1	1	WALKER,CHRISTY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4301 W MARKHAM	SLOT 783	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
57902	Fee-for-Service	1396155446	1396155446	1	1	WIETSTOCK, SHARON O MD	6/5/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	141854	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
57904	Fee-for-Service	1922018670	1922018670	1	1	WASHINGTON, STEVEN A MD	3/31/1991	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	60260	01	General Practice	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
57926	Fee-for-Service	1376570473	1376570473	1	1	WILLOW CREEK/SIX RIVERS	4/7/1994	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	PO BOX 1045	HWY 96	None	WILLOW CREEK	CA	95573	1045	12	06023	40.99466457	-123.6316897	Humboldt County
57943	Fee-for-Service	1649359001	1649359001	1	1	WALL, CYNTHIA LYNN LCSW	7/2/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	30077 SIMPSON LN	None	FORT BRAGG	CA	95437	7759	23	06045	39.39206565	-123.7658956	Mendocino County
57955	Fee-for-Service	1275563462	1275563462	1	1	WATANAKUNAKORN, PAUL W MD	7/29/2022	207R00000X	NA	Other	026	PHYSICIANS	169005	None	None	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
58025	Fee-for-Service	1154315034	1154315034	1	1	WONG, BUU KIM DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	CARSON FOOT CLINIC	500 E CARSON ST	STE 112	CARSON	CA	90745	2792	19	06037	33.83155692	-118.2676378	Los Angeles County
58124	Fee-for-Service	1376781765	1376781765	1	1	W MAIER INC	7/7/2009	193200000X	NA	Other	026	PHYSICIANS	82114	01	General Practice	0	In state provider	None	29099 HOSPITAL RD	STE 112	LAKE ARROWHEAD	CA	92352	0000	36	06071	34.26652661	-117.1690546	San Bernardino County
58147	Fee-for-Service	1477558195	1477558195	1	1	WOLFF, ROBERT S MD	1/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	SIERRA NEVADA EYE CTR	907 MOUNTAIN ST	None	CARSON CITY	NV	89703	3819	00	None	39.169449	-119.772423	Consolidated Municipality of Carson City
58170	Fee-for-Service	1467547398	1467547398	1	1	WAKABAYASHI, MARK MD	5/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	71305	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
58177	Fee-for-Service	1427049816	1427049816	1	1	WOODLAND CARE CTR, LLC	8/15/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	7120 CORBIN AVE	None	RESEDA	CA	91335	3618	19	06037	34.20018	-118.5622135	Los Angeles County
58183	Fee-for-Service	1740332972	1740332972	1	1	WINTER, KAREN	3/12/2025	207R00000X	NA	Other	026	PHYSICIANS	9539	41	Internal Medicine	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
58184	Fee-for-Service	1205098456	1205098456	1	1	WOLFSOHN, JOSHUA B DO	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11186	77	Infectious Disease	0	In state provider	None	1100 W GONZALES RD	STE 110	OXNARD	CA	93036	3379	56	06111	34.21910048	-119.1907575	Ventura County
58192	Fee-for-Service	1922018670	1922018670	1	1	WASHINGTON, STEVEN A MD	3/31/1991	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	60260	08	Family Practice	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
58215	Fee-for-Service	1376570473	1376570473	1	1	WILLOW CREEK/SIX RIVERS	10/6/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	PO BOX 1045	HWY 96	None	WILLOW CREEK	CA	95573	1045	12	06023	40.99466457	-123.6316897	Humboldt County
58274	Fee-for-Service	1740749530	1740749530	1	1	WONG, SAMSON DO	9/1/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19822	None	None	0	In state provider	None	905 MAPLE ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48767797	-122.223049	San Mateo County
58337	Fee-for-Service	1992716740	1992716740	1	1	WODECKI, ANDREW E OD	5/1/1998	152WL0500X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	225 LAUREL AVE	None	PACIFIC GROVE	CA	93950	3651	27	06053	36.61721911	-121.90931	Monterey County
58351	Fee-for-Service	1629161971	1629161971	1	1	WILKIE, HAROLD W JR MD	2/15/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	32679	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1150 SIR FRANCIS DRAKE	None	ROSS	CA	94957	0000	21	06041	37.96435082	-122.5571311	Marin County
58357	Fee-for-Service	1396881033	1396881033	1	1	WINDSOR ELMHAVEN CARE CENTER	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	6940 PACIFIC AVE	None	STOCKTON	CA	95207	2602	39	06077	38.01336589	-121.3212507	San Joaquin County
58381	Fee-for-Service	1790988699	1790988699	1	1	WALKER, XANTHIPPE B LMFT	5/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
58410	Fee-for-Service	1376781765	1376781765	1	1	W MAIER INC	7/7/2009	193200000X	NA	Other	026	PHYSICIANS	82114	66	Emergency Medicine (Urgent Care)	0	In state provider	None	29099 HOSPITAL RD	STE 112	LAKE ARROWHEAD	CA	92352	0000	36	06071	34.26652661	-117.1690546	San Bernardino County
58462	Fee-for-Service	1659336402	1659336402	1	1	WONG, JOHN MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	51406	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
58502	Fee-for-Service	1376570473	1376570473	1	1	WILLOW CREEK/SIX RIVERS	4/7/1994	261QR1300X	NA	Rural Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	PO BOX 1045	HWY 96	None	WILLOW CREEK	CA	95573	1045	12	06023	40.99466457	-123.6316897	Humboldt County
58565	Fee-for-Service	1992982995	1992982995	1	1	WANG, MICHELLE B CRNA	4/11/2008	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
58586	Fee-for-Service	1609056589	1609056589	1	1	WATERMAN, RUTH S MD	8/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126692	05	Anesthesiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
58594	Fee-for-Service	1477020915	1477020915	1	1	WATSON, TIA B NP	1/7/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
58607	Fee-for-Service	1811047525	1811047525	1	1	WONG, TERRENCE C MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	56275	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
58672	Fee-for-Service	1861716953	1861716953	1	1	WIRGA, ALEKSANDRA MD INC	2/24/2011	2084P0800X	NA	Psychiatry	026	PHYSICIANS	74338	36	Psychiatry	0	In state provider	None	3505 LONG BEACH BLVD	STE 2D	LONG BEACH	CA	90807	3992	19	06037	33.82054429	-118.1893881	Los Angeles County
58694	Fee-for-Service	1992775480	1992775480	1	1	WILLIAM H.VETTER, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1102 E LOCUST ST	None	EMMETT	ID	83617	2713	00	None	43.87907647	-116.4858255	Gem County
58706	Fee-for-Service	1568407427	1568407427	1	1	WILMES-REITZ, MARC E PHD	6/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23945 CALABASAS RD	#202	CALABASAS	CA	91302	1552	19	06037	34.15340482	-118.6490978	Los Angeles County
58837	Fee-for-Service	1942215215	1942215215	1	1	WALGREEN CO	9/30/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15650 SAN PABLO AVE	None	SAN PABLO	CA	94806	1240	07	06013	37.99152486	-122.3319602	Contra Costa County
58842	Fee-for-Service	1841207842	1841207842	1	1	WALGREENS CO	4/25/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	191 E YORBA LINDA BLVD	None	PLACENTIA	CA	92870	3328	30	06059	33.88786443	-117.8638701	Orange County
58867	Fee-for-Service	1548356587	1548356587	1	1	WALTON, MARY D LMFT	9/29/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	17822 BEACH BLVD	278	HUNTINGTON BEACH	CA	92647	7180	30	06059	33.70331388	-117.9890471	Orange County
58868	Fee-for-Service	1154764769	1154764769	1	1	WELCARE PHARMACY INC	5/23/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1921 W SAN MARCOS BLVD	STE 140	SAN MARCOS	CA	92078	3906	37	06073	33.13192309	-117.2098658	San Diego County
58897	Fee-for-Service	1811047525	1811047525	1	1	WONG, TERRENCE C MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	56275	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
58926	Fee-for-Service	1023541778	1023541778	1	1	WATSON, KATHERINE L	7/12/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	206 N JACKSON ST	STE 202	GLENDALE	CA	91206	4330	19	06037	34.14852285	-118.2501237	Los Angeles County
58931	Fee-for-Service	1679519649	1679519649	1	1	WILKENS, KENNETH J MD	5/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80116	20	Orthopedic Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
58987	Fee-for-Service	1669913984	1669913984	1	1	WANG, WILLIAM MD	10/16/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	185166	None	None	0	In state provider	None	905 MAPLE ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48767797	-122.223049	San Mateo County
58996	Fee-for-Service	1336130087	1336130087	1	1	WAGNER, MARK A DO	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	5259	30	Radiology	0	In state provider	None	2740 M ST	None	MERCED	CA	95340	2813	24	06047	37.31239905	-120.478839	Merced County
59019	Fee-for-Service	1578943569	1578943569	1	1	WONG, ANDREW L MD	3/7/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	148406	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
59037	Fee-for-Service	1225043516	1225043516	1	1	WALGREEN CO.	3/20/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18515 DEVONSHIRE ST	None	NORTHRIDGE	CA	91324	1308	19	06037	34.25728349	-118.536615	Los Angeles County
59051	Fee-for-Service	1992256523	1992256523	1	1	WOO, GARRETT PT	6/1/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
59058	Fee-for-Service	1649403726	1649403726	1	1	WEINRICH, DEBRA D LCSW	12/17/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10 DECLARATION DRIVE	SUITE B	CHICO	CA	95973	4931	04	06007	39.7706355	-121.8743732	Butte County
59073	Fee-for-Service	1073693354	1073693354	1	1	WORN, VIVIAN E MD	4/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	79284	40	Pediatrics	0	In state provider	None	510-D CYPRESS ST	None	FORT BRAGG	CA	95437	5411	23	06045	39.43260152	-123.798942	Mendocino County
59126	Fee-for-Service	1386654200	1386654200	1	1	WONG, DAVID MD	7/17/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	71461	10	Gastroenterology (M.D. only)	0	In state provider	None	5801 NORRIS CANYON RD	230	SAN RAMON	CA	94583	5440	07	06013	37.77806921	-121.9581994	Contra Costa County
59132	Fee-for-Service	1811345556	1811345556	1	1	WALSH, MAURA E MD	7/19/2021	207P00000X	NA	Other	026	PHYSICIANS	173058	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
59133	Fee-for-Service	1245319276	1245319276	1	1	WYSOCKI, STEVE PHD	8/21/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
59146	Fee-for-Service	1124161872	1124161872	1	1	WAGNER, LLOYD D MD	10/31/1996	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	70226	None	None	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
59193	Fee-for-Service	1922295179	1922295179	1	1	WHITING, STEVE LMFT	11/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 E REDLANDS BLVD	None	REDLANDS	CA	92373	4775	36	06071	34.05731952	-117.181197	San Bernardino County
59201	Fee-for-Service	1467816819	1467816819	1	1	WHITE, ZENA T MD	9/15/2021	390200000X	NA	Other	026	PHYSICIANS	157315	None	None	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
59235	Fee-for-Service	1780147389	1780147389	1	1	WONG, JOHNSON C MD	8/22/2022	207R00000X	NA	Other	026	PHYSICIANS	19991	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
59236	Fee-for-Service	1861513061	1861513061	1	1	WEISS, WILLIAM E PT	12/15/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
59246	Fee-for-Service	1053403402	1053403402	1	1	WA FOOTE MEMORIAL HOSPITAL	7/15/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	205 N EAST AVE	None	JACKSON	MI	49201	1753	00	None	42.25035275	-84.39360669	Jackson County
59279	Fee-for-Service	1811057698	1811057698	1	1	WOODARD, KIMBERLI A	3/28/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	116 S LASSEN ST	None	WILLOWS	CA	95988	3009	11	06021	39.52027795	-122.1995617	Glenn County
59289	Fee-for-Service	1700327061	1700327061	1	1	WALLACE, DAVID W MD	7/11/2022	207L00000X	NA	Other	026	PHYSICIANS	158148	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
59316	Fee-for-Service	1669430468	1669430468	1	1	WILSON, MAURICE E MD	4/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	59382	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
59334	Fee-for-Service	1518234889	1518234889	1	1	WELTY, CARSON MD	8/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118872	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
59350	Fee-for-Service	1306409537	1306409537	1	1	WILLIAMSON, BRIANNA N MD	1/21/2025	2081H0002X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	186681	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
59360	Fee-for-Service	1780601104	1780601104	1	1	WAL-MART PHARMACY	9/27/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#10-2277	323 W SHAW AVE	None	CLOVIS	CA	93612	3604	10	06019	36.811269	-119.7169785	Fresno County
59362	Fee-for-Service	1073693354	1073693354	1	1	WORN, VIVIAN E MD	4/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	79284	01	General Practice	0	In state provider	None	510-D CYPRESS ST	None	FORT BRAGG	CA	95437	5411	23	06045	39.43260152	-123.798942	Mendocino County
59401	Fee-for-Service	1619992781	1619992781	1	1	WIGGINS, MICHAEL H MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55160	None	None	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
59438	Fee-for-Service	1003994849	1003994849	1	1	WOOD, JOHN S MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67525	01	General Practice	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
59483	Fee-for-Service	1205895067	1205895067	1	1	WILLIAMS, DANA I MD	11/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
59489	Fee-for-Service	1346293958	1346293958	1	1	WEISMAN, ROBERT A MD	1/31/1988	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	28603	04	Otology, Laryngology, Rhinology	0	In state provider	None	39000 BOB HOPE DR	STE W301	RANCHO MIRAGE	CA	92270	7036	33	06065	33.763572	-116.4056895	Riverside County
59499	Fee-for-Service	1417450214	1417450214	1	1	WEI, MONICA MD	10/18/2023	207RR0500X	NA	Other	026	PHYSICIANS	189352	None	None	0	In state provider	None	1450 TREAT BLVD	STE 200	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
59506	Fee-for-Service	1114028404	1114028404	1	1	WANG, ALLAN M MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	89518	41	Internal Medicine	0	In state provider	None	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
59508	Fee-for-Service	1770045650	1770045650	1	1	WONG, STEPHANIE M MD	10/19/2022	208M00000X	NA	Other	026	PHYSICIANS	180409	None	None	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
59527	Fee-for-Service	1831106525	1831106525	1	1	WU, LI-CHIH MD	6/3/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41762	34	Urology and Urological Surgery	0	In state provider	None	600 N GARFIELD AVE	STE 204	MONTEREY PARK	CA	91754	1169	19	06037	34.06820797	-118.1228835	Los Angeles County
59533	Fee-for-Service	1053403402	1053403402	1	1	WA FOOTE MEMORIAL HOSPITAL	7/15/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	205 N EAST AVE	None	JACKSON	MI	49201	1753	00	None	42.25035275	-84.39360669	Jackson County
59576	Fee-for-Service	1477553444	1477553444	1	1	WONG, BILL NAM MD	6/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48992	None	None	0	In state provider	SUITE 140	5575 W LAS POSITAS BLVD	STE 130	PLEASANTON	CA	94588	5800	01	06001	37.69214859	-121.8796532	Alameda County
59591	Fee-for-Service	1043624836	1043624836	1	1	WELLS, BRENT R OD	10/5/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1112 VINE ST	None	PASO ROBLES	CA	93446	5505	40	06079	35.62602516	-120.6938682	San Luis Obispo County
59629	Fee-for-Service	1518074160	1518074160	1	1	WAGONER, GENESA R MD	7/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77273	66	Emergency Medicine (Urgent Care)	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
59632	Fee-for-Service	1699018598	1699018598	1	1	WONG, JONATHAN K S MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132175	40	Pediatrics	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
59642	Fee-for-Service	1851929442	1851929442	1	1	WONG, STEPHANIE MD	4/3/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187481	70	Clinic (mixed specialty)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
59658	Fee-for-Service	1902326705	1902326705	1	1	WETLE, LAURA E LMFT	8/6/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	120594	-	NOT APPLICABLE	0	In state provider	None	1207 EAST FRUIT STREET	BUILDING B	SANTA ANA	CA	92701	4206	30	06059	33.75238847	-117.8539245	Orange County
59680	Fee-for-Service	1629680970	1629680970	1	1	WILLIS, ASHLEY K LCSW	9/19/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	256 CAJON ST	SUITE E	REDLANDS	CA	92373	5278	36	06071	34.05204454	-117.1802319	San Bernardino County
59681	Fee-for-Service	1720217979	1720217979	1	1	WALID, SHEREAF	12/26/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	33423 N 32ND AVE	None	PHOENIX	AZ	85085	8874	00	None	33.786909	-112.129047	Maricopa County
59700	Fee-for-Service	1922545342	1922545342	1	1	WELCOME PHARMACY GROUP INC	11/19/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	828 EAST VALLEY BLVD	STE B	SAN GABRIEL	CA	91776	3699	19	06037	34.08018612	-118.0895417	Los Angeles County
59747	Fee-for-Service	1497827190	1497827190	1	1	WALGREEN CO	3/13/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 E VISTA CHINO	None	PALM SPRINGS	CA	92262	3511	33	06065	33.84486346	-116.5274865	Riverside County
59780	Fee-for-Service	1043715840	1043715840	1	1	WILLIAMS, DENNIS LMFT	3/14/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	440 E COMMONWEALTH AVE S	None	FULLERTON	CA	92832	2014	30	06059	33.87038647	-117.9159885	Orange County
59918	Fee-for-Service	1518074160	1518074160	1	1	WAGONER, GENESA R MD	7/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77273	40	Pediatrics	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
59931	Fee-for-Service	1851929442	1851929442	1	1	WONG, STEPHANIE MD	4/3/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187481	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
59988	Fee-for-Service	1487485470	1487485470	1	1	WANG, JESSICA CNP	1/21/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	888 S BREA CANYON RD	STE 330	DIAMOND BAR	CA	91789	3059	19	06037	34.00137763	-117.8453859	Los Angeles County
60061	Fee-for-Service	1982781852	1982781852	1	1	WEATHERFORD TEXAS HOSPITAL	12/27/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	713 E ANDERSON ST	None	WEATHERFORD	TX	76086	5705	00	None	32.74749946	-97.7856735	Parker County
60085	Fee-for-Service	1841468717	1841468717	1	1	WANG, WENDA	10/26/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
60116	Fee-for-Service	1134199946	1134199946	2	1	WONG, DEREK ALAN, MD	2/18/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	73118	01	General Practice	0	In state provider	None	544 N GLENDALE AVE	STE D	GLENDALE	CA	91206	3311	19	06037	34.15454904	-118.2429872	Los Angeles County
60150	Fee-for-Service	1043213242	1043213242	1	1	WAGREICH, CARL R DPM	9/28/2009	261QP1100X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	PROFESSIONAL CORPORATION	23451 MADISON ST	STE 230	TORRANCE	CA	90505	4761	19	06037	33.81197627	-118.3478154	Los Angeles County
60204	Fee-for-Service	1730285370	1730285370	1	1	WALLEN, JASON M MD	6/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81230	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
60245	Fee-for-Service	1285825455	1285825455	1	1	WILLIAMS, JERI Y MD	6/2/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	120399	None	None	0	In state provider	None	8327 BRIMHALL ROAD	SUITE 703	BAKERSFIELD	CA	93312	4048	15	06029	35.36876659	-119.0959355	Kern County
60273	Fee-for-Service	1790983401	1790983401	1	1	WEINSTEIN, JENNIFER F PSYD	5/18/2020	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
60291	Fee-for-Service	1669655650	1669655650	1	1	WHITLOCK, PATRICK W MD	7/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125226	20	Orthopedic Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
60307	Fee-for-Service	1568407377	1568407377	1	2	WOLSTAN, BARRY J MD	1/31/2017	207W00000X	NA	Ophthalmology	026	PHYSICIANS	30536	18	Ophthalmology	0	In state provider	None	23600 TELO AVE	SUITE 100	TORRANCE	CA	90505	4035	19	06037	33.81215054	-118.3384029	Los Angeles County
60348	Fee-for-Service	1982781852	1982781852	1	1	WEATHERFORD TEXAS HOSPITAL	10/1/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	713 E ANDERSON ST	None	WEATHERFORD	TX	76086	5705	00	None	32.74749946	-97.7856735	Parker County
60376	Fee-for-Service	1306482344	1306482344	1	1	WILLIS, LESTER CNP	2/18/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7067 N MARIPOSA	103	FRESNO	CA	93720	2988	10	06019	36.838944	-119.7792995	Fresno County
60407	Fee-for-Service	1548726789	1548726789	1	1	WAUCHOPE, ARIEL M CNP	4/20/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4829 CLAIREMONT DR	None	SAN DIEGO	CA	92117	2706	37	06073	32.83175462	-117.2052088	San Diego County
60422	Fee-for-Service	1801123914	1801123914	1	1	WEGRZYN, TAMMY NP	7/24/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3634 ELIZABETH ST	None	RIVERSIDE	CA	92506	2506	33	06065	33.95782448	-117.3904065	Riverside County
60431	Fee-for-Service	1588159370	1588159370	1	1	WILSON, MELINDA PHD	11/16/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1819 CLIFF DR	F	SANTA BARBARA	CA	93109	1650	42	06083	34.40137954	-119.7214154	Santa Barbara County
60458	Fee-for-Service	1013593839	1013593839	1	1	WAYMENT, ANDREW MD	11/14/2023	207P00000X	NA	Other	026	PHYSICIANS	189388	None	None	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
60467	Fee-for-Service	1679941983	1679941983	1	1	WILKINS, MICHELE PSY D A	9/7/2016	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYCHOLOGICAL CORP	3171 LOS FELIZ BLVD	STE 311-B	LOS ANGELES	CA	90039	1537	19	06037	34.12369709	-118.2682266	Los Angeles County
60485	Fee-for-Service	1558766972	1558766972	1	1	WAL-MART STORES, INC	6/15/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3705 E SOUTH ST	None	LONG BEACH	CA	90805	4521	19	06037	33.86026343	-118.1478013	Los Angeles County
60489	Fee-for-Service	1700891710	1700891710	1	1	WALGREEN CO	9/3/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1430 EASTLAKE PKWY	None	CHULA VISTA	CA	91915	1926	37	06073	32.62994867	-116.9650465	San Diego County
60524	Fee-for-Service	1396778379	1396778379	1	1	WASHOE TRIBE OF NV & CA	9/1/2002	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	1	Border provider	None	1559 WATASHEAMU RD	None	GARDNERVILLE	NV	89460	7455	00	None	38.90016089	-119.7157447	Douglas County
60546	Fee-for-Service	1720191885	1720191885	1	1	WHEELER, ANISE T CNP	2/21/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
60567	Fee-for-Service	1841652450	1841652450	1	1	WEST, TENAYA A DPM	6/26/2019	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
60568	Fee-for-Service	1013398429	1013398429	1	1	WINKS, ROBYN R LMFT	10/17/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	54240 RIDGEVIEW DR.	SUITE 203	IDYLLWILD	CA	92549	0000	33	06065	33.74443331	-116.7145497	Riverside County
60590	Fee-for-Service	1871508101	1871508101	1	1	WALGREEN CO.	2/11/1988	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	22 SAN PEDRO RD	None	DALY CITY	CA	94014	2528	41	06081	37.68893852	-122.4669569	San Mateo County
60594	Fee-for-Service	1245419571	1245419571	1	1	WOLF, HARRY C IV MD	2/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94952	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
60645	Fee-for-Service	1881614782	1881614782	1	1	WINSLOW, LISA M LCSW	12/19/2005	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2220 SAINT GEORGE LN	STE 2	CHICO	CA	95926	1307	04	06007	39.7555	-121.8460989	Butte County
60660	Fee-for-Service	1538195797	1538195797	1	1	WATCHER, MELISSA A MD	1/31/1991	207N00000X	NA	Dermatology	026	PHYSICIANS	71250	07	Dermatology	0	In state provider	None	1506 E CHAPMAN AVE	None	ORANGE	CA	92866	2231	30	06059	33.78778851	-117.837621	Orange County
60666	Fee-for-Service	1942486246	1942486246	1	1	WANG, LILI X MD	4/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103177	78	Neoplastic Diseases/Oncology	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
60718	Fee-for-Service	1588001622	1588001622	1	1	WU, DIANA C MD	5/1/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	133043	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
60757	Fee-for-Service	1942512025	1942512025	1	1	WILLIAMS, CHERI L LMFT	1/7/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	260 MAPLE COURT	SUITE 103	VENTURA	CA	93003	3553	56	06111	34.27027545	-119.24562	Ventura County
60762	Fee-for-Service	1861726309	1861726309	1	1	WASSEL, ANDREA D CCC-SLP	10/7/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
60779	Fee-for-Service	1669587002	1669587002	1	1	WHEELER, MARGARET B MD	2/1/1996	207R00000X	NA	Other	026	PHYSICIANS	80740	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
60807	Fee-for-Service	1114011608	1114011608	1	1	WARTELL, ANTHONY E MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93566	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
60813	Fee-for-Service	1396778379	1396778379	1	1	WASHOE TRIBE OF NV & CA	9/1/2002	261Q00000X	NA	Other	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	1	Border provider	None	1559 WATASHEAMU RD	None	GARDNERVILLE	NV	89460	7455	00	None	38.90016089	-119.7157447	Douglas County
60916	Fee-for-Service	1558398313	1558398313	1	1	WILLIAMS, ELIZABETH L MD	12/11/2002	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	57091	08	Family Practice	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
60928	Fee-for-Service	1144544669	1144544669	1	1	WONG, LAWRENCE MD	7/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111577	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
60949	Fee-for-Service	1982608774	1982608774	2	1	WOODVILLE, TIMOTHY J	2/25/2009	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	591 E 10TH AVE	None	CHICO	CA	95926	2353	04	06007	39.75048145	-121.8450592	Butte County
60953	Fee-for-Service	1942486246	1942486246	1	1	WANG, LILI X MD	4/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103177	68	Hematology	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
60999	Fee-for-Service	1417581059	1417581059	1	1	WESTERN ACUTE CARE SURGEONS	10/9/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	INC	401 E HIGHLAND AVE	STE 351	SAN BERNARDINO	CA	92404	3830	36	06071	34.1358627	-117.2757778	San Bernardino County
61050	Fee-for-Service	1699389270	1699389270	1	1	WELCH, SHANNON LMFT	12/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	194 GOLD FLAT RD	None	NEVADA CITY	CA	95959	2334	29	06057	39.24788768	-121.0236887	Nevada County
61097	Fee-for-Service	1932358355	1932358355	1	1	WIJAYARATNE, IMANIE S	12/4/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
61175	Fee-for-Service	1497159552	1497159552	1	1	WONG, SHARON A OD	7/17/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3300 E SOUTH ST	105	LONG BEACH	CA	90805	4579	19	06037	33.86018093	-118.1537163	Los Angeles County
61182	Fee-for-Service	1558579144	1558579144	1	1	WOO, BRIAN MICHAEL MD	4/28/2010	1223S0112X	NA	Dental Provider	026	PHYSICIANS	107428	02	General Surgery	0	In state provider	None	290 N WAYTE LANE	None	FRESNO	CA	93701	1324	10	06019	36.74643429	-119.7837416	Fresno County
61183	Fee-for-Service	1912948019	1912948019	1	1	WILSON, SAMUEL G MD	4/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55580	01	General Practice	0	In state provider	None	14075 HESPERIA RD	STE 201-203	VICTORVILLE	CA	92395	4500	36	06071	34.50679185	-117.296399	San Bernardino County
61192	Fee-for-Service	1710947841	1710947841	1	1	WILLIS, JOSEPH I MD	1/29/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	32748	30	Radiology	0	In state provider	None	1828 S WESTERN AVE	None	LOS ANGELES	CA	90006	5808	19	06037	34.04079509	-118.3089792	Los Angeles County
61234	Fee-for-Service	1982748018	1982748018	1	1	WANG, PO W MD	3/1/1999	2084P0800X	NA	Psychiatry	026	PHYSICIANS	60666	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
61235	Fee-for-Service	1750879664	1750879664	1	1	WHITE, JANINE PT	10/29/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
61250	Fee-for-Service	1568676948	1568676948	1	1	WELTE, FRANK J MD	11/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136522	None	None	0	In state provider	None	29101 HOSPITAL RD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
61269	Fee-for-Service	1114283819	1114283819	1	1	WILKE, SCOTT A MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126968	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
61333	Fee-for-Service	1033739339	1033739339	1	1	WINDHEIM, JOSEPH MD	12/11/2023	208M00000X	NA	Other	026	PHYSICIANS	191235	None	None	0	In state provider	None	1250 16TH STREET	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
61347	Fee-for-Service	1972685956	1972685956	1	1	WILLIAMS, WILLIAM T MD	6/1/1992	174400000X	NA	Other	026	PHYSICIANS	33990	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	502 SAN GABRIEL AVE	None	AZUSA	CA	91702	2938	19	06037	34.130034	-117.908812	Los Angeles County
61416	Fee-for-Service	1750791661	1750791661	1	1	WALIA, SANDEEP S MD	12/1/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	160895	None	None	0	In state provider	None	215 CHINA GRADE LOOP	None	BAKERSFIELD	CA	93308	1707	15	06029	35.4265209	-119.0190909	Kern County
61421	Fee-for-Service	1679641666	1679641666	1	1	WALLACE, THOMAS M MD	10/2/1983	193400000X	NA	Other	026	PHYSICIANS	42269	41	Internal Medicine	0	In state provider	None	1400 FLORIDA AVE	STE 105	MODESTO	CA	95350	4444	50	06099	37.66410995	-120.996159	Stanislaus County
61434	Fee-for-Service	1225161631	1225161631	1	1	WHITSON, JARED M MD	5/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88916	34	Urology and Urological Surgery	0	In state provider	None	1001 POTRERO AVE	3A20	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
61459	Fee-for-Service	1740869387	1740869387	1	1	WONG, JUSTIN F	5/13/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
61470	Fee-for-Service	1912948019	1912948019	1	1	WILSON, SAMUEL G MD	4/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55580	66	Emergency Medicine (Urgent Care)	0	In state provider	None	14075 HESPERIA RD	STE 201-203	VICTORVILLE	CA	92395	4500	36	06071	34.50679185	-117.296399	San Bernardino County
61522	Fee-for-Service	1568881696	1568881696	1	1	WILLSEY, KYLE N DO	7/4/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	14770	40	Pediatrics	0	In state provider	None	18133 VENTURA BLVD	200 2ND FLOOR	TARZANA	CA	91356	3616	19	06037	34.1657808	-118.5283188	Los Angeles County
61538	Fee-for-Service	1720139462	1720139462	1	1	WEISS, ERIC MD	2/28/1984	207P00000X	NA	Other	026	PHYSICIANS	53748	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2448 STORY RD	None	SAN JOSE	CA	95122	1029	43	06085	37.34771126	-121.8314181	Santa Clara County
61539	Fee-for-Service	1679566608	1679566608	1	1	WEINBERG, DAVID L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29491	07	Dermatology	0	In state provider	None	931 SAN BRUNO AVE W	None	SAN BRUNO	CA	94066	3440	41	06081	37.62774029	-122.4191925	San Mateo County
61553	Fee-for-Service	1013908433	1013908433	1	1	WYTHE, EVAN T MD	6/1/1984	207P00000X	NA	Other	026	PHYSICIANS	52284	66	Emergency Medicine (Urgent Care)	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5695	35	06069	36.83504962	-121.3858245	San Benito County
61557	Fee-for-Service	1689846321	1689846321	1	1	WARD, SABRINA C MD	5/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112428	05	Anesthesiology	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
61579	Fee-for-Service	1902330707	1902330707	1	1	WANG, DAVID MD	4/25/2022	207L00000X	NA	Other	026	PHYSICIANS	175890	None	None	0	In state provider	None	2425 SAMARITAN DRIVE	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
61615	Fee-for-Service	1164508685	1164508685	1	1	WEINER, JONATHAN MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	41339	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5446 N PALM AVE	STE 105	FRESNO	CA	93704	1945	10	06019	36.8164428	-119.8082864	Fresno County
61647	Fee-for-Service	1639304975	1639304975	1	1	WIN, SANDAR MD	1/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	107902	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LANE	SUITE 450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
61652	Fee-for-Service	1851573083	1851573083	1	1	WOO, CHRISTOPHER Y MD	2/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105106	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
61670	Fee-for-Service	1306843610	1306843610	1	1	WALTS, ANN E MD	10/31/1982	207ZP0102X	NA	Other	026	PHYSICIANS	26015	22	Pathology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
61698	Fee-for-Service	1619956927	1619956927	1	1	WISNOFF, WARREN J DO	4/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	9093	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
61763	Fee-for-Service	1891746046	1891746046	1	1	WALTER ALLEN FINK, JR., D.O.	5/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	401 15TH AVE SE	None	PUYALLUP	WA	98372	3715	00	None	47.17745153	-122.2900155	Pierce County
61766	Fee-for-Service	1881125441	1881125441	1	1	WAI, KATHERINE C MD	7/1/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	161100	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
61815	Fee-for-Service	1558596213	1558596213	1	1	WATKINS, AMELIA C MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148900	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
61835	Fee-for-Service	1699063701	1699063701	1	1	WILKINSON, MICHAEL J MD	6/25/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	135918	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
61838	Fee-for-Service	1548334295	1548334295	1	1	WILLNER, AYAL MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	80193	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2840 LONG BEACH BLVD	# 300	LONG BEACH	CA	90806	1516	19	06037	33.808743	-118.189341	Los Angeles County
61869	Fee-for-Service	1457565814	1457565814	1	1	WILKOSZ, MARY E NP	10/25/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
61893	Fee-for-Service	1871754655	1871754655	1	1	WAGLE, NAVEED MD	6/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100135	13	Neurology (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
61904	Fee-for-Service	1255652582	1255652582	1	1	WILEY, ANDREW L DO	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14856	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
61909	Fee-for-Service	1861009664	1861009664	1	1	WALKER, GREGORY L CNP	3/28/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
61964	Fee-for-Service	1033537204	1033537204	1	1	WEISBERG, ASHER B MD	8/9/2024	208G00000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
61965	Fee-for-Service	1508421710	1508421710	1	1	WALTON, EDWARD M MD	4/29/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
61969	Fee-for-Service	1477830271	1477830271	1	1	WATSON, NORIKO U DO	7/17/2024	207RH0002X	NA	Adult Primary Care	026	PHYSICIANS	16290	None	None	0	In state provider	None	7115 GREENBACK LN	FL 2	CITRUS HEIGHTS	CA	95621	6133	34	06067	38.679237	-121.298859	Sacramento County
62043	Fee-for-Service	1023021029	1023021029	1	1	WILLIAMS, SOLOMON S MD	7/27/2023	2084P0805X	NA	Psychiatry	026	PHYSICIANS	182340	None	None	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
62067	Fee-for-Service	1477568756	1477568756	1	1	WALGREEN CO	10/6/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #5525	7155 VAN NUYS BLVD	None	VAN NUYS	CA	91405	3006	19	06037	34.20063829	-118.4487784	Los Angeles County
62125	Fee-for-Service	1730283185	1730283185	1	1	WHITEMAN, JON-ANDREW LMFT	8/26/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
62136	Fee-for-Service	1235404617	1235404617	1	1	WRIGHT, DONAVON T DPM	9/3/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	01	General Practice	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
62148	Fee-for-Service	1962761387	1962761387	1	1	WEST COAST HOME HEALTH	4/25/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	MANAGEMENT INC	13746 VICTORY BLVD	STE 311	VAN NUYS	CA	91401	6726	19	06037	34.18664551	-118.432764	Los Angeles County
62170	Fee-for-Service	1700964020	1700964020	1	1	WILLIAMS, JAMES J MD	8/1/1998	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	24808	40	Pediatrics	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	0000	39	06077	37.88652418	-121.2820956	San Joaquin County
62180	Fee-for-Service	1033731518	1033731518	1	1	WILLIAMS BROOKS, JACQUELYN	7/9/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
62203	Fee-for-Service	1831226083	1831226083	1	1	WILSON, ELEANOR L	1/24/2007	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5000 CALIFORNIA AVE	STE 203	BAKERSFIELD	CA	93309	0711	15	06029	35.36362594	-119.0576588	Kern County
62208	Fee-for-Service	1679539407	1679539407	1	1	WILCZYNSKI, SHARON MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	52867	22	Pathology (M.D. only)	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
62268	Fee-for-Service	1528086824	1528086824	1	1	WIEDAU, MARTINA H MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65989	None	None	0	In state provider	H MD	1245 16TH ST	None	SANTA MONICA	CA	90404	1235	19	06037	34.02726451	-118.4857138	Los Angeles County
62282	Fee-for-Service	1366753360	1366753360	1	1	WILLIAMS, BRADLEY J MD	10/1/2019	207P00000X	NA	Other	026	PHYSICIANS	117869	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
62324	Fee-for-Service	1467518886	1467518886	1	1	WAXMAN, DANIEL A MD	10/5/2010	207W00000X	NA	Ophthalmology	026	PHYSICIANS	8782	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
62336	Fee-for-Service	1063442879	1063442879	1	1	WONG, JOE K MD	4/9/2014	207R00000X	NA	Other	026	PHYSICIANS	64262	None	None	0	In state provider	None	31852 COAST HIGHWAY	SUITE 301	LAGUNA BEACH	CA	92651	6764	30	06059	33.49997237	-117.7425025	Orange County
62337	Fee-for-Service	1124486550	1124486550	1	1	WEST, KRISTINA N NP	2/20/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
62339	Fee-for-Service	1154787497	1154787497	1	1	WOODSON, JESSILA CNP	4/5/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11103 VENICE BLVD	None	LOS ANGELES	CA	90034	6914	19	06037	34.01379685	-118.4159354	Los Angeles County
62396	Fee-for-Service	1578554960	1578554960	1	1	WOOLLETT,PETER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	79-1019 HAUKAPILA ST	None	KEALAKEKUE	HI	96750	0000	00	None	19.519965	-155.918154	Hawaii County
62414	Fee-for-Service	1033379722	1033379722	1	1	WU, AIMEE I MD	8/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108210	05	Anesthesiology	0	In state provider	None	1500 E DUARTE RD	BLDG 149	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
62453	Fee-for-Service	1730194002	1730194002	1	1	WALGREEN CO #00842	1/14/1987	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	350 N CAPITOL AVE	None	SAN JOSE	CA	95133	1937	43	06085	37.37182239	-121.8445339	Santa Clara County
62496	Fee-for-Service	1689962169	1689962169	1	1	WILLIAMS, STACY M PT	7/9/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
62581	Fee-for-Service	1124474812	1124474812	1	1	WOLDAY, FEVEN MD	8/21/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	155390	08	Family Practice	0	In state provider	None	2140 GRAND AVE	STE 125	CHINO HILLS	CA	91709	6802	36	06071	33.99623518	-117.7579477	San Bernardino County
62587	Fee-for-Service	1003808429	1003808429	1	1	WOODWARD, PAULA J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N MEDICAL DR	None	SALT LAKE CTY	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
62607	Fee-for-Service	1851372130	1851372130	1	1	WALKER, CHRISTOPHER W MD	5/7/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	71574	08	Family Practice	0	In state provider	None	3700 VACA VALLEY PKWY	None	VACAVILLE	CA	95688	9430	48	06095	38.39008977	-121.9378499	Solano County
62625	Fee-for-Service	1588041792	1588041792	1	1	WALGREEN CO.	10/2/2015	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16382	2323 16TH STREET	SUITE 100	BAKERSFIELD	CA	93301	3453	15	06029	35.37238027	-119.0288508	Kern County
62645	Fee-for-Service	1891085312	1891085312	1	1	WEINBERG, AARON S MD	9/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124185	41	Internal Medicine	0	In state provider	None	8631 W 3RD ST	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
62647	Fee-for-Service	1023143757	1023143757	1	1	WESTERN FOOT & ANKLE	10/1/2002	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	CENTER INC	3400 W BALL RD	STE 209	ANAHEIM	CA	92804	3737	30	06059	33.81724472	-118.0083216	Orange County
62661	Fee-for-Service	1972252187	1972252187	1	1	WYATT DIALYSIS LLC	5/31/2023	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3350 CALIFORNIA BLVD	STE A	NAPA	CA	94558	3312	28	06055	38.32075178	-122.3058537	Napa County
62674	Fee-for-Service	1114454832	1114454832	1	1	WILLIAMS, COURTNEY LMFT	11/7/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
62705	Fee-for-Service	1649263591	1649263591	1	1	WITTNEBEL, KARL MD	11/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52959	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
62717	Fee-for-Service	1134581895	1134581895	1	1	WARD, REBECCA MD	6/3/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	191604	40	Pediatrics	0	In state provider	None	555 TACHEVAH DR	SUITE 2E-107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
62724	Fee-for-Service	1073834024	1073834024	1	1	WILLIAMS, JARRETT G MD	9/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111443	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
62729	Fee-for-Service	1104947829	1104947829	1	1	WEST OAKLAND HEALTH COUN	9/1/1991	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	700 ADELINE ST	None	OAKLAND	CA	94607	2608	01	06001	37.80430011	-122.2879962	Alameda County
62771	Fee-for-Service	1467897322	1467897322	1	1	WEST COAST NEUROLOGY, INC	3/17/2021	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	None	630 S RAYMOND AVE	STE 310	PASADENA	CA	91105	3278	19	06037	34.13505223	-118.1487761	Los Angeles County
62772	Fee-for-Service	1952725798	1952725798	1	1	WOLF, JAMIE R	3/14/2014	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	217 W CERRITOS AVE	None	ANAHEIM	CA	92805	6549	30	06059	33.81058193	-117.9065445	Orange County
62803	Fee-for-Service	1154767408	1154767408	1	1	WALMART INC	6/14/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 SOUTH BLOSSER RD	None	SANTA MARIA	CA	93454	5190	42	06083	34.94815303	-120.4537787	Santa Barbara County
62872	Fee-for-Service	1477668622	1477668622	1	1	WHANG, KAREN MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69272	02	General Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
62884	Fee-for-Service	1790128924	1790128924	1	1	WINTERS, KATHRYN D MD	4/4/2017	207R00000X	NA	Other	026	PHYSICIANS	141944	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
62906	Fee-for-Service	1912081126	1912081126	1	1	WARD, RONALD R MD	6/24/2009	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	30748	04	Otology, Laryngology, Rhinology	0	In state provider	None	350 PARNASSUS AVE	STE 501	SAN FRANCISCO	CA	94117	3608	38	06075	37.76403932	-122.4561371	San Francisco County
62927	Fee-for-Service	1891085312	1891085312	1	1	WEINBERG, AARON S MD	9/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124185	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	8631 W 3RD ST	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
62960	Fee-for-Service	1184061376	1184061376	1	1	WOODS, MEGHAN M MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132679	01	General Practice	0	In state provider	None	3687 MT DIABLO BLVD	SUITE 200	LAFAYETTE	CA	94549	3717	07	06013	37.8898926	-122.1304235	Contra Costa County
62963	Fee-for-Service	1720464993	1720464993	1	1	WEST VALLEYIDENCE OPCO, LLC	8/1/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE CENTER LLC	7057 SHOUP AVENUE	None	WEST HILLS	CA	91307	2335	19	06037	34.19888523	-118.6146904	Los Angeles County
62971	Fee-for-Service	1932258258	1932258258	1	1	WONG, ELAINE MD	7/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85039	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
62986	Fee-for-Service	1356722250	1356722250	1	1	WANG, SIYUAN DO	3/13/2023	207P00000X	NA	Other	026	PHYSICIANS	20485	None	None	0	In state provider	None	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
62993	Fee-for-Service	1245245570	1245245570	1	1	WALGREEN CO	10/21/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6010 N FIGARDEN DR	None	FRESNO	CA	93722	7922	10	06019	36.82299839	-119.8703655	Fresno County
63004	Fee-for-Service	1437675980	1437675980	1	3	WEST COAST WOUND AND SKIN	2/27/2018	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CARE INC	3615 E IMPERIAL HIGHWAY	None	LYNWOOD	CA	90262	2652	19	06037	33.93099766	-118.2039509	Los Angeles County
63011	Fee-for-Service	1972518207	1972518207	1	1	WALGREEN CO	11/25/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	27982 LA PAZ RD	None	LAGUNA NIGUEL	CA	92677	3921	30	06059	33.55690213	-117.7093902	Orange County
63017	Fee-for-Service	1164990305	1164990305	1	1	WELLER, ANDREA	4/28/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
63071	Fee-for-Service	1114356482	1114356482	1	1	WHEELER, KELLY LMFT	5/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41760 IVY STREET	SUITE 204	MURRIETA	CA	92562	0000	33	06065	33.55331844	-117.2081759	Riverside County
63079	Fee-for-Service	1376546127	1376546127	1	1	WINKLER, STUART N MD	12/4/1986	207RN0300X	NA	Nephrology	026	PHYSICIANS	28385	41	Internal Medicine	0	In state provider	None	10833 LE CONTE AVE	BLDG 32	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
63152	Fee-for-Service	1760101430	1760101430	1	1	WATKINS, ISELA LMFT	3/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
63191	Fee-for-Service	1821164146	1821164146	2	1	WHITE MEMORIAL MEDICAL PLAZA	11/27/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY	1701 E CESAR E CHAVEZ AV	109	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
63192	Fee-for-Service	1346345485	1346345485	1	1	WYDRO, JENNIFER R	6/19/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
63207	Fee-for-Service	1265759534	1265759534	1	1	WEINER, JEFFREY M MD	11/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129901	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 NORTH VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
63272	Fee-for-Service	1245776681	1245776681	1	1	WIELAND, DEBORAH L LMFT	8/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17111 BEACH BLVD	203	HUNTINGTON BEACH	CA	92647	5978	30	06059	33.713937	-117.9892085	Orange County
63292	Fee-for-Service	1821154881	1821154881	1	1	WOODBURY, BRENT L DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6700 N 1ST ST	STE 105	FRESNO	CA	93710	3947	10	06019	36.83586697	-119.7721176	Fresno County
63317	Fee-for-Service	1154312890	1154312890	1	1	WELLER, STEPHEN A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34851	78	Neoplastic Diseases/Oncology	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
63370	Fee-for-Service	1982053336	1982053336	1	1	WOLTMANN, TAI K PSYD	9/5/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
63386	Fee-for-Service	1477817708	1477817708	1	1	WEISBLATT, BEVERLY H LMFT	7/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4405 RIVERSIDE DR	209	BURBANK	CA	91505	4047	19	06037	34.15222929	-118.3480509	Los Angeles County
63390	Fee-for-Service	1972760528	1972760528	1	1	WILSON, TIMOTHY S LCSW	11/7/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
63401	Fee-for-Service	1558640953	1558640953	1	1	WINTER, GRETCHEN E MD	6/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12705	41	Internal Medicine	0	In state provider	None	450 EAST ROMIE LANE	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
63403	Fee-for-Service	1043849607	1043849607	1	1	WRIGHT, JAYSON MD	5/24/2024	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	178620	01	General Practice	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	42	06083	34.42887662	-119.7237878	Santa Barbara County
63405	Fee-for-Service	1306862032	1306862032	1	1	WANG, JAW-YAN MD	4/3/1978	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	32140	08	Family Practice	0	In state provider	None	7275 E SOUTHGATE DR	STE 402	SACRAMENTO	CA	95823	2632	34	06067	38.493576	-121.436559	Sacramento County
63454	Fee-for-Service	1720281322	1720281322	1	1	WONG, GRACE E MD	11/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126097	20	Orthopedic Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
63473	Fee-for-Service	1720292733	1720292733	1	1	WESTERN ASSOCIATES IN	11/28/2018	193400000X	NA	Other	026	PHYSICIANS	17987	02	General Surgery	0	In state provider	SURGERY MEDICAL GROUP A	4101 TULLY RD	SUITE 101	MODESTO	CA	95356	8980	50	06099	37.69867589	-121.0127412	Stanislaus County
63519	Fee-for-Service	1851501233	1851501233	1	2	WEST COUNTY MEDICAL CLINIC	11/6/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	100 E. MARKET ST.	None	LONG BEACH	CA	90805	5924	19	06037	33.85427352	-118.193571	Los Angeles County
63531	Fee-for-Service	1871678557	1871678557	1	1	WONG, KING YUE OD	3/14/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1431 7TH ST	STE 201	SANTA MONICA	CA	90401	2638	19	06037	34.01801015	-118.4914623	Los Angeles County
63535	Fee-for-Service	1598759102	1598759102	1	1	WRIGHT, RICHARD G MD	4/30/1992	207L00000X	NA	Other	026	PHYSICIANS	32699	05	Anesthesiology	0	In state provider	None	1900 POINT WEST WAY	STE 222	SACRAMENTO	CA	95815	4704	34	06067	38.599677	-121.431447	Sacramento County
63537	Fee-for-Service	1255080198	1255080198	1	1	WEAR, JOHN G MD	8/28/2024	207R00000X	NA	Other	026	PHYSICIANS	21491	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
63542	Fee-for-Service	1457559668	1457559668	1	1	WADE-KEMPIAK, KRISTEN T MD	9/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99439	40	Pediatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
63555	Fee-for-Service	1982654307	1982654307	1	1	WRUBEL, KAREN L DPM	2/8/2015	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	13624 HAWTHORNE BLVD	STE 206	HAWTHORNE	CA	90250	5818	19	06037	33.9083784	-118.3523983	Los Angeles County
63605	Fee-for-Service	1154312890	1154312890	1	1	WELLER, STEPHEN A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34851	01	General Practice	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
63611	Fee-for-Service	1245467885	1245467885	1	1	WESTERN UNIVERSITY OF HEALTH	6/15/2010	261Q00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND ST	STE 2	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
63613	Fee-for-Service	1902163710	1902163710	1	1	WHEALON, MATTHEW D MD	4/29/2019	208C00000X	NA	General Surgery	026	PHYSICIANS	128935	02	General Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
63626	Fee-for-Service	1932291366	1932291366	1	1	WALI, SHILPA MD	3/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	75564	13	Neurology (M.D. only)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
63646	Fee-for-Service	1316037419	1316037419	1	1	WEOTT, PATRICIA A NP	5/17/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
63683	Fee-for-Service	1144257627	1144257627	1	1	WOO, JENNIFER H DPM	11/1/1999	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6734 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91606	1615	19	06037	34.19314245	-118.3877632	Los Angeles County
63692	Fee-for-Service	1912761529	1912761529	1	1	WILDOMAR SEN ASST LIV, LLC	12/16/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	32365 S PASADENA ST	None	WILDOMAR	CA	92595	9551	33	06065	33.60281242	-117.2681882	Riverside County
63716	Fee-for-Service	1972609527	1972609527	1	1	WHITNEY, JOHN C MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	73247	40	Pediatrics	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
63739	Fee-for-Service	1780757732	1780757732	1	1	WEINSTEIN, SUSAN	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
63756	Fee-for-Service	1356456776	1356456776	1	1	WIPPERMANN, BRIAN D MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85132	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7500 HOSPITAL DR	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
63766	Fee-for-Service	1952885972	1952885972	1	1	WILSON, NICOLLE D	3/23/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4000 CIVIC CENTER DRIVE	STE 100	SAN RAFAEL	CA	94903	4173	21	06041	38.0041783	-122.538861	Marin County
63836	Fee-for-Service	1457773822	1457773822	1	1	WONG, DORIS H OPTOMETRIC	9/3/2013	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	5580 SPRINGDALE AVENUE	SUITE E	PLEASANTON	CA	94588	3707	01	06001	37.69179	-121.9259312	Alameda County
63841	Fee-for-Service	1497827471	1497827471	1	1	WONG, LAUREEN S PHD	1/27/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
63862	Fee-for-Service	1972980175	1972980175	1	1	WAL-MART STORES, INC	7/21/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1180 S DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	2203	19	06037	34.00153633	-117.8106481	Los Angeles County
63865	Fee-for-Service	1093463788	1093463788	1	1	WRONKA, SEAN E PT	3/15/2022	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1464 MADERA RD	UNIT I-1	SIMI VALLEY	CA	93065	7034	56	06111	34.26580213	-118.7961902	Ventura County
63895	Fee-for-Service	1154312890	1154312890	1	1	WELLER, STEPHEN A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34851	30	Radiology	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
63899	Fee-for-Service	1831258417	1831258417	1	1	WEI, ZHI-GANG MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74674	07	Dermatology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
63908	Fee-for-Service	1881132926	1881132926	1	1	WAL-MART STORES INC	6/7/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	875 E H ST	None	CHULA VISTA	CA	91910	7807	37	06073	32.637816	-117.0248805	San Diego County
63944	Fee-for-Service	1710321278	1710321278	1	1	WANG, YVETTE L MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132451	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
63969	Fee-for-Service	1043926322	1043926322	1	1	WALTER, KENNETH LMFT	4/16/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	141 PARKER ST	None	VACAVILLE	CA	95688	3921	48	06095	38.35806912	-121.9898561	Solano County
64045	Fee-for-Service	1396123808	1396123808	1	1	WALSH, BRANDON C MD	9/8/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	179648	None	None	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
64123	Fee-for-Service	1285714170	1285714170	1	1	WEICHERS, STUART A MD	8/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
64222	Fee-for-Service	1922186816	1922186816	1	1	WILLIAMS, DAVID B MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	17557	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
64267	Fee-for-Service	1619054236	1619054236	1	1	WU, PATRICIA S MD	1/31/1994	207RE0101X	NA	Endocrinology	026	PHYSICIANS	53034	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
64313	Fee-for-Service	1891219341	1891219341	1	1	WILCOX, ASHLEE CCC-SLP	10/18/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
64343	Fee-for-Service	1730167370	1730167370	1	2	WEINER, PAUL D DPM	1/18/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	480 REDWOOD ST	STE 10	VALLEJO	CA	94590	2958	48	06095	38.12315545	-122.2597619	Solano County
64360	Fee-for-Service	1942236716	1942236716	1	1	WOOD, DENNIS P PHD	8/2/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
64403	Fee-for-Service	1215099460	1215099460	1	1	WESTERN ACUTE CARE	1/3/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PHYSICIANS INC	2623 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2927	19	06037	33.98921547	-118.2242565	Los Angeles County
64472	Fee-for-Service	1992792774	1992792774	1	1	WILSON, MICHAEL L DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2220 E FRUIT ST	STE 214	SANTA ANA	CA	92701	4459	30	06059	33.75277851	-117.8354745	Orange County
64482	Fee-for-Service	1871141044	1871141044	2	1	WHITTINGTON, RUTH I LMFT	7/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	404 W PINE ST.,	STE1	LODI	CA	95240	4091	39	06077	38.13437954	-121.2780387	San Joaquin County
64505	Fee-for-Service	1164437174	1164437174	1	1	WALGREEN CO	1/19/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8917 TRAUTWEIN RD	None	RIVERSIDE	CA	92508	9473	33	06065	33.88900767	-117.3244103	Riverside County
64506	Fee-for-Service	1942310016	1942310016	1	1	WEINACKER, ANN B MD	12/11/2002	207RC0200X	NA	Other	026	PHYSICIANS	68182	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
64524	Fee-for-Service	1588018436	1588018436	1	1	WHALEN, DANIELLE E MD	6/2/2021	2084N0402X	NA	Neurology	026	PHYSICIANS	153833	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
64528	Fee-for-Service	1306813910	1306813910	1	1	WEGERT, STEVEN MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1011 NORTH WEBER	None	COLORADO SPGS	CO	80903	2466	00	None	38.84827715	-104.8190816	El Paso County
64565	Fee-for-Service	1346687530	1346687530	1	1	WINN, KAYLA M CRNA	9/11/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
64641	Fee-for-Service	1629099395	1629099395	1	1	WILLIAMS, GLYN D MD	9/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	51099	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
64729	Fee-for-Service	1356320626	1356320626	1	1	WOODS, GEORGE M MD	12/4/2007	207L00000X	NA	Other	026	PHYSICIANS	68414	05	Anesthesiology	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
64770	Fee-for-Service	1679623383	1679623383	1	1	WU, JOCELYN	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67401	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
64776	Fee-for-Service	1174065734	1174065734	1	1	WALSH, ERIN H	5/10/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
64785	Fee-for-Service	1316573256	1316573256	1	1	WONG, TIMOTHY MD	9/1/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
64807	Fee-for-Service	1669549473	1669549473	1	1	WITTENBERG, COLLEEN MD	12/1/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	71464	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
64821	Fee-for-Service	1154525921	1154525921	1	1	WILLIAM YU D.O.	8/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	506 6TH ST	None	BROOKLYN	NY	11215	3609	00	None	40.668219	-73.979352	Kings County
64852	Fee-for-Service	1972538353	1972538353	1	2	WEIL, DAVID J MD	1/21/2021	208600000X	NA	General Surgery	026	PHYSICIANS	54871	None	None	0	In state provider	None	2601 E CHAPMAN AVE	None	ORANGE	CA	92869	3206	30	06059	33.78785251	-117.826365	Orange County
64861	Fee-for-Service	1669424131	1669424131	1	1	WHETSTONE, WILLIAM D MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62963	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
64908	Fee-for-Service	1093972077	1093972077	1	1	WU, DANNY W MD	6/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103925	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
64920	Fee-for-Service	1235160102	1235160102	1	1	WAGNER, GARY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	24987	07	Dermatology	0	In state provider	None	1500 MCHENRY AVE	None	MODESTO	CA	95350	4529	50	06099	37.66532847	-120.9939178	Stanislaus County
64929	Fee-for-Service	1063427359	1063427359	1	1	WALGREEN CO.	2/18/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3460 EL CAMINO REAL	None	SANTA CLARA	CA	95051	2809	43	06085	37.35225555	-121.9921875	Santa Clara County
65061	Fee-for-Service	1679623383	1679623383	1	1	WU, JOCELYN	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67401	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
65152	Fee-for-Service	1548789050	1548789050	1	1	WELLSPACE HEALTH	9/20/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2433 MARCONI AVE	None	SACRAMENTO	CA	95821	4807	34	06067	38.619405	-121.4045595	Sacramento County
65161	Fee-for-Service	1851634786	1851634786	1	1	WANG, SERENA K MD	4/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135917	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
65181	Fee-for-Service	1548621568	1548621568	1	1	WORTH, BRANDON DO	5/12/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	20048	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	9363	10	06019	36.7423511	-119.7834688	Fresno County
65192	Fee-for-Service	1497174023	1497174023	1	1	WIENER, ZEV A MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	136661	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
65352	Fee-for-Service	1376643494	1376643494	1	1	WEISS BENOIT, LYNETTE M LCSW	6/4/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	123 NEVADA ST	STE A	NEVADA CITY	CA	95959	2603	29	06057	39.26304453	-121.0157916	Nevada County
65372	Fee-for-Service	1295154326	1295154326	1	1	WHITE, ISAAC P	9/24/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1555 RIVER PARK DR	SUITE 206L	SACRAMENTO	CA	95815	4604	34	06067	38.600019	-121.434687	Sacramento County
65401	Fee-for-Service	1639257124	1639257124	1	1	WHANG, CHRISTOPHER S MD	3/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84865	None	None	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
65440	Fee-for-Service	1548789050	1548789050	1	1	WELLSPACE HEALTH	5/25/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	2433 MARCONI AVE	None	SACRAMENTO	CA	95821	4807	34	06067	38.619405	-121.4045595	Sacramento County
65504	Fee-for-Service	1386977288	1386977288	1	1	WONG, GREGORY K MD	3/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124939	40	Pediatrics	0	In state provider	None	1201 W LA VETA	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
65541	Fee-for-Service	1598321838	1598321838	1	1	WILLIAMS, JULIE A LMFT	5/5/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17000 S. HARLAN RD	None	LATHROP	CA	95330	8738	39	06077	37.80929182	-121.2956055	San Joaquin County
65568	Fee-for-Service	1295702637	1295702637	1	1	WASHINGTON, ROBERT D MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68728	41	Internal Medicine	0	In state provider	None	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
65601	Fee-for-Service	1982608717	1982608717	1	2	WALLACE, DANIEL J MD	3/10/2022	207RR0500X	NA	Other	026	PHYSICIANS	30533	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
65603	Fee-for-Service	1477804441	1477804441	1	1	WISE, LINDA E OT	10/11/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
65728	Fee-for-Service	1548789050	1548789050	1	1	WELLSPACE HEALTH	9/20/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2433 MARCONI AVE	None	SACRAMENTO	CA	95821	4807	34	06067	38.619405	-121.4045595	Sacramento County
65778	Fee-for-Service	1124179353	1124179353	1	1	WHISMAN, KATHLEEN E MD	8/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79463	08	Family Practice	0	In state provider	None	678 PETALUMA AVE	None	SEBASTOPOL	CA	95472	4217	49	06097	38.39639163	-122.8199806	Sonoma County
65812	Fee-for-Service	1083807309	1083807309	1	1	WHITMAN, JOHN M MD	7/1/2008	390200000X	NA	Other	026	PHYSICIANS	105105	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
65817	Fee-for-Service	1457579724	1457579724	1	1	WILLIS, JOYCE M	1/24/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
65865	Fee-for-Service	1326090804	1326090804	1	1	WELLS, JAMES D MD	7/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	78059	01	General Practice	0	In state provider	None	1141 ROSE AVENUE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
65873	Fee-for-Service	1528082542	1528082542	1	1	WRIGHT, JOHN A JR MD	4/6/1979	207L00000X	NA	Other	026	PHYSICIANS	38597	05	Anesthesiology	0	In state provider	None	550 WASHINGTON ST	STE 331	SAN DIEGO	CA	92103	2227	37	06073	32.75003652	-117.1603431	San Diego County
65877	Fee-for-Service	1164439675	1164439675	1	1	WANG, ANDREW MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66792	41	Internal Medicine	0	In state provider	None	909 HYDE ST	STE 125	SAN FRANCISCO	CA	94109	4832	38	06075	37.78939387	-122.4170945	San Francisco County
65883	Fee-for-Service	1396823126	1396823126	1	1	WOMMACK, LINDA P MD	10/17/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	41207	40	Pediatrics	0	In state provider	None	3230 BEARD RD	STE A	NAPA	CA	94558	3673	28	06055	38.3216968	-122.2953847	Napa County
65888	Fee-for-Service	1427517150	1427517150	1	1	WERBY, JASPER MD	10/24/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
65911	Fee-for-Service	1639532567	1639532567	1	1	WATSON, RACHEL W MD	7/1/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	152540	40	Pediatrics	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
65949	Fee-for-Service	1306825997	1306825997	1	1	WILLIAM BEAUMONT HOSPITAL	5/24/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	44201 DEQUINDRE	None	TROY	MI	48098	1117	00	None	42.61849536	-83.09121784	Oakland County
65951	Fee-for-Service	1235275975	1235275975	1	1	WINDSOR ELK GROVE CARE	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	& REHAB CENTER	9461 BATEY AVE	None	ELK GROVE	CA	95624	2005	34	06067	38.413206	-121.3600005	Sacramento County
65962	Fee-for-Service	1730490277	1730490277	1	1	WALLACE, JAMES MD FACS	8/21/2024	2086S0127X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
65979	Fee-for-Service	1053315838	1053315838	1	1	WOODALL, BRADFORD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3000 MACK RD	None	FAIRFIELD	OH	45014	5335	00	None	39.31129717	-84.51710189	Butler County
66015	Fee-for-Service	1316591175	1316591175	1	1	WU, CHUNG-HAO CRNA	10/22/2019	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
66065	Fee-for-Service	1316431810	1316431810	1	1	WANG, DENNIS LCSW	3/9/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
66101	Fee-for-Service	1215942503	1215942503	2	1	WALGREEN CO	8/10/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	535 S PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	4220	19	06037	33.83315029	-118.3850549	Los Angeles County
66110	Fee-for-Service	1366753022	1366753022	1	1	WASSON, MINA K MD	8/25/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	167860	40	Pediatrics	0	In state provider	None	12395 EL CAMINO REAL	STE 219	SAN DIEGO	CA	92130	3084	37	06073	32.94324259	-117.2396525	San Diego County
66121	Fee-for-Service	1811194046	1811194046	1	1	WANG, JEFFREY K MD	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128714	34	Urology and Urological Surgery	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
66128	Fee-for-Service	1285701185	1285701185	1	1	WONG, ERNA WEI MD	7/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	49296	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
66153	Fee-for-Service	1790558252	1790558252	1	1	WIDMANN, DUSTIN A CRNA	6/3/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
66185	Fee-for-Service	1588623045	1588623045	1	1	WANG, MICHAEL M MD	4/30/1990	207R00000X	NA	Other	026	PHYSICIANS	49214	None	None	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
66186	Fee-for-Service	1891758157	1891758157	1	1	WHITNEY, JANET MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7126	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
66209	Fee-for-Service	1699061002	1699061002	1	1	WORKIE, BETRE M MD	3/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139417	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
66211	Fee-for-Service	1609113935	1609113935	1	1	WATKINS, LINDSEY C LMFT	6/25/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2001 NORTH CHESTER	None	BAKERSFIELD	CA	93308	2654	15	06029	35.42456102	-119.0213307	Kern County
66237	Fee-for-Service	1306825997	1306825997	1	1	WILLIAM BEAUMONT HOSPITAL	5/24/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	44201 DEQUINDRE	None	TROY	MI	48098	1117	00	None	42.61849536	-83.09121784	Oakland County
66250	Fee-for-Service	1235444605	1235444605	1	1	WANG, LI-JUNG J OD	2/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	75036 GERALD FORD DRIVE	None	PALM DESERT	CA	92211	2080	33	06065	33.78158473	-116.353994	Riverside County
66267	Fee-for-Service	1326423815	1326423815	1	1	WALTER, LESLIE A CNM	1/10/2017	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	617 SAXONY PL	STE 103	ENCINITAS	CA	92024	2797	37	06073	33.05482353	-117.285912	San Diego County
66277	Fee-for-Service	1861776817	1861776817	1	1	WELCH, MARY E DO	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11996	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1400 E CHURCH STREET	EM DEPT	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
66294	Fee-for-Service	1033776174	1033776174	1	1	WATANABE, KANA CRNA	6/3/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
66320	Fee-for-Service	1245357367	1245357367	1	1	WILKINS, KENDRA E LCSW	2/22/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
66342	Fee-for-Service	1972737500	1972737500	1	1	WOODS, RYAN M MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103924	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
66351	Fee-for-Service	1952141384	1952141384	1	1	WATSON, SHANTEL S	10/25/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
66366	Fee-for-Service	1265972301	1265972301	1	1	WU, JESSICA CNP	6/12/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8491 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90069	4218	19	06037	34.08988507	-118.3757716	Los Angeles County
66406	Fee-for-Service	1760534986	1760534986	1	1	WOOLERY, JAMES D MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	34457	36	Psychiatry	0	In state provider	None	660 SANITARIUM RD	# 104	DEER PARK	CA	94576	9710	28	06055	38.54206023	-122.47561	Napa County
66450	Fee-for-Service	1003860313	1003860313	1	1	WICKENS, JASON C MD	4/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	18	Ophthalmology	2	Out of state provider	None	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89052	4186	00	None	36.180999	-115.3174815	Clark County
66474	Fee-for-Service	1013183219	1013183219	3	1	WALGREEN CO	5/6/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 LOS ANGELES AVE	None	MOORPARK	CA	93021	0000	56	06111	34.27891953	-118.8829485	Ventura County
66489	Fee-for-Service	1992166912	1992166912	1	1	WESTERVELT, LAQUICHA Y NP	11/21/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
66494	Fee-for-Service	1215592027	1215592027	1	1	WEST, BENJAMIN MD	10/18/2023	390200000X	NA	Other	026	PHYSICIANS	181940	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
66532	Fee-for-Service	1417134040	1417134040	1	1	WADHWA, VIKRAM S MD	3/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102605	None	None	0	In state provider	None	505 PARNASSUS AVE	L 352	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
66540	Fee-for-Service	1720302573	1720302573	1	1	WINKLER, ELLEN M LMFT	9/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	30423 CANWOOD ST	SUITE 138	AGOURA HILLS	CA	91301	4315	19	06037	34.14710182	-118.7842501	Los Angeles County
66541	Fee-for-Service	1114098027	1114098027	1	1	WEISS, MARVIN C MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47016	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
66547	Fee-for-Service	1528246881	1528246881	1	1	WANG, XIAOGUANG MD	8/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118779	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
66571	Fee-for-Service	1932603321	1932603321	1	1	WANG, WILLIAM MD	1/10/2024	207L00000X	NA	Other	026	PHYSICIANS	164532	None	None	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
66573	Fee-for-Service	1386653657	1386653657	1	1	WU, HONG MD	8/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92464	41	Internal Medicine	0	In state provider	None	1783 EL CAMINO REAL	# 8454	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
66583	Fee-for-Service	1962400531	1962400531	1	1	WONG, CALVIN K MD	5/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	79819	08	Family Practice	0	In state provider	None	15611 POMERADO RD	SUITE 400	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
66637	Fee-for-Service	1902055866	1902055866	1	1	WHITE MEMORIAL MED GRP	1/1/2003	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	INC	1701 E CESAR E CHAVEZ AV	STE 100	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
66640	Fee-for-Service	1346241460	1346241460	1	1	WEST COAST HOSPITALS INC	10/1/1980	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	919 FREEDOM BLVD	None	WATSONVILLE	CA	95076	3804	44	06087	36.91938657	-121.7604121	Santa Cruz County
66735	Fee-for-Service	1366634966	1366634966	1	1	WATANABE, MIKI MD	7/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	102318	77	Infectious Disease	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
66748	Fee-for-Service	1306851498	1306851498	1	1	WALGREEN CO	8/22/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	150 S GRAND AVE	None	COVINA	CA	91724	3236	19	06037	34.0852152	-117.8724188	Los Angeles County
66768	Fee-for-Service	1437675980	1437675980	1	1	WEST COAST WOUND AND SKIN	2/27/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CARE INC	14857 ROSCOE BLVD	None	PANORAMA CITY	CA	91402	4617	19	06037	34.22150352	-118.4571405	Los Angeles County
66772	Fee-for-Service	1023349891	1023349891	1	1	WILTSE, WES R DO	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11522	25	Physical Medicine and Rehabilitation	0	In state provider	None	135 CARMEN LANE	None	SANTA MARIA	CA	93458	7729	42	06083	34.92484952	-120.4374645	Santa Barbara County
66776	Fee-for-Service	1194069724	1194069724	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1030 SPERRY AVE	None	PATTERSON	CA	95363	9267	50	06099	37.46429929	-121.1424649	Stanislaus County
66780	Fee-for-Service	1033630173	1033630173	1	1	WANG, LUKE L MD	6/24/2022	208600000X	NA	General Surgery	026	PHYSICIANS	176098	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
66784	Fee-for-Service	1730479627	1730479627	1	1	WILLEN, SHAINA M MD	7/16/2020	390200000X	NA	Other	026	PHYSICIANS	159074	40	Pediatrics	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
66813	Fee-for-Service	1629394721	1629394721	1	1	WHITLEY, NICHOLAS R MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118250	01	General Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
66825	Fee-for-Service	1851484299	1851484299	2	1	WILSHIRE WESTGATE MEDICAL	6/29/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY	11860 WILSHIRE BLVD	STE 101	LOS ANGELES	CA	90025	6606	19	06037	34.04705881	-118.4637989	Los Angeles County
66829	Fee-for-Service	1114098027	1114098027	1	1	WEISS, MARVIN C MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47016	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
66830	Fee-for-Service	1720157191	1720157191	1	1	WOLF, SALINA L MD	12/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91454	41	Internal Medicine	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
66902	Fee-for-Service	1629240460	1629240460	1	1	WALGREEN CO.	10/20/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	23925 NEWHALL RANCH RD.	None	SANTA CLARITA	CA	91355	5701	19	06037	34.42975199	-118.5546934	Los Angeles County
66929	Fee-for-Service	1043771462	1043771462	1	1	WONG, KELSEY R DO	11/5/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	19778	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
66959	Fee-for-Service	1285096032	1285096032	1	1	WILLIAMS, MARY-JANE MD	6/11/2020	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
66965	Fee-for-Service	1861419277	1861419277	1	1	WAL-MART STORES, INC	1/4/1991	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	608 LUTHER RD	None	RED BLUFF	CA	96080	5217	52	06103	40.16093174	-122.2333823	Tehama County
67024	Fee-for-Service	1366634966	1366634966	1	1	WATANABE, MIKI MD	7/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	102318	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
67032	Fee-for-Service	1740313709	1740313709	1	1	WACHSMAN, ASHLEY M MD	10/1/1998	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	81644	30	Radiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
67101	Fee-for-Service	1629394721	1629394721	1	1	WHITLEY, NICHOLAS R MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118250	08	Family Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
67108	Fee-for-Service	1912104076	1912104076	1	1	WINTER, ROSA I LCSW	5/24/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
67215	Fee-for-Service	1053310359	1053310359	1	1	WILBERT, LLOYD G MD	11/7/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	135524	30	Radiology	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
67265	Fee-for-Service	1316001167	1316001167	1	1	WALTER ALAIN THOMAS, MD, INC	3/9/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	258 LOMBARD STREET	SUITE 200	THOUSAND OAKS	CA	91360	5806	56	06111	34.1780735	-118.8720855	Ventura County
67280	Fee-for-Service	1801803861	1801803861	1	1	WALGREEN CO	8/29/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15740 WOODRUFF AVE	None	BELLFLOWER	CA	90706	4018	19	06037	33.890067	-118.1173645	Los Angeles County
67317	Fee-for-Service	1861416232	1861416232	1	1	WANG, PAUL MD	1/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89787	40	Pediatrics	0	In state provider	None	1891 E ROSEVILLE PKWY	STE 150	ROSEVILLE	CA	95661	7975	31	06061	38.73119604	-121.2269348	Placer County
67346	Fee-for-Service	1396819884	1396819884	1	1	WALLACE, ANDREA L	11/28/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM DR	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
67364	Fee-for-Service	1437240520	1437240520	1	1	WILLIAM K ROSEN, M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1423 N JEFFERSON AVE	None	SPRINGFIELD	MO	65802	1917	00	None	37.22492991	-93.28917587	Greene County
67365	Fee-for-Service	1942338827	1942338827	1	1	WILLOW PARTNERS MEDICAL	1/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	28	Proctology (colon and rectal)	0	In state provider	CORPORATION	155 W WILLOW ST	STE I	POMONA	CA	91768	1829	19	06037	34.0791853	-117.7537495	Los Angeles County
67383	Fee-for-Service	1447930540	1447930540	1	1	WARREN, KAREN NP	10/5/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15260 VENTURA BLVD	1200	SHERMAN OAKS	CA	91403	5307	19	06037	34.15370926	-118.4656644	Los Angeles County
67468	Fee-for-Service	1699241349	1699241349	1	1	WALLACE, MELANIE LMFT	12/3/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
67505	Fee-for-Service	1336168988	1336168988	1	1	WATERS, NANCY E MD	2/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	42907	77	Infectious Disease	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
67530	Fee-for-Service	1346557014	1346557014	1	24	WASHINGTON TOWNSHIP MEDICAL	3/17/2023	2251P0200X	NA	Physical Therapist	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	FOUNDATION	39500 FREMONT BLVD	100	FREMONT	CA	94538	2101	01	06001	37.5448266	-121.9802588	Alameda County
67532	Fee-for-Service	1245271303	1245271303	1	1	WETTSTEIN, MICHAEL E MD	6/10/2021	2084P2900X	NA	Neurology	026	PHYSICIANS	67921	None	None	0	In state provider	None	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
67571	Fee-for-Service	1396519039	1396519039	1	1	WEBER, ALLISON L LMFT	12/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
67586	Fee-for-Service	1114619061	1114619061	1	1	WYATT, AMBER C CCC-SLP	8/14/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
67593	Fee-for-Service	1083290670	1083290670	1	1	WANG, MELINDA B MD	3/6/2025	207R00000X	NA	Other	026	PHYSICIANS	191801	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
67641	Fee-for-Service	1497760581	1497760581	1	1	WALGREEN CO	8/1/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	27975 BRADLEY RD	None	MENIFEE	CA	92586	2273	33	06065	33.71488653	-117.1922164	Riverside County
67653	Fee-for-Service	1942338827	1942338827	1	1	WILLOW PARTNERS MEDICAL	1/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	CORPORATION	155 W WILLOW ST	STE I	POMONA	CA	91768	1829	19	06037	34.0791853	-117.7537495	Los Angeles County
67703	Fee-for-Service	1033430582	1033430582	1	1	WARD, MICHAEL M MD	7/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123523	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	5722	09	06017	38.72453536	-120.7921649	El Dorado County
67793	Fee-for-Service	1336168988	1336168988	1	1	WATERS, NANCY E MD	2/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	42907	41	Internal Medicine	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
67815	Fee-for-Service	1245246446	1245246446	1	1	WASEEM ULLAH	12/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	205 N EAST AVE	None	JACKSON	MI	49201	1753	00	None	42.25035275	-84.39360669	Jackson County
67924	Fee-for-Service	1871565416	1871565416	1	1	WALTON, DAVID L MD	1/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	74318	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
67937	Fee-for-Service	1184640906	1184640906	2	1	WHERRY, TRACI L MD	5/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	36	Psychiatry	2	Out of state provider	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
67944	Fee-for-Service	1841336740	1841336740	1	1	WENSLEY, MICHAEL K MD	5/13/2024	163WG0000X	NA	Other	026	PHYSICIANS	78267	01	General Practice	0	In state provider	None	20054 HAWTHORNE BLVD	None	TORRANCE	CA	90503	1518	19	06037	33.849909	-118.353614	Los Angeles County
67991	Fee-for-Service	1033430582	1033430582	1	1	WARD, MICHAEL M MD	7/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123523	01	General Practice	0	In state provider	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	5722	09	06017	38.72453536	-120.7921649	El Dorado County
68017	Fee-for-Service	1164468328	1164468328	1	1	WHEELER, MARK D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
68058	Fee-for-Service	1598896250	1598896250	1	1	WEST SACRAMENTO DIALYSIS LLC	11/7/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3450 INDUSTRIAL BLVD	STE 100	WEST SACRAMENTO	CA	95691	5053	57	06113	38.5736905	-121.5598635	Yolo County
68096	Fee-for-Service	1972536316	1972536316	1	1	WYCLIFFE, NATHANIEL D MD	7/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	43291	30	Radiology	0	In state provider	None	25455 BARTON RD	STE 107B	LOMA LINDA	CA	92354	3139	36	06071	34.04805253	-117.249534	San Bernardino County
68103	Fee-for-Service	1164699781	1164699781	1	1	WANG, SHARON Y DO	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	10629	77	Infectious Disease	0	In state provider	None	801 S CHEVY CHASE DR	STE 105	GLENDALE	CA	91205	4432	19	06037	34.136757	-118.2396195	Los Angeles County
68143	Fee-for-Service	1275170342	1275170342	1	1	WU, JENNY	8/27/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21293	08	Family Practice	0	In state provider	None	1020 29TH ST	STE 580	SACRAMENTO	CA	95816	5126	34	06067	38.572803	-121.4685	Sacramento County
68174	Fee-for-Service	1316275092	1316275092	1	1	WATSON, GEORGE M MD	6/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	101510	18	Ophthalmology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
68177	Fee-for-Service	1992090815	1992090815	1	1	WIEGLEY, NASIM MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134869	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
68191	Fee-for-Service	1972558666	1972558666	1	1	WANG, EDWARD MD	3/31/1988	208800000X	NA	Other	026	PHYSICIANS	54057	34	Urology and Urological Surgery	0	In state provider	None	1525 WEBSTER ST	STE D	FAIRFIELD	CA	94533	4935	48	06095	38.2570563	-122.0475622	Solano County
68220	Fee-for-Service	1164476081	1164476081	1	1	WICKREMASINGHE, ASELA MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	56448	41	Internal Medicine	0	In state provider	None	1524 W LACEY BLVD	None	HANFORD	CA	93230	5965	16	06031	36.32816338	-119.6690189	Kings County
68245	Fee-for-Service	1952489718	1952489718	1	1	WON,ROSA MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68625	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
68248	Fee-for-Service	1871658864	1871658864	1	1	WAKHARKAR, RUTA V MD	11/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130330	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
68263	Fee-for-Service	1275507857	1275507857	1	1	WANG, ENOCH J MD	2/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78846	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
68289	Fee-for-Service	1043429152	1043429152	1	1	WHALEN, SEAN P MD	10/19/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	87385	30	Radiology	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
68306	Fee-for-Service	1851306948	1851306948	1	1	WALGREEN CO	11/1/2003	332B00000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	120 W PARKRIDGE AVE	None	CORONA	CA	92880	1450	33	06065	33.89333259	-117.5639788	Riverside County
68321	Fee-for-Service	1417029232	1417029232	1	1	WILSON, DEANNA W MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	41983	18	Ophthalmology	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
68323	Fee-for-Service	1437675980	1437675980	1	2	WEST COAST WOUND AND SKIN	2/27/2018	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7039 ALONDRA BLVD	None	PARAMOUNT	CA	90723	3925	19	06037	33.88919451	-118.175787	Los Angeles County
68349	Fee-for-Service	1760703086	1760703086	1	1	WANG, NORBY C MD	1/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140530	02	General Surgery	0	In state provider	None	1180 N INDIAN CANYON DR	SUITE E421	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
68358	Fee-for-Service	1952164105	1952164105	1	1	WALLER, TASHA RENA	3/13/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	16909 BELFOREST DR	None	CARSON	CA	90746	1112	19	06037	33.87877689	-118.2656739	Los Angeles County
68377	Fee-for-Service	1487698932	1487698932	1	1	WRIGHT, JOHN H MD	7/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77080	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
68415	Fee-for-Service	1023210192	1023210192	1	1	WOLFF, EMILY L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	401 E 20TH ST	None	COVINGTON	KY	41014	1583	00	None	39.06787024	-84.50013318	Kenton County
68429	Fee-for-Service	1063963916	1063963916	1	1	WHANG, BARO CRNA	12/20/2017	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
68445	Fee-for-Service	1932109295	1932109295	1	1	WOGENSEN, KENNETH K	2/8/2015	2084N0400X	NA	Neurology	026	PHYSICIANS	52870	None	None	0	In state provider	None	665 W NAOMI AVE	STE 201	ARCADIA	CA	91007	7563	19	06037	34.12419973	-118.0539868	Los Angeles County
68485	Fee-for-Service	1649285974	1649285974	1	1	WALGREEN CO	7/19/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5900 CALLE REAL	None	GOLETA	CA	93117	2312	42	06083	34.44152999	-119.8281048	Santa Barbara County
68599	Fee-for-Service	1952914681	1952914681	1	13	WEST COAST KIDNEY	11/23/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	110 TAMPICO	STE 200	WALNUT CREEK	CA	94598	2962	07	06013	37.91113845	-122.0458263	Contra Costa County
68648	Fee-for-Service	1952164105	1952164105	1	1	WALLER, TASHA RENA	3/13/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	16909 BELFOREST DR	None	CARSON	CA	90746	1112	19	06037	33.87877689	-118.2656739	Los Angeles County
68663	Fee-for-Service	1760941249	1760941249	1	1	WERTH, ELISA LMFT	4/9/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
68698	Fee-for-Service	1558821033	1558821033	1	1	WISNIOWSKI, PAUL K MD	4/25/2023	208600000X	NA	General Surgery	026	PHYSICIANS	182320	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
68706	Fee-for-Service	1023038700	1023038700	1	1	WERTHMAN, PHILIP MD	5/31/1994	208800000X	NA	Other	026	PHYSICIANS	74157	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	RM B240	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
68707	Fee-for-Service	1699729384	1699729384	1	1	WILLIAM M MCDONNELL MD	3/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
68854	Fee-for-Service	1366536625	1366536625	1	1	WU, MARK L MD	8/3/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72344	22	Pathology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
68877	Fee-for-Service	1417187139	1417187139	1	1	WAI, CARRIE S PHD	7/21/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
68913	Fee-for-Service	1245660091	1245660091	1	1	WANIGASEKARA MOHOTTI, TIRTHA	8/3/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	LAC	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
68942	Fee-for-Service	1558908475	1558908475	1	1	WELLINGER, OLIVIA PT	12/23/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
68959	Fee-for-Service	1023588308	1023588308	1	1	WILLIS EDUCATION	1/21/2025	174N00000X	NA	Other	107	DOULA GROUP PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	15	06029	0	0	None
68984	Fee-for-Service	1881633865	1881633865	1	1	WON, SE K MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	1301 PUNCHBOWL	None	HONOLULU	HI	96813	2499	00	None	21.30800017	-157.8550765	Honolulu County
69002	Fee-for-Service	1871511105	1871511105	1	1	WOO, LAURA E MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50654	05	Anesthesiology	0	In state provider	None	6633 TELEGRAPH AVE	STE B	OAKLAND	CA	94609	1115	01	06001	37.85249324	-122.2602468	Alameda County
69003	Fee-for-Service	1104139443	1104139443	1	1	WIEST, DANIEL J MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132112	05	Anesthesiology	0	In state provider	None	FRESNO & R STREET	None	FRESNO	CA	93721	1365	10	06019	36.741663	-119.7841005	Fresno County
69009	Fee-for-Service	1447337118	1447337118	1	1	WANG, GEORGE J PA	1/14/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1701 ZONAL AVE.	None	LOS ANGELES	CA	90033	1065	19	06037	34.06219051	-118.2106555	Los Angeles County
69025	Fee-for-Service	1922336114	1922336114	1	1	WHITE, WENDY E MD	12/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110153	67	Endocrinology	0	In state provider	None	39000 BOB HOPE DRIVE	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
69044	Fee-for-Service	1457451494	1457451494	1	1	WATTS-WHITE, PAULA A MD	4/29/1999	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	55408	40	Pediatrics	0	In state provider	None	635 ANDERSON RD	STE 13	DAVIS	CA	95616	3505	57	06113	38.5487623	-121.7587554	Yolo County
69050	Fee-for-Service	1619426046	1619426046	1	1	WILCOX, MICHAEL LPCC	5/14/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1622 4TH ST	None	SANTA ROSA	CA	95404	4020	49	06097	38.448162	-122.6995335	Sonoma County
69086	Fee-for-Service	1164622908	1164622908	1	1	WOGU, ELIJAH U DO	5/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	9318	14	Neurological Surgery	0	In state provider	None	400 NORTH PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
69099	Fee-for-Service	1043226608	1043226608	1	1	WALGREEN CO	7/7/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	41400 BLACOW RD	None	FREMONT	CA	94538	3387	01	06001	37.5225065	-121.9708497	Alameda County
69124	Fee-for-Service	1851303739	1851303739	1	1	WARE, SUZANNE MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77628	08	Family Practice	0	In state provider	None	8787 HALL RD	None	LAMONT	CA	93241	1953	15	06029	35.25969451	-118.908099	Kern County
69132	Fee-for-Service	1720077480	1720077480	1	1	WOLF, JEFFREY L MD	6/29/1989	207RH0000X	NA	Hematology	026	PHYSICIANS	25431	68	Hematology	0	In state provider	None	3001 COLBY ST	# AT	BERKELEY	CA	94705	2039	01	06001	37.85496934	-122.2575642	Alameda County
69142	Fee-for-Service	1457740342	1457740342	1	1	WOOD, ERICA R CCC-SLP	6/14/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
69292	Fee-for-Service	1942284062	1942284062	1	1	WINN, KAREN L MD	11/30/1986	207R00000X	NA	Other	026	PHYSICIANS	41685	67	Endocrinology	0	In state provider	None	130 E ROMIE LN	STE D	SALINAS	CA	93901	3160	27	06053	36.66175331	-121.6541075	Monterey County
69334	Fee-for-Service	1790361384	1790361384	1	1	WIN, KHAING KHAING MD	8/19/2024	390200000X	NA	Other	026	PHYSICIANS	187506	08	Family Practice	0	In state provider	None	550 W RANCH VIEW DR	2005	ROCKLIN	CA	95765	5396	31	06061	38.83760761	-121.2972372	Placer County
69346	Fee-for-Service	1124284880	1124284880	1	1	WHITELEY, PATRICK M MD	12/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116571	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
69385	Fee-for-Service	1811072564	1811072564	1	1	WALRAVENS, CHRISTINE F MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145081	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
69430	Fee-for-Service	1992102412	1992102412	1	1	WESTCARE CALIFORNIA, INC	12/5/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1150 W LACY BLVD	ROOMS 563 & 707	HANFORD	CA	93230	3575	16	06031	36.330741	-119.6619435	Kings County
69431	Fee-for-Service	1063456085	1063456085	1	1	WANG, HONG MD	12/22/2022	207L00000X	NA	Other	026	PHYSICIANS	174946	None	None	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
69446	Fee-for-Service	1235577925	1235577925	1	1	WHITE, CORISSA L PSYD	8/10/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
69527	Fee-for-Service	1467655720	1467655720	1	1	WILLIAMS, CLAUDIA M LCSW	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	62941	-	NOT APPLICABLE	0	In state provider	None	5628 E SLAUSON AVENUE	None	COMMERCE	CA	90040	2922	19	06037	33.98593459	-118.163681	Los Angeles County
69581	Fee-for-Service	1942284062	1942284062	1	1	WINN, KAREN L MD	11/30/1986	207R00000X	NA	Other	026	PHYSICIANS	41685	41	Internal Medicine	0	In state provider	None	130 E ROMIE LN	STE D	SALINAS	CA	93901	3160	27	06053	36.66175331	-121.6541075	Monterey County
69594	Fee-for-Service	1447461272	1447461272	1	1	WRIGHT, TABITA A MD	9/8/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58586	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
69600	Fee-for-Service	1699057927	1699057927	1	1	WOODS, LAWRENCE LCSW	5/8/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	129088	-	NOT APPLICABLE	0	In state provider	None	1400 EMELINE AVENUE	BUILDING K	SANTA CRUZ	CA	95060	1976	44	06087	36.99276804	-122.0178271	Santa Cruz County
69664	Fee-for-Service	1023307725	1023307725	1	1	WONG, CHRISTINE MD	3/8/2023	207P00000X	NA	Other	026	PHYSICIANS	142696	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
69670	Fee-for-Service	1134632185	1134632185	1	1	WALSH, KATHLEEN PT	6/18/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
69674	Fee-for-Service	1134784382	1134784382	1	1	WE DO CARE HOME HEALTH	7/14/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	21220 DEVONSHIRE ST	UNIT 202-B	CHATSWORTH	CA	91311	8262	19	06037	34.25721448	-118.594494	Los Angeles County
69721	Fee-for-Service	1871510297	1871510297	1	1	WAL-MART STORES, INC	10/13/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	27470 ALICIA PKWY	None	LAGUNA NIGUEL	CA	92677	3412	30	06059	33.563556	-117.7130295	Orange County
69763	Fee-for-Service	1679560767	1679560767	1	1	WELTON, TIMOTHY H OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	303 W LINCOLN AVE	STE 120	ANAHEIM	CA	92805	2928	30	06059	33.83508976	-117.9177981	Orange County
69820	Fee-for-Service	1154519189	1154519189	1	1	WALSTAD, KRISTIN LEE PT	11/15/2007	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11930 HERITAGE OAKS PL	#9 & 8	AUBURN	CA	95603	2458	31	06061	38.94059662	-121.0995593	Placer County
69821	Fee-for-Service	1588154892	1588154892	1	1	WIN, HNINYEE A DO	10/3/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	22281	41	Internal Medicine	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
69826	Fee-for-Service	1174187223	1174187223	1	1	WENSLEY, ASHLEY A CRNA	1/6/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
69911	Fee-for-Service	1073225660	1073225660	1	1	WASHINGTON, JAMIE S RCP	2/10/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
69936	Fee-for-Service	1467530956	1467530956	1	1	WYNN, RHODA D MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91197	84	Surgery-Head and Neck	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
69937	Fee-for-Service	1821245820	1821245820	1	1	WELCH, JAMES N MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116252	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
69949	Fee-for-Service	1073755005	1073755005	1	1	WANG, PAO-CHING MD	8/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105446	41	Internal Medicine	0	In state provider	None	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
69992	Fee-for-Service	1477238004	1477238004	1	1	WINNER, KAREL R NP	9/11/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7293 DUMOSA AVE	SUITE 5, 7 & 8	YUCCA VALLEY	CA	92284	3700	36	06071	34.12094334	-116.4177385	San Bernardino County
70011	Fee-for-Service	1679590913	1679590913	1	1	WAL-MART STORES, INC	2/1/1996	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102537	1515 DANA DR	None	REDDING	CA	96003	4014	45	06089	40.58563652	-122.34321	Shasta County
70016	Fee-for-Service	1043496821	1043496821	1	1	WINGO, ALIZA MD	11/4/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	STE 2800	SACRAMENTO	CA	95817	1353	34	06067	38.555631	-121.459203	Sacramento County
70029	Fee-for-Service	1770533622	1770533622	1	1	WILLIAMS, A JEFRI	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	274 N MAIN ST	None	LOGAN	UT	84321	3915	00	None	41.73627941	-111.834816	Cache County
70053	Fee-for-Service	1659398907	1659398907	1	1	WAL-MART STORES, INC	1/11/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102546	2300 N TUSTIN ST	None	ORANGE	CA	92865	3706	30	06059	33.828075	-117.8385255	Orange County
70059	Fee-for-Service	1962429381	1962429381	1	1	WAL-MART STORES, INC	10/18/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102150	3382 MURPHY CANYON RD	None	SAN DIEGO	CA	92123	2654	37	06073	32.805243	-117.116379	San Diego County
70095	Fee-for-Service	1104905199	1104905199	1	1	WESTERN PULMONARY MED GR	6/1/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	220 LAGUNA RD	STE 2	FULLERTON	CA	92835	2523	30	06059	33.89562646	-117.9305833	Orange County
70154	Fee-for-Service	1518285717	1518285717	1	1	WANG, JANE MD	8/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	45559	25	Physical Medicine and Rehabilitation	0	In state provider	None	349 EAST BULLARD	SUITE 105	FRESNO	CA	93710	5298	10	06019	36.82285854	-119.7825885	Fresno County
70160	Fee-for-Service	1851014492	1851014492	1	1	WESTCARE CALIFORNIA, INC.	10/28/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	707 LETTS AVE	None	CORCORAN	CA	93212	1753	16	06031	36.10297481	-119.5675775	Kings County
70203	Fee-for-Service	1215942305	1215942305	1	1	WALGREEN CO	8/13/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 MAGNOLIA AVE	None	RIVERSIDE	CA	92506	2903	33	06065	33.95316868	-117.3966345	Riverside County
70234	Fee-for-Service	1538812045	1538812045	1	1	WETTSTEIN, TATIANA N	5/24/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
70245	Fee-for-Service	1033363759	1033363759	1	1	WEISING, CHANDRA N LCSW	2/2/2009	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	4050 MARKET STREET	None	VENTURA	CA	93003	5625	56	06111	34.25912183	-119.2394249	Ventura County
70292	Fee-for-Service	1700465424	1700465424	1	1	WILS TRANSPORTATION	10/4/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	845 15TH STREET	SUITE 103, PMB#: 49213	SAN DIEGO	CA	92101	8092	37	06073	32.713983	-117.150352	San Diego County
70312	Fee-for-Service	1780047381	1780047381	1	1	WONG, IVY PT	3/7/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1300 E MAIN ST	STE. 210	ALHAMBRA	CA	91801	4150	19	06037	34.10150419	-118.1134548	Los Angeles County
70331	Fee-for-Service	1083662340	1083662340	1	1	WICHERSKI, BEATA A MD	2/28/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53981	40	Pediatrics	0	In state provider	None	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
70349	Fee-for-Service	1134324148	1134324148	1	1	WARDONO, IRA P MD	7/13/2010	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	112875	None	None	0	In state provider	None	420 34TH STREET	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
70364	Fee-for-Service	1144757204	1144757204	1	1	WRIGHT, STEPHANIE LCSW	12/6/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
70379	Fee-for-Service	1104905199	1104905199	1	1	WESTERN PULMONARY MED GR	6/1/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	220 LAGUNA RD	STE 2	FULLERTON	CA	92835	2523	30	06059	33.89562646	-117.9305833	Orange County
70382	Fee-for-Service	1518218122	1518218122	1	1	WEBER, MICHAL PHD	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
70397	Fee-for-Service	1619384385	1619384385	1	1	WEISE, DANIELA S LMFT	7/29/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21 TAMAL VISTA BLVD	SUITE 255	CORTE MADERA	CA	94925	1130	21	06041	37.93173997	-122.5179353	Marin County
70490	Fee-for-Service	1093720328	1093720328	1	1	WALGREEN CO	9/9/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	937 N H ST	None	LOMPOC	CA	93436	4148	42	06083	34.65297442	-120.4577595	Santa Barbara County
70496	Fee-for-Service	1841855525	1841855525	1	1	WATHUGALA, MELANIE MD	7/10/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187166	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
70503	Fee-for-Service	1285770560	1285770560	1	1	WEYRICH, JAMES J OD	1/31/1988	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2018 E 17TH ST	None	SANTA ANA	CA	92705	8647	30	06059	33.7597707	-117.8381627	Orange County
70549	Fee-for-Service	1831540673	1831540673	1	1	WHITE, MICHAEL MD	10/23/2023	207R00000X	NA	Other	026	PHYSICIANS	185096	None	None	0	In state provider	None	2975 NORTH SYCAMORE DR.	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
70561	Fee-for-Service	1073099438	1073099438	1	1	WEBER, MATTHEW DO	2/28/2025	390200000X	NA	Other	026	PHYSICIANS	17641	20	Orthopedic Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
70619	Fee-for-Service	1144549973	1144549973	1	1	WUCHENICH, JOHN R MD	8/15/2023	207R00000X	NA	Other	026	PHYSICIANS	162333	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
70627	Fee-for-Service	1407264203	1407264203	1	1	WAHIDI, NASRATULLAH MD	9/4/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	146559	36	Psychiatry	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
70639	Fee-for-Service	1386626729	1386626729	1	1	WAGMAN, ALLAN J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27772	30	Radiology	0	In state provider	None	100 OCEANGATE	STE 1000	LONG BEACH	CA	90802	4347	19	06037	33.76655046	-118.1989306	Los Angeles County
70668	Fee-for-Service	1275625881	1275625881	1	1	WEST GROUP PHARMACEUTICA	3/17/2006	332B00000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PROCARE PHARMACY	9191 WESTMINSTER AVE	None	GARDEN GROVE	CA	92844	2751	30	06059	33.75946879	-117.9688437	Orange County
70676	Fee-for-Service	1851470033	1851470033	1	1	WALLACE, DOUGLAS C MD	12/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66727	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
70687	Fee-for-Service	1396750105	1396750105	1	1	WUNSCHEL, STEVEN R MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53236	34	Urology and Urological Surgery	0	In state provider	None	1401 SPANOS CT	STE 111	MODESTO	CA	95355	2812	50	06099	37.66975543	-120.9724048	Stanislaus County
70704	Fee-for-Service	1205174505	1205174505	1	1	WONG, KELLY L MD	9/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123565	41	Internal Medicine	0	In state provider	None	5565 W LAS POSITAS BLVD	SUITE 260	PLEASANTON	CA	94588	5807	01	06001	37.69215143	-121.8800337	Alameda County
70743	Fee-for-Service	1538130406	1538130406	1	1	WEBSTER, BRUCE D	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4662 KATELLA AVE	STE E	LOS ALAMITOS	CA	90720	2668	30	06059	33.80297507	-118.0513143	Orange County
70753	Fee-for-Service	1083681258	1083681258	1	1	WHELAN, JOHN P MD	7/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	53446	83	Rheumatology	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
70770	Fee-for-Service	1104951508	1104951508	1	1	WAPNIR, IRENE L MD	3/29/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	50558	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
70803	Fee-for-Service	1003851130	1003851130	1	1	WHITE, FREDERICK E D0	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	4393	None	None	0	In state provider	None	995 SAINT JOHN PL	None	HEMET	CA	92543	4436	33	06065	33.74848448	-116.9616465	Riverside County
70847	Fee-for-Service	1083648307	1083648307	1	1	WARWICK, TANYA C MD	2/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95384	41	Internal Medicine	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
70848	Fee-for-Service	1710904941	1710904941	1	1	WAL-MART STORES, INC	8/20/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-5136	1131 N BEALE RD	None	MARYSVILLE	CA	95901	6107	58	06115	39.12555102	-121.5748093	Yuba County
70853	Fee-for-Service	1982757407	1982757407	1	1	WEST COUNTY OPTOMETRY	8/1/1993	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11780 SAN PABLO AVE	STE B	EL CERRITO	CA	94530	7103	07	06013	37.92771491	-122.3199892	Contra Costa County
70892	Fee-for-Service	1053522078	1053522078	1	1	WAHIDI, GHALIB M MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98850	41	Internal Medicine	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
70963	Fee-for-Service	1851470033	1851470033	1	1	WALLACE, DOUGLAS C MD	12/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66727	02	General Surgery	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
70979	Fee-for-Service	1801300298	1801300298	1	1	WYNN MEDICAL CENTER	2/9/2018	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	9126 VALLEY BLVD STE B	None	ROSEMEAD	CA	91770	1987	19	06037	34.08089747	-118.0704869	Los Angeles County
71026	Fee-for-Service	1013953579	1013953579	1	1	WOLDESENBET, MESFIN MD	5/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3001 SAINT ROSE PARKWAY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
71041	Fee-for-Service	1083681258	1083681258	1	1	WHELAN, JOHN P MD	7/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	53446	41	Internal Medicine	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
71127	Fee-for-Service	1487399325	1487399325	1	1	WELL, NICOLE CCC-SLP	12/14/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
71137	Fee-for-Service	1083648307	1083648307	1	1	WARWICK, TANYA C MD	2/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95384	13	Neurology (M.D. only)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
71157	Fee-for-Service	1346523438	1346523438	1	1	WRIGHT, CORI R CNP	2/22/2022	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
71167	Fee-for-Service	1629180203	1629180203	1	1	WELCH, MELISSA W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 E CHESTNUT ST	None	LOUISVILLE	KY	40202	1831	00	None	38.24813211	-85.7507777	Jefferson County
71171	Fee-for-Service	1063617116	1063617116	1	1	WEIGHT, STEPHEN S MD	7/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82871	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 MED PLAZA	SUITE 365,420,120	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
71181	Fee-for-Service	1053522078	1053522078	1	1	WAHIDI, GHALIB M MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98850	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
71218	Fee-for-Service	1831262203	1831262203	2	1	WATANABE, BRIAN I MD	12/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	83423	01	General Practice	0	In state provider	None	863 N DOUGLAS STREET	SUITE 100	EL SEGUNDO	CA	90245	2087	19	06037	33.92830583	-118.3831669	Los Angeles County
71223	Fee-for-Service	1407174410	1407174410	1	1	WA, CHRYSTAL V MD	10/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121389	67	Endocrinology	0	In state provider	None	3883 AIRWAY DR	STE 201	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
71251	Fee-for-Service	1851470033	1851470033	1	1	WALLACE, DOUGLAS C MD	12/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66727	33	Thoracic Surgery	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
71258	Fee-for-Service	1225033996	1225033996	1	1	WAINSTEIN, MARK A MD	8/17/2023	208800000X	NA	Other	026	PHYSICIANS	152876	None	None	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
71275	Fee-for-Service	1114424710	1114424710	1	1	WILLIAMS, JESSICA ASHLEY J M	4/7/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	174461	None	None	0	In state provider	D	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
71316	Fee-for-Service	1013953579	1013953579	1	1	WOLDESENBET, MESFIN MD	5/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	1	Border provider	None	3001 SAINT ROSE PARKWAY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
71380	Fee-for-Service	1730518432	1730518432	1	1	WAL-MART STORE INC	7/1/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1739 S VICTORIA AVE	None	VENTURA	CA	93003	6503	56	06111	34.25829287	-119.2110876	Ventura County
71384	Fee-for-Service	1316018229	1316018229	1	1	WOLFE, DAVID T DO	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7516	08	Family Practice	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
71456	Fee-for-Service	1063617116	1063617116	1	1	WEIGHT, STEPHEN S MD	7/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82871	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	SUITE 365,420,120	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
71508	Fee-for-Service	1831262203	1831262203	2	1	WATANABE, BRIAN I MD	12/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	83423	41	Internal Medicine	0	In state provider	None	863 N DOUGLAS STREET	SUITE 100	EL SEGUNDO	CA	90245	2087	19	06037	33.92830583	-118.3831669	Los Angeles County
71548	Fee-for-Service	1932300811	1932300811	1	1	WESSELS, DELIA A MD	3/21/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	88380	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
71644	Fee-for-Service	1730584129	1730584129	1	1	WOODLAND GARDEN I & II LLC	8/14/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1717 KATY PLACE	None	ESCONDIDO	CA	92026	1855	37	06073	33.1542654	-117.1233909	San Diego County
71695	Fee-for-Service	1023120060	1023120060	1	1	WHITELEY, JOANNA C MD	7/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84966	08	Family Practice	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
71722	Fee-for-Service	1114113115	1114113115	1	1	WALGREENS CO	11/30/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#21141	217 ALMA ST	STE 200	PALO ALTO	CA	94301	1017	43	06085	37.44563438	-122.1673764	Santa Clara County
71763	Fee-for-Service	1053818062	1053818062	1	1	WARM CARE HOSPICE AND	11/25/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE	12550 BROOKHURST ST	SUITE C	GARDEN GROVE	CA	92840	4834	30	06059	33.780591	-117.9584435	Orange County
71812	Fee-for-Service	1255369450	1255369450	1	1	WILLIAMS, FREDDIE A JR MD	4/22/2011	207L00000X	NA	Other	026	PHYSICIANS	53688	05	Anesthesiology	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	3526	19	06037	34.02390148	-118.184319	Los Angeles County
71845	Fee-for-Service	1144072711	1144072711	1	1	WILLIAMS, AMBER NP	4/29/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
71897	Fee-for-Service	1023645132	1023645132	1	1	WU, JONATHAN MD	10/1/2024	207L00000X	NA	Other	026	PHYSICIANS	189140	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
71918	Fee-for-Service	1649583410	1649583410	1	1	WIJEGUNAWARDENA, AMA S MD	7/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125459	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
71931	Fee-for-Service	1285286880	1285286880	1	1	WELLS, NAESHA LMFT	1/21/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
71934	Fee-for-Service	1245394774	1245394774	1	1	WISMER, KATHERINE M LMFT	8/6/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
71961	Fee-for-Service	1023278819	1023278819	1	1	WONG, ERIC A MD	8/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116150	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
72018	Fee-for-Service	1831129725	1831129725	1	1	WANKLIN, ROBERT J MD	5/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52717	66	Emergency Medicine (Urgent Care)	0	In state provider	None	520 W I ST	None	LOS BANOS	CA	93635	3419	24	06047	37.06346603	-120.8593647	Merced County
72020	Fee-for-Service	1467980854	1467980854	1	1	WARNELO, JONATHAN S DO	8/9/2019	207R00000X	NA	Other	026	PHYSICIANS	16595	41	Internal Medicine	0	In state provider	None	7955 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4001	30	06059	33.75932839	-117.9902744	Orange County
72025	Fee-for-Service	1154896272	1154896272	1	1	WILCOX, STEPHANIE M NP	11/8/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
72039	Fee-for-Service	1730177486	1730177486	1	1	WILCOX, DENNIS D MD	4/2/2008	208600000X	NA	General Surgery	026	PHYSICIANS	44471	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6699 ALVARADO RD	STE 2205	SAN DIEGO	CA	92120	5240	37	06073	32.77665383	-117.0540279	San Diego County
72051	Fee-for-Service	1316945058	1316945058	1	1	WITT, DYLAN J MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71312	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
72052	Fee-for-Service	1053818062	1053818062	1	1	WARM CARE HOSPICE AND	11/25/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE	12550 BROOKHURST ST	SUITE C	GARDEN GROVE	CA	92840	4834	30	06059	33.780591	-117.9584435	Orange County
72065	Fee-for-Service	1184669749	1184669749	1	1	WATTERSON, MARTIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2000 HOSPITAL DR	None	SEDRO WOOLLEY	WA	98284	4327	00	None	48.49548051	-122.2760925	Skagit County
72070	Fee-for-Service	1952914681	1952914681	1	12	WEST COAST KIDNEY	11/23/2022	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	494 HAWTHORNE AVE	STE B	OAKLAND	CA	94609	3069	01	06001	37.82131309	-122.2662483	Alameda County
72099	Fee-for-Service	1255369450	1255369450	1	1	WILLIAMS, FREDDIE A JR MD	4/22/2011	207L00000X	NA	Other	026	PHYSICIANS	53688	01	General Practice	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	3526	19	06037	34.02390148	-118.184319	Los Angeles County
72107	Fee-for-Service	1679651426	1679651426	1	1	WESLEY, PAUL T MD	11/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	53892	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13855 E 14TH ST	None	SAN LEANDRO	CA	94578	2611	01	06001	37.712385	-122.143428	Alameda County
72136	Fee-for-Service	1639177520	1639177520	2	1	WHITTIER PRIMARY CARE PHYSIC	3/30/2022	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	15111 E. WHITTIER BLVD.	SUITE 102	WHITTIER	CA	90603	3301	19	06037	33.94841455	-118.0049729	Los Angeles County
72138	Fee-for-Service	1225038185	1225038185	1	1	WOODS, DAVID J MD	2/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86919	None	None	0	In state provider	None	6009 PENTZ RD	STE A	PARADISE	CA	95969	5542	04	06007	39.75746555	-121.5723505	Butte County
72140	Fee-for-Service	1386674927	1386674927	1	1	WILSON, FIONA C MD	10/30/1990	207R00000X	NA	Other	026	PHYSICIANS	68635	01	General Practice	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
72189	Fee-for-Service	1124123245	1124123245	1	1	WARF, CURREN MD	8/31/1989	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	67146	40	Pediatrics	0	In state provider	None	100 CONGRESS ST	PEDIATRICS	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
72198	Fee-for-Service	1265460828	1265460828	1	1	WALGREEN CO	12/26/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2453 S AZUSA AVE	None	WEST COVINA	CA	91792	1536	19	06037	34.03209594	-117.914484	Los Angeles County
72213	Fee-for-Service	1295029098	1295029098	1	1	WOODARD, PATRICK A MD	7/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
72215	Fee-for-Service	1750744165	1750744165	1	1	WANG, TRACY C OD	10/26/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
72237	Fee-for-Service	1134208291	1134208291	1	1	WOO, BEVERLY M MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75071	40	Pediatrics	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
72246	Fee-for-Service	1992815336	1992815336	1	1	WARD, HARRY J MD	1/1/1982	207RN0300X	NA	Nephrology	026	PHYSICIANS	40214	None	None	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
72257	Fee-for-Service	1912988775	1912988775	1	1	WINDER, KEITH A DO	8/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
72261	Fee-for-Service	1134176613	1134176613	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3724 CRENSHAW BLVD	None	LOS ANGELES	CA	90016	5804	19	06037	34.01920721	-118.3350691	Los Angeles County
72285	Fee-for-Service	1124412275	1124412275	1	1	WARREN, MATTHEW B MD	10/4/2021	207LC0200X	NA	Other	026	PHYSICIANS	170797	None	None	0	In state provider	None	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
72326	Fee-for-Service	1730177486	1730177486	1	1	WILCOX, DENNIS D MD	4/2/2008	208600000X	NA	General Surgery	026	PHYSICIANS	44471	02	General Surgery	0	In state provider	None	6699 ALVARADO RD	STE 2205	SAN DIEGO	CA	92120	5240	37	06073	32.77665383	-117.0540279	San Diego County
72404	Fee-for-Service	1033134523	1033134523	1	1	WILSON, MELLISA M	2/25/2009	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1792 TRIBUTE ROAD	STE 350	SACRAMENTO	CA	95815	4322	34	06067	38.598219	-121.445964	Sacramento County
72410	Fee-for-Service	1013088913	1013088913	1	1	WALD, PAMELA S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39048	40	Pediatrics	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
72411	Fee-for-Service	1881140044	1881140044	1	1	WALKER, QUESTA E NP	1/1/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2559 W ROSAMOND BLVD	STE D	ROSAMOND	CA	93560	6267	15	06029	34.86420508	-118.1771868	Kern County
72436	Fee-for-Service	1841205176	1841205176	1	1	WALGREEN CO	6/4/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20011 BOLLINGER RD	None	CUPERTINO	CA	95014	4532	43	06085	37.3100911	-122.0238802	Santa Clara County
72441	Fee-for-Service	1205904133	1205904133	1	1	WILLE, MARK MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	25177	41	Internal Medicine	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
72443	Fee-for-Service	1003438623	1003438623	1	1	WENZ, ROBERT C CRNA	8/13/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
72501	Fee-for-Service	1164507349	1164507349	1	1	WOODLAND, LARRY A LCSW	10/2/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	63566	-	NOT APPLICABLE	0	In state provider	None	300 SUNNY HILLS DR	BLDG 3	SAN ANSELMO	CA	94960	1909	21	06041	37.98269146	-122.5611947	Marin County
72555	Fee-for-Service	1265427439	1265427439	1	1	WESTCOTT, JAMES A MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	40706	08	Family Practice	0	In state provider	None	114 MISSION RANCH BLVD	STE 10	CHICO	CA	95926	2186	04	06007	39.75356438	-121.8600403	Butte County
72628	Fee-for-Service	1497874598	1497874598	1	1	WHITTEN, DEBORAH LMFT	5/21/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1904 RICHLAND AVE	None	CERES	CA	95307	9440	50	06099	37.60031128	-120.9658226	Stanislaus County
72700	Fee-for-Service	1275026668	1275026668	1	1	WANG, ZHIMIAO CA	11/6/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1608 LAUREL ST	None	SAN CARLOS	CA	94070	5217	41	06081	37.494878	-122.2472602	San Mateo County
72712	Fee-for-Service	1689753295	1689753295	1	1	WOMEN'S HEALTH GROUP	1/1/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1850 SULLIVAN AVE	STE 312	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
72737	Fee-for-Service	1497713846	1497713846	1	1	WOLF, RICHARD B DO	5/31/1996	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	6028	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
72746	Fee-for-Service	1972007862	1972007862	1	1	WHITED, MATTHEW D MD	5/10/2021	390200000X	NA	Other	026	PHYSICIANS	165421	None	None	0	In state provider	None	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
72753	Fee-for-Service	1427138619	1427138619	1	1	WONG, RICHARD M MD	12/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	62188	18	Ophthalmology	0	In state provider	None	255 E WEBER AVE	None	STOCKTON	CA	95202	2706	39	06077	37.95422434	-121.2877163	San Joaquin County
72766	Fee-for-Service	1891857405	1891857405	1	1	WAKIM, PAUL E	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	4964	20	Orthopedic Surgery	0	In state provider	None	17220 NEWHOPE ST	STE 127	FOUNTAIN VALLEY	CA	92708	4283	30	06059	33.713244	-117.923877	Orange County
72769	Fee-for-Service	1427006808	1427006808	1	1	WILEY, DANA MD	7/8/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
72814	Fee-for-Service	1386006088	1386006088	1	1	WELZENBACH, MATTHEW	12/13/2022	207R00000X	NA	Other	026	PHYSICIANS	161635	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
72823	Fee-for-Service	1861495483	1861495483	1	1	WALKER, KATHY N MD	5/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	62528	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	CARING FOR YOU OBSTETRIC	3012 SAN GABRIEL BLVD	None	ROSEMEAD	CA	91770	2536	19	06037	34.06363316	-118.090457	Los Angeles County
72859	Fee-for-Service	1104272814	1104272814	1	1	WEN, TIMOTHY MD	7/30/2021	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168645	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
72910	Fee-for-Service	1659809523	1659809523	1	1	WOSTAK, MATTHEW G DO	6/29/2021	207P00000X	NA	Other	026	PHYSICIANS	18677	None	None	0	In state provider	None	7500 HOSPITAL DRIVE	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
72930	Fee-for-Service	1700181419	1700181419	1	1	WARRIOR, VANESSA L	5/15/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	980 ROOSEVELT	STE 100	IRVINE	CA	92620	3670	30	06059	33.69380208	-117.7653165	Orange County
72950	Fee-for-Service	1295964427	1295964427	1	1	WASHINGTON, COURTNEY R MD	9/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108767	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVENUE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
73027	Fee-for-Service	1962674283	1962674283	1	1	WALDRON, PAUL R MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120662	77	Infectious Disease	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
73034	Fee-for-Service	1922206481	1922206481	1	1	WIGAN, CAROLINE V MD	3/18/2019	207L00000X	NA	Other	026	PHYSICIANS	139255	05	Anesthesiology	0	In state provider	None	MARSHALL WAY	None	PLACERVILLE	CA	95667	0000	09	06017	38.72587744	-120.791388	El Dorado County
73053	Fee-for-Service	1114939568	1114939568	1	1	WEINSTOCK, BERNARD I MD	7/15/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	34920	04	Otology, Laryngology, Rhinology	0	In state provider	PROFESSIONAL CORPORATION	3839 CONSTELLATION RD	STE A	LOMPOC	CA	93436	0432	42	06083	34.70235386	-120.4654307	Santa Barbara County
73059	Fee-for-Service	1598941072	1598941072	1	1	WAL-MART STORES, INC	1/7/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 105335	250 WILD CAT DR	None	BRAWLEY	CA	92227	9654	13	06025	32.96363371	-115.5458549	Imperial County
73146	Fee-for-Service	1669009775	1669009775	1	1	WILSON, CAMILLE MD	12/7/2023	390200000X	NA	Other	026	PHYSICIANS	188246	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
73162	Fee-for-Service	1255409835	1255409835	1	1	WINSLOW, DEAN L MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84691	77	Infectious Disease	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
73167	Fee-for-Service	1497047195	1497047195	1	1	WANG, EDWARD W MD	9/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144459	41	Internal Medicine	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
73203	Fee-for-Service	1851404040	1851404040	1	1	WATANABE, DENNIS H OD	3/1/1994	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4476 TWEEDY BLVD	None	SOUTH GATE	CA	90280	6359	19	06037	33.94280053	-118.1931037	Los Angeles County
73205	Fee-for-Service	1841217189	1841217189	1	1	WAL-MART STORES INC	1/19/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-2952	41200 MURRIETA H SPG RD	None	MURRIETA	CA	92562	0000	33	06065	33.552576	-117.192663	Riverside County
73214	Fee-for-Service	1699471482	1699471482	1	1	WEA CA PC	12/5/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	969 E 12TH ST	STE D	LOS ANGELES	CA	99021	2201	19	06037	34.03122522	-118.2477485	Los Angeles County
73223	Fee-for-Service	1922156702	1922156702	1	1	WOODING, DAVID MD	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61938	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
73227	Fee-for-Service	1972827483	1972827483	1	1	WOMENS PAVILION MEDICAL	9/13/2010	193400000X	NA	Other	026	PHYSICIANS	55892	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	GROUP INC	191 S BUENA VISTA ST	STE 340	BURBANK	CA	91505	4554	19	06037	34.15872557	-118.3283863	Los Angeles County
73291	Fee-for-Service	1205903127	1205903127	1	1	WEBER, JOHN J MD	9/12/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64073	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
73306	Fee-for-Service	1699090332	1699090332	1	1	WALLIN, DINA MD	3/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120626	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
73345	Fee-for-Service	1396762647	1396762647	1	1	WAL-MART STORES, INC	12/5/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102251	17150 GALE AVE	None	CITY OF INDUSTRY	CA	91745	1809	19	06037	33.9984	-117.9323325	Los Angeles County
73351	Fee-for-Service	1578524617	1578524617	1	1	WILLIAMS, ARTHUR H MD	9/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	21327	22	Pathology (M.D. only)	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
73354	Fee-for-Service	1760409189	1760409189	1	1	WAL-MART STORES, INC	1/30/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101915	57980 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	5878	36	06071	34.129467	-116.399628	San Bernardino County
73372	Fee-for-Service	1760936835	1760936835	1	1	WELL STREET PSYCHOLOGICAL GR	7/12/2023	103TB0200X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	100 S IMPERIAL HWY	None	ANAHEIM	CA	92807	3943	30	06059	33.85001282	-117.7903584	Orange County
73417	Fee-for-Service	1114260858	1114260858	1	1	WEAVER, CATHERINE M MD	5/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135102	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
73447	Fee-for-Service	1689659187	1689659187	1	1	WALTER, LOUISE C MD	9/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	61028	38	Geriatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
73450	Fee-for-Service	1255409835	1255409835	1	1	WINSLOW, DEAN L MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84691	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
73462	Fee-for-Service	1992861694	1992861694	1	1	WESTSIDE COMMUNITY MENTAL	3/23/2016	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	1301 PIERCE STREET	None	SAN FRANCISCO	CA	94115	4005	38	06075	37.78238106	-122.4359186	San Francisco County
73486	Fee-for-Service	1487099412	1487099412	1	1	WOOD, EDWARD H MD	6/24/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	134004	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
73492	Fee-for-Service	1699471482	1699471482	1	1	WEA CA PC	12/5/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	39	Preventive (M.D. only)	0	In state provider	None	969 E 12TH ST	STE D	LOS ANGELES	CA	99021	2201	19	06037	34.03122522	-118.2477485	Los Angeles County
73494	Fee-for-Service	1609099894	1609099894	1	1	WOODLEY, TRICIA E	7/30/2007	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1234 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3911	38	06075	37.781144	-122.4390035	San Francisco County
73507	Fee-for-Service	1891836482	1891836482	1	1	WEST CONTRA COSTA UROLOG	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	SURGERY MED GRP INC	2089 VALE RD	STE 25	SAN PABLO	CA	94806	3849	07	06013	37.95396781	-122.3375393	Contra Costa County
73535	Fee-for-Service	1679559983	1679559983	1	1	WAYNE GENERAL HOSPITAL	7/1/2023	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	950 MATTHEW DR	None	WAYNESBORO	MS	39367	2567	00	None	31.67419648	-88.6340655	Wayne County
73546	Fee-for-Service	1396057576	1396057576	1	1	WONG, WAIKEONG P MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132901	30	Radiology	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
73550	Fee-for-Service	1215092382	1215092382	1	1	WUSTHOFF, COURTNEY J MD	10/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92656	79	Neurology-Child	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
73580	Fee-for-Service	1205903127	1205903127	1	1	WEBER, JOHN J MD	9/12/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64073	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
73609	Fee-for-Service	1043452659	1043452659	1	1	WLADYKA, CHRISTOPHER G MD	8/27/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	119260	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
73640	Fee-for-Service	1912906140	1912906140	1	1	WOLNISTY, CARL MD	3/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	5804	41	Internal Medicine	0	In state provider	None	3838 SHERMAN DR	STE 7	RIVERSIDE	CA	92503	4001	33	06065	33.92678822	-117.4368632	Riverside County
73661	Fee-for-Service	1760936835	1760936835	1	1	WELL STREET PSYCHOLOGICAL GR	7/12/2023	103TB0200X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	100 S IMPERIAL HWY	None	ANAHEIM	CA	92807	3943	30	06059	33.85001282	-117.7903584	Orange County
73684	Fee-for-Service	1437847837	1437847837	1	1	WISEMD	3/19/2024	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1111 W 4TH ST	STE A	MADERA	CA	93637	4474	20	06039	36.95563823	-120.0735861	Madera County
73727	Fee-for-Service	1447273438	1447273438	1	2	WASHOE TRIBE HEALTH CLIN	3/7/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	1559 WATASHEAMU RD	None	GARDNERVILLE	NV	89460	7455	00	None	38.90016089	-119.7157447	Douglas County
73742	Fee-for-Service	1518974575	1518974575	1	1	WALGREEN CO.	4/30/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17383 MAIN ST	None	HESPERIA	CA	92345	6111	36	06071	34.41887306	-117.2836865	San Bernardino County
73743	Fee-for-Service	1649659954	1649659954	1	1	WANG, KATHLEEN J DO	7/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	14992	01	General Practice	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
73749	Fee-for-Service	1306888995	1306888995	1	1	WAGNER, KENDALL S MD	10/17/1987	174400000X	NA	Other	026	PHYSICIANS	40943	20	Orthopedic Surgery	0	In state provider	None	12522 LAMBERT RD	None	WHITTIER	CA	90606	2758	19	06037	33.96495228	-118.0466484	Los Angeles County
73753	Fee-for-Service	1699013250	1699013250	1	1	WESTERN HEALTH RESOURCES	4/1/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	281 HARVEY DR	UNIT A	GLENDALE	CA	91206	4112	19	06037	34.14922116	-118.2276936	Los Angeles County
73759	Fee-for-Service	1831150200	1831150200	1	1	WOLKE, IRA S MD	3/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88183	30	Radiology	0	In state provider	None	555 SOUTH 7TH AVE	None	BARSTOW	CA	92311	3086	36	06071	34.894062	-117.0196215	San Bernardino County
73760	Fee-for-Service	1972977783	1972977783	2	1	WWJD PHARMACY CORP	5/20/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9091 EDINGER AVE	STE B	WESTMINSTER	CA	92683	7458	30	06059	33.73034951	-117.9706005	Orange County
73764	Fee-for-Service	1598826612	1598826612	1	1	WEINBERG, BENJAMIN M MD	6/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80826	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
73782	Fee-for-Service	1699471482	1699471482	1	1	WEA CA PC	12/5/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	44	Public Health	0	In state provider	None	969 E 12TH ST	STE D	LOS ANGELES	CA	99021	2201	19	06037	34.03122522	-118.2477485	Los Angeles County
73783	Fee-for-Service	1376806661	1376806661	1	1	WOODHULL, ASHLEYANN C PHD	5/30/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
73792	Fee-for-Service	1265799803	1265799803	1	1	WU, WINSTON S MD	6/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129892	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
73798	Fee-for-Service	1659435790	1659435790	1	1	WEBSTER, CHRISTY F LCSW	11/10/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
73807	Fee-for-Service	1881932846	1881932846	1	1	WENDELL, SHIRLEY V NP	8/18/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
73808	Fee-for-Service	1346778081	1346778081	1	1	WARD-MCKINLAY, THOMAS PHD	6/14/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
73822	Fee-for-Service	1679559983	1679559983	1	1	WAYNE GENERAL HOSPITAL	7/1/2023	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	950 MATTHEW DR	None	WAYNESBORO	MS	39367	2567	00	None	31.67419648	-88.6340655	Wayne County
73824	Fee-for-Service	1750396081	1750396081	1	1	WALGREEN CO	1/30/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	980 E CYPRESS AVE	None	REDDING	CA	96002	1002	45	06089	40.5710705	-122.353722	Shasta County
73866	Fee-for-Service	1265814289	1265814289	1	1	WRITT, JERROD D MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136828	01	General Practice	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
73881	Fee-for-Service	1235209669	1235209669	1	1	WOODY, JAY ROBERT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
73882	Fee-for-Service	1720582349	1720582349	1	1	WU, ERIC M MD	10/7/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
73919	Fee-for-Service	1316150477	1316150477	1	1	WOJCIECH C JANOWSKI MD	5/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4403 HARRISON BLVD	STE 3815	OGDEN	UT	84403	3330	00	None	41.18328	-111.9536955	Weber County
73930	Fee-for-Service	1053364471	1053364471	1	1	WROBLEWSKI, EDMUND M MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	44723	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4355	42	06083	34.42967671	-119.7228362	Santa Barbara County
73950	Fee-for-Service	1760936835	1760936835	1	1	WELL STREET PSYCHOLOGICAL GR	1/12/2024	103TB0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	100 S IMPERIAL HWY	None	ANAHEIM	CA	92807	3943	30	06059	33.85001282	-117.7903584	Orange County
73956	Fee-for-Service	1760420939	1760420939	1	1	WISECARVER, JAMES L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
73958	Fee-for-Service	1770872335	1770872335	1	1	WEAGRAFF, SANDRA L LMFT	5/29/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12371 LEWIS ST	103	GARDEN GROVE	CA	92840	4687	30	06059	33.78341032	-117.8984137	Orange County
74006	Fee-for-Service	1144214636	1144214636	1	1	WINDHAM, MARION R MD	1/2/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	34630	01	General Practice	0	In state provider	None	81709 DR CARREON BLVD	STE C3	INDIO	CA	92201	5577	33	06065	33.70733082	-116.2400326	Riverside County
74029	Fee-for-Service	1609915768	1609915768	1	1	WASSER, HARRIS L MD	1/1/2002	207R00000X	NA	Other	026	PHYSICIANS	37142	41	Internal Medicine	0	In state provider	None	2950 SYCAMORE DR	STE 200	SIMI VALLEY	CA	93065	1210	56	06111	34.28932056	-118.7438673	Ventura County
74046	Fee-for-Service	1457388811	1457388811	1	1	WOOD, WALTER H MD	12/17/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	39822	07	Dermatology	0	In state provider	None	2016 FOREST AVE	STE 5	SAN JOSE	CA	95128	4804	43	06085	37.327006	-121.933009	Santa Clara County
74077	Fee-for-Service	1396762621	1396762621	1	1	WAL-MART STORES INC	9/5/1996	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 102297	25450 THE OLD RD	None	STEVENSON RANCH	CA	91381	1704	19	06037	34.38298427	-118.5711734	Los Angeles County
74082	Fee-for-Service	1942352174	1942352174	1	1	WAREHOUSE, JUDI M LMFT	2/3/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
74089	Fee-for-Service	1619003944	1619003944	1	1	WONG, CLINTON K OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12810 HEACOCK ST	STE B104	MORENO VALLEY	CA	92553	3171	33	06065	33.934851	-117.2437635	Riverside County
74097	Fee-for-Service	1053470716	1053470716	1	1	WELGREEN, SANDRA MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37079	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
74110	Fee-for-Service	1356356646	1356356646	1	1	WALGREEN CO	11/16/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4201 DALE RD	None	MODESTO	CA	95356	9767	50	06099	37.700883	-121.0500865	Stanislaus County
74157	Fee-for-Service	1871828228	1871828228	1	1	WILLIAMS, JULIE T K MFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52441	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	None	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
74164	Fee-for-Service	1659385151	1659385151	1	1	WELLS, STEPHEN R MD APC	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	49731	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	110 TAMPICO	STE 220	WALNUT CREEK	CA	94598	2962	07	06013	37.91113845	-122.0458263	Contra Costa County
74172	Fee-for-Service	1720582349	1720582349	1	1	WU, ERIC M MD	10/7/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
74213	Fee-for-Service	1023168259	1023168259	1	1	WILSON, SANDRA A LMFT	4/7/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3590 EL PORTAL DR.	7, 8, 9, 10, 15, 16, & 1	REDDING	CA	96002	3154	45	06089	40.55435123	-122.3565549	Shasta County
74268	Fee-for-Service	1437178803	1437178803	1	1	WU, GLORIA MD	6/8/2010	207W00000X	NA	Ophthalmology	026	PHYSICIANS	59994	18	Ophthalmology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
74270	Fee-for-Service	1417482555	1417482555	1	1	WEINGART, MICHAEL MD	12/28/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169383	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
74281	Fee-for-Service	1699287698	1699287698	1	1	WEST, ELIZABETH CNP	10/21/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
74283	Fee-for-Service	1124430111	1124430111	1	1	WELL-CARE PHARMACY	8/22/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3645 NORTHGATE BLVD	STE F	SACRAMENTO	CA	95834	1641	34	06067	38.631906	-121.4762625	Sacramento County
74323	Fee-for-Service	1033124128	1033124128	1	1	WALGREEN CO	10/8/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 W. TEHACHAPI BLVD	None	TEHACHAPI	CA	93561	0000	15	06029	35.1318273	-118.4672295	Kern County
74458	Fee-for-Service	1982072351	1982072351	1	1	WONG, ALEXANDER MD	9/25/2023	207R00000X	NA	Other	026	PHYSICIANS	188230	None	None	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
74486	Fee-for-Service	1598968166	1598968166	1	1	WEIR, PAUL D MD INC	8/25/1999	207L00000X	NA	Other	026	PHYSICIANS	62412	None	None	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
74488	Fee-for-Service	1598181091	1598181091	1	1	WESTCHESTER MEDICAL CENTER	5/26/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	241 NORTH RD	None	POUGHKEEPSIE	NY	12601	1154	00	None	41.717502	-73.9281915	Dutchess County
74642	Fee-for-Service	1649603390	1649603390	1	1	WILLIS, PAUL S MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121277	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
74648	Fee-for-Service	1760446751	1760446751	1	1	WANG, WENDY MD	3/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87570	40	Pediatrics	0	In state provider	None	201 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6385	43	06085	37.36812305	-122.0312314	Santa Clara County
74680	Fee-for-Service	1750716510	1750716510	1	1	WONG, NICHOLAS L	2/9/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
74719	Fee-for-Service	1275071771	1275071771	1	1	WILKINSON, MALLORY LMFT	11/18/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4344 LATHAM ST.	110	RIVERSIDE	CA	92501	0400	33	06065	34.00198519	-117.3739252	Riverside County
74726	Fee-for-Service	1023054798	1023054798	1	1	WOODARD, ROGER MD	10/31/1991	207P00000X	NA	Other	026	PHYSICIANS	37338	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
74729	Fee-for-Service	1225314107	1225314107	1	1	WELLCARE MEDICAL GROUP	8/17/2012	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	16415 S COLORADO AVENUE	SUITE 208	PARAMOUNT	CA	90723	5054	19	06037	33.8853075	-118.1614695	Los Angeles County
74738	Fee-for-Service	1770868580	1770868580	1	1	WALGREEN CO.	2/13/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1745 UNIVERSITY AVENUE	None	RIVERSIDE	CA	92507	5343	33	06065	33.97576049	-117.349551	Riverside County
74778	Fee-for-Service	1417927310	1417927310	1	1	WANDEL, AMY G MD	1/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52862	24	Plastic Surgery	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
74781	Fee-for-Service	1861656308	1861656308	1	1	WASHINGTON RADIATION	6/30/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	ONCOLOGY	39101 CIVIC CENTER DRIVE	None	FREMONT	CA	94538	5817	01	06001	37.55467054	-121.9770646	Alameda County
74793	Fee-for-Service	1174213037	1174213037	1	1	WESTMINSTER HOME INC	10/17/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7571 WYOMING STREET	None	WESTMINSTER	CA	92683	9322	30	06059	33.76101649	-117.9973395	Orange County
74794	Fee-for-Service	1639503972	1639503972	1	1	WHITE FIR HOLDINGS LLC	1/3/2014	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2600 L STREET	None	SACRAMENTO	CA	95816	5612	34	06067	38.571921	-121.472541	Sacramento County
74836	Fee-for-Service	1417578550	1417578550	1	1	WILCOXON, ANNA S NP	9/9/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
74932	Fee-for-Service	1427603109	1427603109	1	1	WILLMS, HANNAH L	10/14/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
74942	Fee-for-Service	1043795370	1043795370	1	1	WORTHAM, TERREN C CRNA	12/19/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
75014	Fee-for-Service	1942640776	1942640776	1	1	WALKER, MICHAEL	5/21/2020	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2865 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
75016	Fee-for-Service	1225314107	1225314107	1	1	WELLCARE MEDICAL GROUP	8/17/2012	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	16415 S COLORADO AVENUE	SUITE 208	PARAMOUNT	CA	90723	5054	19	06037	33.8853075	-118.1614695	Los Angeles County
75018	Fee-for-Service	1245245539	1245245539	1	1	WALGREEN CO	3/9/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1071 N MAIN ST	None	MANTECA	CA	95336	3744	39	06077	37.81152667	-121.2170527	San Joaquin County
75058	Fee-for-Service	1871765305	1871765305	1	1	WONG, ANDY W MD	8/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112021	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1509 WILSON TER	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
75115	Fee-for-Service	1053585711	1053585711	1	1	WHITLATCH, LYMAN W MD	8/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108303	14	Neurological Surgery	0	In state provider	None	251 COHASSET ROAD	STE 370	CHICO	CA	95926	2776	04	06007	39.75090044	-121.8522609	Butte County
75129	Fee-for-Service	1700813318	1700813318	1	1	WANG, SHENG-YONG MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	74153	45	Nephrology (Renal-Kidney)	0	In state provider	None	2324 MONTPELIER DRIVE	STE 8	SAN JOSE	CA	95116	1612	43	06085	37.3648224	-121.8481115	Santa Clara County
75159	Fee-for-Service	1518949049	1518949049	1	1	WELLER, MICHAEL H MD	7/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	12497	30	Radiology	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
75165	Fee-for-Service	1851681464	1851681464	1	1	WANG, TINA J MD	8/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122282	25	Physical Medicine and Rehabilitation	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
75173	Fee-for-Service	1023216926	1023216926	1	1	WINSTON, TIFFANY M LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
75202	Fee-for-Service	1942080981	1942080981	1	1	WELL MENTAL HEALTH COUNSELIN	4/10/2024	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	6281 BEACH BLVD	316	BUENA PARK	CA	90621	4253	30	06059	33.869295	-118.0001115	Orange County
75263	Fee-for-Service	1457419046	1457419046	1	1	WONG, ADAM K MD	4/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95311	05	Anesthesiology	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
75270	Fee-for-Service	1801156799	1801156799	1	1	WU, ROGER Y MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142467	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95242	3635	39	06077	38.12188356	-121.285872	San Joaquin County
75300	Fee-for-Service	1225314107	1225314107	1	1	WELLCARE MEDICAL GROUP	8/17/2012	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	16415 S COLORADO AVENUE	SUITE 208	PARAMOUNT	CA	90723	5054	19	06037	33.8853075	-118.1614695	Los Angeles County
75329	Fee-for-Service	1043375231	1043375231	1	1	WASTILA, LISA J MD	1/1/1998	207R00000X	NA	Other	026	PHYSICIANS	60801	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
75334	Fee-for-Service	1285747931	1285747931	1	1	WANG, JOHN ZHENG MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67229	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
75345	Fee-for-Service	1194803841	1194803841	1	1	WONG, LISA MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	79656	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
75347	Fee-for-Service	1033295084	1033295084	2	1	WELLSPACE HEALTH	3/12/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4441 AUBURN BLVD	SUITES A, B, C, D, E, F	SACRAMENTO	CA	95841	4139	34	06067	38.647872	-121.361436	Sacramento County
75370	Fee-for-Service	1932468774	1932468774	1	1	WILKIE, SEAN A MD	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121311	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
75376	Fee-for-Service	1124130943	1124130943	1	1	WILCHES, ALBERTO MD	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	47920	08	Family Practice	0	In state provider	None	7831 JACKSON ST	None	PARAMOUNT	CA	90723	5016	19	06037	33.88544074	-118.1616267	Los Angeles County
75383	Fee-for-Service	1164818035	1164818035	1	1	WIEGAND, SARAH E DO	7/28/2021	2084N0402X	NA	Neurology	026	PHYSICIANS	16503	None	None	0	In state provider	None	8001 FROST STREET	None	SAN DIEGO	CA	92123	2746	37	06073	32.802147	-117.151371	San Diego County
75386	Fee-for-Service	1114063716	1114063716	1	1	WU, DENNIS Y MD	3/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77652	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
75415	Fee-for-Service	1700813318	1700813318	1	1	WANG, SHENG-YONG MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	74153	41	Internal Medicine	0	In state provider	None	2324 MONTPELIER DRIVE	STE 8	SAN JOSE	CA	95116	1612	43	06085	37.3648224	-121.8481115	Santa Clara County
75460	Fee-for-Service	1639469828	1639469828	1	1	WU, PETER W J MD	9/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125228	18	Ophthalmology	0	In state provider	None	1650 RESPONSE RD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
75467	Fee-for-Service	1780660472	1780660472	1	1	WATANABE, ALYSSA T MD	12/1/2003	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	63862	30	Radiology	0	In state provider	None	391 N MAIN ST	STE 110	CORONA	CA	92880	2001	33	06065	33.88549996	-117.5647021	Riverside County
75490	Fee-for-Service	1942080981	1942080981	1	1	WELL MENTAL HEALTH COUNSELIN	4/10/2024	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	6281 BEACH BLVD	316	BUENA PARK	CA	90621	4253	30	06059	33.869295	-118.0001115	Orange County
75496	Fee-for-Service	1508805722	1508805722	1	1	WEILAND, FREDERICK L MD	12/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	39050	42	Nuclear Medicine	0	In state provider	None	333 SUNRISE AVE	None	ROSEVILLE	CA	95661	3479	31	06061	38.740806	-121.272001	Placer County
75526	Fee-for-Service	1629176912	1629176912	1	1	WONG, PIERRE MD	6/11/1998	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	55315	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
75544	Fee-for-Service	1568540102	1568540102	1	1	WU, JULIE MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75303	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
75545	Fee-for-Service	1528707551	1528707551	1	1	WHEEL& CARE LLC	11/27/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	9245 LAGUNA SPRING DRIVE	200	ELK GROVE	CA	95758	7987	34	06067	38.422494	-121.3965495	Sacramento County
75582	Fee-for-Service	1356324974	1356324974	1	1	WAETJEN, LOIS E MD	5/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68623	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	# M1477	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
75603	Fee-for-Service	1497389365	1497389365	1	1	WARLICK-BROWN, SAMANTHA Y	3/11/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	12476 CRYSTAL RANCH RD	None	MOORPARK	CA	93021	2916	56	06111	34.26501629	-118.8880954	Ventura County
75606	Fee-for-Service	1023070661	1023070661	2	1	WOODS, DIRK W MD	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	280 MAPLE	None	ASHLAND	OR	97520	1552	00	None	42.20644248	-122.724936	Jackson County
75621	Fee-for-Service	1285747931	1285747931	1	1	WANG, JOHN ZHENG MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67229	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
75652	Fee-for-Service	1285895128	1285895128	1	1	WESTBROOK, ROBYN PHD	8/5/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10833 LE CONTE AVE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
75680	Fee-for-Service	1740387737	1740387737	1	1	WU, MECHELE M NP	10/17/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
75715	Fee-for-Service	1326307554	1326307554	1	1	WILKINS, PAUL A CRNA	2/26/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
75725	Fee-for-Service	1326053331	1326053331	1	1	WALGREEN CO	10/6/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15316 NORDHOFF ST	None	NORTH HILLS	CA	91343	2234	19	06037	34.23548263	-118.465897	Los Angeles County
75741	Fee-for-Service	1962430231	1962430231	1	1	WANG, MARCUS J MD	6/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78434	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
75749	Fee-for-Service	1558865147	1558865147	1	1	WICOMB, KYLE R MD	7/29/2022	207R00000X	NA	Other	026	PHYSICIANS	176702	None	None	0	In state provider	None	1415 ROSS AVENUE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
75790	Fee-for-Service	1396061834	1396061834	1	1	WESTERDAHL, DANIEL E MD	11/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118464	41	Internal Medicine	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4897	36	06071	34.03717616	-117.2046115	San Bernardino County
75801	Fee-for-Service	1669801262	1669801262	1	1	WEINGARTEN, NAFTOLI H DPM PC	2/23/2015	193400000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	901 E SAN ANTONIO DR	None	LONG BEACH	CA	90807	2211	19	06037	33.83829601	-118.1824972	Los Angeles County
75824	Fee-for-Service	1871859843	1871859843	1	1	WONG, MARRON C MD	10/29/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	128208	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
75840	Fee-for-Service	1487703476	1487703476	1	1	WEISS, ROBERTO	11/30/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	282 LANDIS AVENUE	None	CHULA VISTA	CA	91910	2627	37	06073	32.64168665	-117.0812298	San Diego County
75890	Fee-for-Service	1497389365	1497389365	1	1	WARLICK-BROWN, SAMANTHA Y	3/11/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	12476 CRYSTAL RANCH RD	None	MOORPARK	CA	93021	2916	56	06111	34.26501629	-118.8880954	Ventura County
75902	Fee-for-Service	1164420808	1164420808	1	1	WOLKOV, HARVEY B MD	2/28/1982	2085R0001X	NA	Other	026	PHYSICIANS	42995	30	Radiology	0	In state provider	None	1800 I ST	None	SACRAMENTO	CA	95814	3004	34	06067	38.578113	-121.4819685	Sacramento County
75942	Fee-for-Service	1427070754	1427070754	1	1	WALKER, JOE A MD	2/20/2004	103T00000X	NA	Mental Health Outpatient Services	026	PHYSICIANS	46287	26	Psychiatry (child)	0	In state provider	None	2340 CLAY ST	FL 7	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
75951	Fee-for-Service	1023457009	1023457009	1	1	WU, I-KUNG MD	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156777	01	General Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.76344756	-122.4581992	San Francisco County
76057	Fee-for-Service	1972624435	1972624435	1	1	WENG, VICTOR K DO	1/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10594	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
76123	Fee-for-Service	1134160823	1134160823	1	1	WOLF, DAVID I MD	3/31/1988	207N00000X	NA	Dermatology	026	PHYSICIANS	48743	07	Dermatology	0	In state provider	None	2067 W VISTA WAY	STE 250	VISTA	CA	92083	6034	37	06073	33.18505594	-117.285958	San Diego County
76181	Fee-for-Service	1316120876	1316120876	1	1	WEINER, BENNETT A OD	3/1/1995	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1339 W WHITTIER BLVD	None	LA HABRA	CA	90631	3612	30	06059	33.93933652	-117.9612375	Orange County
76186	Fee-for-Service	1124262316	1124262316	1	1	WALGREEN CO.	7/1/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #09817	9305 MISSION GORGE RD	None	SANTEE	CA	92071	3815	37	06073	32.83856247	-116.995401	San Diego County
76216	Fee-for-Service	1023639176	1023639176	1	1	WONG, ARTHUR MD	10/16/2020	207R00000X	NA	Other	026	PHYSICIANS	163178	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
76227	Fee-for-Service	1780890723	1780890723	1	1	WILSON, INGRID M PHD	3/4/1998	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5855 GREEN VALLEY CIR	STE 109	CULVER CITY	CA	90230	6965	19	06037	33.98317787	-118.3886464	Los Angeles County
76229	Fee-for-Service	1427070754	1427070754	1	1	WALKER, JOE A MD	2/20/2004	103T00000X	NA	Mental Health Outpatient Services	026	PHYSICIANS	46287	36	Psychiatry	0	In state provider	None	2340 CLAY ST	FL 7	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
76252	Fee-for-Service	1366885501	1366885501	1	1	WAGNER, BRENT M MD	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143208	41	Internal Medicine	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
76274	Fee-for-Service	1255856621	1255856621	1	1	WIDMAN, ELENA M LCSW	12/22/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
76283	Fee-for-Service	1225018096	1225018096	1	1	WILSON, MATHEW P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 N WILMOT RD	None	TUCSON	AZ	85711	2602	00	None	32.227209	-110.8556595	Pima County
76373	Fee-for-Service	1942330832	1942330832	1	1	WU, VAN N	6/9/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8451 ELK GROVE BLVD	STE 7	ELK GROVE	CA	95758	9571	34	06067	38.409885	-121.392063	Sacramento County
76427	Fee-for-Service	1205456217	1205456217	1	1	WILSON, CANDACE MD	9/25/2023	207R00000X	NA	Other	026	PHYSICIANS	190192	None	None	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
76460	Fee-for-Service	1760172787	1760172787	1	1	WAIMEA BAY HOLDINGS LLC	6/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	7039 ALONDRA BLVD	None	PARAMOUNT	CA	90723	3925	19	06037	33.88919451	-118.175787	Los Angeles County
76480	Fee-for-Service	1861892754	1861892754	1	1	WAL-MART STORES INC	6/8/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	82-491 AVENUE 42	None	INDIO	CA	92203	9307	33	06065	33.743826	-116.284453	Riverside County
76510	Fee-for-Service	1003635707	1003635707	1	1	WEITZEL, FREDERIKE BIRTH DO	4/11/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
76532	Fee-for-Service	1831696194	1831696194	1	1	WARSTADT, NICHOLUS M MD	4/21/2022	207P00000X	NA	Other	026	PHYSICIANS	175155	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
76544	Fee-for-Service	1144346370	1144346370	1	1	WEITZ, JANICE D CRNA	5/16/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
76643	Fee-for-Service	1669716593	1669716593	1	1	WALIA, PARAMPREET MD	11/11/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	132246	None	None	0	In state provider	None	2151 HARBOR	SUITE 3100	FULLERTON	CA	92835	3820	30	06059	33.89443025	-117.9288328	Orange County
76645	Fee-for-Service	1609632090	1609632090	1	1	WADE, ALEXANDER E LCSW	4/17/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2810 LONE TREE WAY	SUITE 9	ANTIOCH	CA	94509	4956	07	06013	37.99499587	-121.8077774	Contra Costa County
76666	Fee-for-Service	1063807154	1063807154	1	1	WINGFIELD, PETER MD	9/6/2020	207L00000X	NA	Other	026	PHYSICIANS	147428	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
76720	Fee-for-Service	1689603011	1689603011	1	1	WATKINS, BARRY E MD	8/1/1998	2086S0105X	NA	General Surgery	026	PHYSICIANS	79865	20	Orthopedic Surgery	0	In state provider	None	11370 ANDERSON ST	STE 1500	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
76744	Fee-for-Service	1831463082	1831463082	1	1	WILLOW LINK, LLC	10/21/2011	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	14795 JEFFREY ROAD	SUITE 202	IRVINE	CA	92618	0401	30	06059	33.68748311	-117.7710103	Orange County
76753	Fee-for-Service	1932307360	1932307360	1	1	WEINER, ANGELA K MD	6/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
76784	Fee-for-Service	1619968351	1619968351	1	1	WU, JOY Y MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55455	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
76797	Fee-for-Service	1083799308	1083799308	1	1	WONG, DAN C MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	50335	68	Hematology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
76805	Fee-for-Service	1902129273	1902129273	1	1	WOLFSON, NIKOLAJ MD APC	2/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	51436	None	None	0	In state provider	None	2300 SUTTER ST	STE 207	SAN FRANCISCO	CA	94115	3029	38	06075	37.78546004	-122.4384038	San Francisco County
76836	Fee-for-Service	1700497211	1700497211	1	1	WERMER, LOUISIANA LMFT	9/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4929 WILSHIRE BLVD	SUITE 245	LOS ANGELES	CA	90010	3859	19	06037	34.0621435	-118.3380975	Los Angeles County
76845	Fee-for-Service	1215932207	1215932207	1	1	WARMOTH, MICHAEL R MD	11/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144504	40	Pediatrics	0	In state provider	None	100 WEST CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
76866	Fee-for-Service	1306851688	1306851688	1	1	WALGREEN CO	4/1/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6144 DEWEY DR	None	CITRUS HEIGHTS	CA	95621	6212	34	06067	38.677608	-121.3097895	Sacramento County
76880	Fee-for-Service	1699092239	1699092239	1	1	WONG, CHRISTINE W MD	8/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121099	41	Internal Medicine	0	In state provider	None	3687 MT DIABLO BLVD	#200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
76892	Fee-for-Service	1376149195	1376149195	1	1	WELSH, GARRETT CRNA	4/2/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
76966	Fee-for-Service	1790837920	1790837920	1	1	WU, CHRISTINA MD	11/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84072	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
76967	Fee-for-Service	1982752895	1982752895	1	1	WIELENGA, JUANITA	11/1/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4000 14TH ST	SUITE 314	RIVERSIDE	CA	92501	4018	33	06065	33.97771007	-117.3818381	Riverside County
77007	Fee-for-Service	1679767925	1679767925	1	1	WAHID, ALI A MD	8/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106703	08	Family Practice	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4404	50	06099	37.66508443	-120.9962589	Stanislaus County
77057	Fee-for-Service	1972538353	1972538353	1	1	WEIL, DAVID J MD	1/31/1991	2086S0105X	NA	General Surgery	026	PHYSICIANS	54871	None	None	0	In state provider	None	1045 ATLANTIC AVE	STE 1008	LONG BEACH	CA	90813	3410	19	06037	33.780267	-118.1850795	Los Angeles County
77063	Fee-for-Service	1649230749	1649230749	1	1	WITT, FRANK J DPM	1/14/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	22110 ROSCOE BLVD	STE 201	CANOGA PARK	CA	91304	3861	19	06037	34.21957849	-118.6082685	Los Angeles County
77072	Fee-for-Service	1619968351	1619968351	1	1	WU, JOY Y MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55455	67	Endocrinology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
77076	Fee-for-Service	1457697641	1457697641	1	1	WALKER-WILLIAMS, FELICIA LC	3/6/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	1609 RIVENDEL DR	None	CORONA	CA	92883	0717	33	06065	33.81286782	-117.5448441	Riverside County
77086	Fee-for-Service	1467890632	1467890632	1	1	WANG, HUA MD	1/3/2019	207SG0201X	NA	Other	026	PHYSICIANS	139175	40	Pediatrics	0	In state provider	None	2195 CLUB CENTER DR	STE L	SAN BERNARDINO	CA	92408	4162	36	06071	34.06055692	-117.2814193	San Bernardino County
77088	Fee-for-Service	1083799308	1083799308	1	1	WONG, DAN C MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	50335	78	Neoplastic Diseases/Oncology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
77162	Fee-for-Service	1962662296	1962662296	1	1	WANG, CHUEN-SHIN C MD	7/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107729	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	1778	19	06037	34.06373445	-118.443537	Los Angeles County
77163	Fee-for-Service	1235215484	1235215484	1	1	WORCESTER, CARRIE C MD	3/23/1992	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	22839	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
77171	Fee-for-Service	1851479513	1851479513	1	1	WATERS, MORGAN S MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61030	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
77235	Fee-for-Service	1780848358	1780848358	1	1	WILLIAMS, MATTHEW R LCSW	11/3/2014	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	836 57TH STREET	SUITE 422	SACRAMENTO	CA	95819	3327	34	06067	38.566602	-121.4334135	Sacramento County
77259	Fee-for-Service	1447277686	1447277686	1	1	WAL-MART STORES INC	9/20/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	34500 MONTEREY AVE	None	PALM DESERT	CA	92211	2089	33	06065	33.798618	-116.384841	Riverside County
77282	Fee-for-Service	1720203383	1720203383	1	1	WIKTOR, AREK J MD	1/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
77317	Fee-for-Service	1881203198	1881203198	1	1	WONG, BRYAN K PT	10/14/2020	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
77354	Fee-for-Service	1356691265	1356691265	1	1	WEST, ANNA R LMFT	8/17/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	11643 GLENOAKS BLVD	None	PACOIMA	CA	91331	1050	19	06037	34.28133474	-118.4198166	Los Angeles County
77366	Fee-for-Service	1801859160	1801859160	1	1	WALTER, CHRISTY L DO	11/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	9231	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
77369	Fee-for-Service	1992259345	1992259345	1	1	WHITE, CARMEN N	7/8/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
77377	Fee-for-Service	1083799308	1083799308	1	1	WONG, DAN C MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	50335	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
77413	Fee-for-Service	1154374361	1154374361	1	1	WITHOP, ILANA C NP	8/30/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
77419	Fee-for-Service	1396234670	1396234670	1	1	WILSON, JACOB L MD	9/27/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	175136	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
77503	Fee-for-Service	1518710060	1518710060	1	1	WOOD, DOROTHY J LAC	4/17/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	320 RIVER ST	None	SANTA CRUZ	CA	95060	2723	44	06087	36.98095917	-122.028884	Santa Cruz County
77525	Fee-for-Service	1548244247	1548244247	2	1	WILSON, MATTHEW T MD	3/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53944	02	General Surgery	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	95642	2564	30	06059	33.56008604	-117.6657795	Orange County
77530	Fee-for-Service	1033328901	1033328901	1	1	WOODLAND RESIDENTIAL SVS	1/16/2003	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	NORTH PROGRAM	418 NORTH ST	None	WOODLAND	CA	95695	3234	57	06113	38.67990123	-121.7755755	Yolo County
77545	Fee-for-Service	1427390517	1427390517	1	2	WABUKE, CHARITY LMFT	8/15/2016	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
77559	Fee-for-Service	1174558902	1174558902	1	1	WOLF, PAUL S DC	9/1/2001	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	260 S HALCYON RD	None	ARROYO GRANDE	CA	93420	3135	40	06079	35.11527982	-120.5916242	San Luis Obispo County
77683	Fee-for-Service	1730194069	1730194069	1	1	WALGREEN CO	9/20/1984	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	423 N SANTA CRUZ AVE	None	LOS GATOS	CA	95030	5320	43	06085	37.22996577	-121.9805084	Santa Clara County
77732	Fee-for-Service	1598844631	1598844631	1	1	WEILEPP, ANNE E MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80964	91	Pharmacology-Clinical	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
77734	Fee-for-Service	1104393008	1104393008	1	1	WEDDLE, RACHEL	1/29/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1610 ARDEN WAY	SUITE 195	SACRAMENTO	CA	95815	4035	34	06067	38.598597	-121.42863	Sacramento County
77742	Fee-for-Service	1487699567	1487699567	1	1	WELLBOUND OF VALLEJO LLC	10/18/2006	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	480 REDWOOD ST	BLDG D, STE 40	VALLEJO	CA	94590	2958	48	06095	38.12315545	-122.2597619	Solano County
77794	Fee-for-Service	1720137094	1720137094	1	1	WAKELEE, HEATHER A MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63195	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
77810	Fee-for-Service	1083720346	1083720346	1	1	WONG, ROBINA Y MD	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66594	41	Internal Medicine	0	In state provider	None	1174 CASTRO ST	STE 200	MOUNTAIN VIEW	CA	94040	2569	43	06085	37.3822628	-122.0861276	Santa Clara County
77821	Fee-for-Service	1568004216	1568004216	1	1	WALMART INC	12/6/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5500 GROSSMONT CENTER DR	STE 210	LA MESA	CA	91942	3016	37	06073	32.7793549	-117.0091108	San Diego County
77854	Fee-for-Service	1053618777	1053618777	1	2	WE CARE HOME CARE AND	4/22/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3077 STEVENSON BLVD	None	FREMONT	CA	94538	2316	01	06001	37.54768241	-121.9722835	Alameda County
77866	Fee-for-Service	1174540306	1174540306	1	1	WAL-MART STORES, INC	2/20/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHAR 10-5152	6433 FALLBROOK AVE	None	WEST HILLS	CA	91307	3543	19	06037	34.187778	-118.62621	Los Angeles County
77878	Fee-for-Service	1821273780	1821273780	1	1	WILLIAMS, ELLIZA MARIE T	1/13/2021	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
77885	Fee-for-Service	1407304090	1407304090	1	1	WAITE, ERIN N	2/8/2021	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
77902	Fee-for-Service	1013177500	1013177500	1	1	WANG, STEVE C DO	7/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13775	01	General Practice	0	In state provider	None	1000 GREENLEY AVE	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
77917	Fee-for-Service	1609989177	1609989177	1	1	WALGREEN CO	11/8/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16145 SIERRA LAKES PKWY	None	FONTANA	CA	92336	1243	36	06071	34.13894422	-117.452804	San Bernardino County
77940	Fee-for-Service	1326218348	1326218348	1	1	WANG, EUGENE Y OD	3/28/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6860 AVENIDA ENCINAS	None	CARLSBAD	CA	92009	3201	37	06073	33.10754269	-117.3146974	San Diego County
77975	Fee-for-Service	1215015011	1215015011	1	1	WEN, ANDREW MD	4/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72908	40	Pediatrics	0	In state provider	PERMANENTE MEDICAL GROUP	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
78018	Fee-for-Service	1598844631	1598844631	1	1	WEILEPP, ANNE E MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80964	07	Dermatology	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
78044	Fee-for-Service	1346557014	1346557014	1	1	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FOUNDATION	2557 MOWRY AVE	STE 30	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
78045	Fee-for-Service	1699273367	1699273367	1	1	WALGREEN CO	8/28/2018	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#21154	730-740 LONG BEACH BLVD	STE A, STE C	LONG BEACH	CA	90813	4480	19	06037	33.77609541	-118.1892777	Los Angeles County
78062	Fee-for-Service	1053380519	1053380519	1	1	WEINREICH, DON H MD INC	3/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	66461	08	Family Practice	0	In state provider	EAST BAY PRIMARY AND PRE	3000 COLBY ST	STE 307	BERKELEY	CA	94705	2058	01	06001	37.85473248	-122.2575793	Alameda County
78064	Fee-for-Service	1316968282	1316968282	1	1	WEHRLE, MALCOLM J	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	64523	05	Anesthesiology	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
78083	Fee-for-Service	1720137094	1720137094	1	1	WAKELEE, HEATHER A MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63195	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
78253	Fee-for-Service	1417491952	1417491952	1	1	WEST LA THERAPIST CORP	3/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12340 SANTA MONICA BLVD	214	LOS ANGELES	CA	90025	7522	19	06037	34.03928164	-118.4661237	Los Angeles County
78289	Fee-for-Service	1932544905	1932544905	1	1	WAKIM, MICHAEL T MD	8/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140365	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
78300	Fee-for-Service	1578764023	1578764023	1	1	WALGREEN CO	8/22/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3507 CANNON RD	None	OCEANSIDE	CA	92056	4977	37	06073	33.17113905	-117.2546316	San Diego County
78319	Fee-for-Service	1821431610	1821431610	1	1	WILKEY, STEWART F DO	6/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13771	08	Family Practice	0	In state provider	None	25455 BARTON ROAD	SUITE 108A	LOMA LINDA	CA	92354	3139	36	06071	34.04805253	-117.249534	San Bernardino County
78327	Fee-for-Service	1003391988	1003391988	1	1	WAITHAKA, RUTH N	11/9/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	60 NEWBURN CT	None	BEAUMONT	CA	92223	3131	33	06065	33.91995057	-116.9601911	Riverside County
78329	Fee-for-Service	1356616544	1356616544	1	1	WAN, JENNIFER J MD	7/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	128087	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
78408	Fee-for-Service	1194782219	1194782219	1	1	WOLFMAN ELIAS O	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	139 LAUREL ST	None	FORT BRAGG	CA	95437	3403	23	06045	39.4455633	-123.805069	Mendocino County
78450	Fee-for-Service	1164489951	1164489951	1	1	WALLACE JR MD, MILTON A	11/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6144 AIRPORT BLVD	None	MOBILE	AL	36608	0000	00	None	30.678273	-88.1839215	Mobile County
78461	Fee-for-Service	1780750588	1780750588	1	1	WONG, JONATHAN D MD	12/31/1994	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	49948	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
78496	Fee-for-Service	1831287978	1831287978	1	1	WESTSIDE FAMILY HLTH CTR	5/20/2009	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	3861 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4605	19	06037	34.01133074	-118.4159833	Los Angeles County
78512	Fee-for-Service	1003841164	1003841164	1	1	WEINBERG, KENNETH I MD	12/17/1996	2080P0207X	NA	Hematology	026	PHYSICIANS	55579	01	General Practice	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
78518	Fee-for-Service	1841224151	1841224151	1	1	WRAY, CHRISTOPHER L MD	1/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87769	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
78581	Fee-for-Service	1992958383	1992958383	1	2	WUNSCHEL, STEVEN R MD	4/1/2017	208800000X	NA	Other	026	PHYSICIANS	53236	34	Urology and Urological Surgery	0	In state provider	INC	2121 COLORADO AVE	STE C	TURLOCK	CA	95382	2012	50	06099	37.5117454	-120.8353096	Stanislaus County
78616	Fee-for-Service	1003391988	1003391988	1	1	WAITHAKA, RUTH N	11/9/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	60 NEWBURN CT	None	BEAUMONT	CA	92223	3131	33	06065	33.91995057	-116.9601911	Riverside County
78624	Fee-for-Service	1558517904	1558517904	1	1	WENTWORTH, KELLY L MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125396	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
78649	Fee-for-Service	1851524433	1851524433	1	1	WONG, MATTHEW MD INC	10/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	84553	36	Psychiatry	0	In state provider	None	23700 CAMINO DEL SOL	None	TORRANCE	CA	90505	5017	19	06037	33.8102385	-118.3441185	Los Angeles County
78678	Fee-for-Service	1760909576	1760909576	1	1	WILLIAMS, ALICIA A AU	9/7/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
78717	Fee-for-Service	1902200918	1902200918	1	1	WALLACE HOME MEDICAL SUPPLIE	6/22/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	S	12310 LOS OSOS VALLEY RD	None	SAN LUIS OBISPO	CA	93405	7220	40	06079	35.24819639	-120.6838313	San Luis Obispo County
78744	Fee-for-Service	1760418172	1760418172	1	1	WULFF, CHRISTOPHER MD	2/28/1993	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	53168	41	Internal Medicine	0	In state provider	UCLA CTR FOR HLTH SCIENC	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
78782	Fee-for-Service	1831287978	1831287978	1	1	WESTSIDE FAMILY HLTH CTR	5/21/2009	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	3861 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4605	19	06037	34.01133074	-118.4159833	Los Angeles County
78813	Fee-for-Service	1508893504	1508893504	1	1	WIXSON, DAVID MD	12/12/1979	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	36165	30	Radiology	0	In state provider	None	120 LA CASA VIA	STE 212	WALNUT CREEK	CA	94598	3007	07	06013	37.91202407	-122.0419227	Contra Costa County
78814	Fee-for-Service	1679849228	1679849228	1	1	WU, SHERRY MD	5/3/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	154491	41	Internal Medicine	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
78840	Fee-for-Service	1982163002	1982163002	1	1	WENTWORTH, BRENT P DO	7/25/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19546	None	None	0	In state provider	None	4700 SOQUEL DR	None	SOQUEL	CA	95073	2427	44	06087	36.98815433	-121.9571695	Santa Cruz County
78882	Fee-for-Service	1447420989	1447420989	1	1	WONG, ALINE Y MD	6/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100918	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
78973	Fee-for-Service	1508994088	1508994088	1	1	WILLIAM H NUESSE MD & MARY-	8/21/2018	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	ANN NUESSE DO AMC	867 S TUSTIN ST	None	ORANGE	CA	92866	3426	30	06059	33.774102	-117.835733	Orange County
78975	Fee-for-Service	1972962397	1972962397	1	1	WONG, LORRAINE R PHD	3/18/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD ROAD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
79030	Fee-for-Service	1710369624	1710369624	1	1	WANG, ANTHONY MD	10/2/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	145944	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
79058	Fee-for-Service	1740629294	1740629294	1	1	WUN, LUCY OD INC	8/22/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10525 S DE ANZA BLVD	STE 190	CUPERTINO	CA	95014	4448	43	06085	37.31526	-122.032408	Santa Clara County
79071	Fee-for-Service	1831287978	1831287978	1	1	WESTSIDE FAMILY HLTH CTR	5/20/2009	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	3861 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4605	19	06037	34.01133074	-118.4159833	Los Angeles County
79089	Fee-for-Service	1356052385	1356052385	1	1	WECARE MEDICAL TRANSPORT, LL	1/7/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	C	4700 EASTON DR	#7	BAKERSFIELD	CA	93309	9428	15	06029	35.36816587	-119.0544704	Kern County
79101	Fee-for-Service	1750789046	1750789046	1	1	WATERMANIDENCE OPCO LLC	1/1/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	OF WATERMAN LLC	1850 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4831	36	06071	34.131951	-117.2787955	San Bernardino County
79106	Fee-for-Service	1689092066	1689092066	1	1	WALKER, REBEKAH A PT	4/26/2019	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
79152	Fee-for-Service	1316264559	1316264559	1	1	WALGREEN CO	9/20/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13390 POWAY RD	None	POWAY	CA	92064	4626	37	06073	32.95654343	-117.0412404	San Diego County
79178	Fee-for-Service	1467479717	1467479717	1	1	WAL-MART STORES INC	1/22/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM #10-2418	4300 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6811	09	06017	38.70482049	-120.8281534	El Dorado County
79210	Fee-for-Service	1679507131	1679507131	1	1	WHYTE, LYNNE M MD	5/31/1988	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	63864	40	Pediatrics	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
79248	Fee-for-Service	1174818348	1174818348	1	1	WHEATLEY, JONATHAN D MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138734	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
79258	Fee-for-Service	1235271693	1235271693	1	1	WALTON, KIMBERLY MD	7/23/2004	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80933	None	None	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
79262	Fee-for-Service	1508994088	1508994088	1	1	WILLIAM H NUESSE MD & MARY-	8/21/2018	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	ANN NUESSE DO AMC	867 S TUSTIN ST	None	ORANGE	CA	92866	3426	30	06059	33.774102	-117.835733	Orange County
79264	Fee-for-Service	1649441973	1649441973	1	1	WONG, ANDREA F MD	3/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10287	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
79296	Fee-for-Service	1013498245	1013498245	1	1	WRIGHT, SABRINA L RCP	9/18/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
79333	Fee-for-Service	1427126127	1427126127	1	1	WASIELEWSKI, JESSICA N. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2963 E COPPER POINT DR	None	MERIDIAN	ID	83642	0000	00	None	43.58304	-116.35767	Ada County
79360	Fee-for-Service	1831287978	1831287978	1	1	WESTSIDE FAMILY HLTH CTR	5/21/2009	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	3861 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4605	19	06037	34.01133074	-118.4159833	Los Angeles County
79362	Fee-for-Service	1922151174	1922151174	1	1	WANDREI, KARIN E LCSW	11/8/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 BORIS CT	#8	ROHNERT PARK	CA	94928	3893	49	06097	38.33610809	-122.703488	Sonoma County
79367	Fee-for-Service	1164570032	1164570032	1	1	WASHINGTON, DEIRDRE R MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72336	05	Anesthesiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
79396	Fee-for-Service	1184640872	1184640872	1	1	WATTS, DAVID H MD	5/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	29925	01	General Practice	0	In state provider	UC HOSPITAL	350 PARNASSUS AVE	STE 609	SAN FRANCISCO	CA	94117	3608	38	06075	37.76403932	-122.4561371	San Francisco County
79409	Fee-for-Service	1215109228	1215109228	1	1	WALLACE, MARY A MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
79420	Fee-for-Service	1053567842	1053567842	1	1	WANG, MARY J MD	9/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102257	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
79422	Fee-for-Service	1952402026	1952402026	1	1	WATANABE, TERUO OD INC	10/25/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PLAZA VISION OPTOMETRY	18045 GALE AVE	None	CITY OF INDUSTRY	CA	91748	1245	19	06037	33.99500184	-117.9100724	Los Angeles County
79458	Fee-for-Service	1710049838	1710049838	1	1	WALTON, CYNTHIA	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
79477	Fee-for-Service	1124357884	1124357884	1	1	WILTON, JON L CRNA	11/24/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	914 PINE STREET	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
79484	Fee-for-Service	1801992128	1801992128	1	1	WOMENS OB/GYN MED GRP	6/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 DOYLE PARK DR	STE 103	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
79493	Fee-for-Service	1336128669	1336128669	1	1	WEISSMAN, AVRAHAM I MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	50780	05	Anesthesiology	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
79519	Fee-for-Service	1336198811	1336198811	1	1	WELDON, HEATHER E MD	9/11/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154267	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
79629	Fee-for-Service	1538400403	1538400403	1	1	WASIELESKI, LINDSAY L MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126966	40	Pediatrics	0	In state provider	None	3200 KEARNEY STREET	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
79638	Fee-for-Service	1912939067	1912939067	1	1	WARREN RUSSELL ABEL, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1530 9TH ST N	None	ST PETERSBURG	FL	33704	4202	00	None	27.78664382	-82.64678576	Pinellas County
79683	Fee-for-Service	1184640872	1184640872	1	1	WATTS, DAVID H MD	5/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	29925	10	Gastroenterology (M.D. only)	0	In state provider	UC HOSPITAL	350 PARNASSUS AVE	STE 609	SAN FRANCISCO	CA	94117	3608	38	06075	37.76403932	-122.4561371	San Francisco County
79698	Fee-for-Service	1699766592	1699766592	1	1	WHITE MOUNTAIN REGIONAL MED	10/18/2011	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	118 S MOUNTAIN AVE	None	SPRINGERVILLE	AZ	85938	5104	00	None	34.131384	-109.2854205	Apache County
79725	Fee-for-Service	1881038925	1881038925	1	1	WAGNER, DAVID D MD	7/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142670	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1555 SOQUEL DRIVE	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
79731	Fee-for-Service	1306967021	1306967021	1	1	WEST OAKLAND HEALTH COUN	9/1/1991	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	700 ADELINE ST	None	OAKLAND	CA	94607	2608	01	06001	37.80430011	-122.2879962	Alameda County
79737	Fee-for-Service	1497801112	1497801112	1	1	WILL, ALBERT D MD	1/12/2010	2084N0400X	NA	Neurology	026	PHYSICIANS	40219	13	Neurology (M.D. only)	0	In state provider	None	152 PIONEER LANE	SUITE A	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
79749	Fee-for-Service	1356322721	1356322721	1	1	WILLS, CHRIS A MD	8/31/1986	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	44871	20	Orthopedic Surgery	0	In state provider	None	725 W LA VETA AVE	STE 260	ORANGE	CA	92868	4439	30	06059	33.78063949	-117.8603285	Orange County
79755	Fee-for-Service	1154471662	1154471662	1	1	WANG, KUAN-I MD	7/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53663	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	600 N GARFIELD AVE	STE 309	MONTEREY PARK	CA	91754	1172	19	06037	34.06820797	-118.1228835	Los Angeles County
79796	Fee-for-Service	1720132251	1720132251	1	1	WALD, ALISSA S OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2706 HARBOR BLVD	STE B	COSTA MESA	CA	92626	5162	30	06059	33.671484	-117.919112	Orange County
79826	Fee-for-Service	1770598047	1770598047	1	1	WALGREENS CO	11/24/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #06903	5829 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	1001	19	06037	33.86147305	-118.1427711	Los Angeles County
79832	Fee-for-Service	1700059151	1700059151	1	1	WANG, KEVIN MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102872	25	Physical Medicine and Rehabilitation	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
79851	Fee-for-Service	1053308445	1053308445	1	1	WONG, ROBERT MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
79931	Fee-for-Service	1760914543	1760914543	1	1	WILEY, RACHEL L	7/15/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
80018	Fee-for-Service	1306967021	1306967021	1	1	WEST OAKLAND HEALTH COUN	9/1/1991	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	700 ADELINE ST	None	OAKLAND	CA	94607	2608	01	06001	37.80430011	-122.2879962	Alameda County
80027	Fee-for-Service	1285693572	1285693572	1	1	WILSON, DOUGLAS R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71642	08	Family Practice	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
80029	Fee-for-Service	1760785141	1760785141	1	1	WOOD, ERIN L LAC	8/2/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	12704 HIGHWAY 9	None	BOULDER CREEK	CA	95006	9112	44	06087	37.11875915	-122.1206402	Santa Cruz County
80101	Fee-for-Service	1437492667	1437492667	1	1	WANG, HELEN C MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132504	40	Pediatrics	0	In state provider	None	8910 VILLA LA JOLLA DR	STE 110	LA JOLLA	CA	92037	1701	37	06073	32.87058261	-117.2338797	San Diego County
80102	Fee-for-Service	1295819274	1295819274	1	1	WINER, JOSEPH N MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	60471	36	Psychiatry	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
80131	Fee-for-Service	1386168284	1386168284	1	1	WILLENBORG, DANIEL M LCSW	8/22/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	76794	-	NOT APPLICABLE	0	In state provider	None	4141 PACIFIC HIGHWAY	None	SAN DIEGO	CA	92110	2032	37	06073	32.7444541	-117.1921543	San Diego County
80136	Fee-for-Service	1437616687	1437616687	1	1	WEDGEWORTH, MONICA M CRNA	2/5/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
80207	Fee-for-Service	1407168669	1407168669	1	1	WATTS, BRENDA B MD	6/1/2020	207R00000X	NA	Other	026	PHYSICIANS	119649	41	Internal Medicine	0	In state provider	None	1240 BROADWAY	None	EL CAJON	CA	92021	4994	37	06073	32.80773552	-116.9384985	San Diego County
80236	Fee-for-Service	1952875585	1952875585	1	1	WOODLAKE LOVING CARE LLC	9/16/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	8016 WOODLAKE AVE	None	WEST HILLS	CA	91304	3560	19	06037	34.21593	-118.632163	Los Angeles County
80259	Fee-for-Service	1346879418	1346879418	1	1	WANG, GEORGE S MD	9/4/2024	207L00000X	NA	Other	026	PHYSICIANS	177060	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
80266	Fee-for-Service	1215552864	1215552864	1	1	WILLIAMS, NICOLE LPCC	7/13/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	701 HIGH ST	STE 205	AUBURN	CA	95603	4735	31	06061	38.90214664	-121.0682262	Placer County
80313	Fee-for-Service	1285693572	1285693572	1	1	WILSON, DOUGLAS R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71642	01	General Practice	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
80333	Fee-for-Service	1669403853	1669403853	1	1	WELTY, CAROLYN D MD	6/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	35631	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
80378	Fee-for-Service	1750946117	1750946117	1	1	WILSON, DANIELLE DO	9/1/2024	207R00000X	NA	Other	026	PHYSICIANS	21636	41	Internal Medicine	0	In state provider	None	245 TERRACINA BLVD	SUITE 102	REDLANDS	CA	92373	4865	36	06071	34.03858912	-117.2066515	San Bernardino County
80400	Fee-for-Service	1942227277	1942227277	1	1	WAL-MART STORES INC.	3/15/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY10-2609	2770 CARSON ST	None	LAKEWOOD	CA	90712	4004	19	06037	33.830415	-118.1586735	Los Angeles County
80450	Fee-for-Service	1407853252	1407853252	1	1	WINFIELD, DAVID F MD	6/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	69327	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
80537	Fee-for-Service	1902961188	1902961188	1	1	WANG, LYNNA H MD	9/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	82938	40	Pediatrics	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
80579	Fee-for-Service	1780247379	1780247379	1	1	WONG, KAREN DO	11/4/2024	207R00000X	NA	Other	026	PHYSICIANS	20012	45	Nephrology (Renal-Kidney)	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
80591	Fee-for-Service	1669834263	1669834263	1	1	WAIWAIOLE, ALANA L MD	4/2/2021	207L00000X	NA	Other	026	PHYSICIANS	150656	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3522	48	06095	38.26109552	-122.0470245	Solano County
80601	Fee-for-Service	1285693572	1285693572	1	1	WILSON, DOUGLAS R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71642	41	Internal Medicine	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
80606	Fee-for-Service	1902463979	1902463979	1	1	WELTER, MARY L MD	6/10/2024	207R00000X	NA	Other	026	PHYSICIANS	191802	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
80617	Fee-for-Service	1225287352	1225287352	1	1	WAL-MART STORES, INC	1/27/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 105710	3848 MCHENRY AVE	None	MODESTO	CA	95350	1586	50	06099	37.694484	-120.991833	Stanislaus County
80651	Fee-for-Service	1740208537	1740208537	1	1	WAL-MART STORES INC	6/2/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHMCY #10-5156	1540 EAST 2ND ST	None	BEAUMONT	CA	92223	0000	33	06065	33.925086	-116.9516565	Riverside County
80653	Fee-for-Service	1538358387	1538358387	1	1	WILSON, JON	8/14/2008	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	535 E ROMIE LN	STE 3	SALINAS	CA	93901	4026	27	06053	36.65969283	-121.6449044	Monterey County
80658	Fee-for-Service	1740382381	1740382381	1	1	WU, BENJAMIN M MD	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68778	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	625 LINCOLN AVE	None	SAN JOSE	CA	95126	3705	43	06085	37.31809479	-121.9082315	Santa Clara County
80662	Fee-for-Service	1134650005	1134650005	1	1	WONG, VANESSA MD	9/2/2020	207PP0204X	NA	Other	026	PHYSICIANS	159984	40	Pediatrics	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
80666	Fee-for-Service	1528100203	1528100203	1	1	WOLFER, CARL MD INC	1/9/1979	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20984	08	Family Practice	0	In state provider	None	1555 EAST ST	STE 130	REDDING	CA	96001	1153	45	06089	40.58440354	-122.3880021	Shasta County
80702	Fee-for-Service	1336238963	1336238963	1	1	WONG, STEVEN J MD	5/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	46145	30	Radiology	0	In state provider	None	624 S CENTRAL AVENUE	None	GLENDALE	CA	91204	2009	19	06037	34.13847846	-118.2578377	Los Angeles County
80715	Fee-for-Service	1023144672	1023144672	1	1	WOO, KIRSTIN W MD	8/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91612	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
80724	Fee-for-Service	1548789050	1548789050	1	2	WELLSPACE HEALTH	7/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4990 STOCKTON BLVD	None	SACRAMENTO	CA	95820	5406	34	06067	38.530107	-121.4459055	Sacramento County
80729	Fee-for-Service	1942282835	1942282835	1	1	WHETZEL, THOMAS MD	1/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	57560	24	Plastic Surgery	0	In state provider	None	10833 LE CONTE AVE	BLDG 64140	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
80800	Fee-for-Service	1972761120	1972761120	1	1	WHITNEY, JANET DO MPH INC	6/11/2008	261QM1300X	NA	Other	026	PHYSICIANS	7126	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6260 EL CAMINO REAL	SUITE 201	CARLSBAD	CA	92009	1609	37	06073	33.12215813	-117.266659	San Diego County
80850	Fee-for-Service	1700349479	1700349479	1	1	WALMART INC	8/9/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 TUCKER RD	None	TEHACHAPI	CA	93561	0722	15	06029	35.12952166	-118.4674423	Kern County
80866	Fee-for-Service	1780247379	1780247379	1	1	WONG, KAREN DO	11/4/2024	207R00000X	NA	Other	026	PHYSICIANS	20012	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
80872	Fee-for-Service	1851653281	1851653281	1	1	WANG, JIA Y MD	11/19/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	155929	08	Family Practice	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
80904	Fee-for-Service	1134541287	1134541287	1	1	WILLIAMS, KANEESHA J NP	5/19/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
80949	Fee-for-Service	1134650005	1134650005	1	1	WONG, VANESSA MD	9/2/2020	207PP0204X	NA	Other	026	PHYSICIANS	159984	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
80956	Fee-for-Service	1528100203	1528100203	1	1	WOLFER, CARL MD INC	1/9/1979	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20984	01	General Practice	0	In state provider	None	1555 EAST ST	STE 130	REDDING	CA	96001	1153	45	06089	40.58440354	-122.3880021	Shasta County
80974	Fee-for-Service	1669714846	1669714846	1	1	WALDON, MEREDITH F C MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142998	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
81004	Fee-for-Service	1306378559	1306378559	1	1	WETHEY, KEVIN M MD	3/24/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	163661	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
81005	Fee-for-Service	1770790859	1770790859	1	1	WAINWRIGHT, CHRISTINA A	7/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99440	66	Emergency Medicine (Urgent Care)	0	In state provider	MD	101 E VALENCIA MESA	None	FULLERTON	CA	92835	3875	30	06059	33.89356031	-117.9271656	Orange County
81006	Fee-for-Service	1922358092	1922358092	1	1	WAHL, VANESSA M CCC-SLP	4/15/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
81012	Fee-for-Service	1548789050	1548789050	1	2	WELLSPACE HEALTH	7/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4990 STOCKTON BLVD	None	SACRAMENTO	CA	95820	5406	34	06067	38.530107	-121.4459055	Sacramento County
81091	Fee-for-Service	1972761120	1972761120	1	1	WHITNEY, JANET DO MPH INC	6/11/2008	261QM1300X	NA	Other	026	PHYSICIANS	7126	01	General Practice	0	In state provider	None	6260 EL CAMINO REAL	SUITE 201	CARLSBAD	CA	92009	1609	37	06073	33.12215813	-117.266659	San Diego County
81118	Fee-for-Service	1770682593	1770682593	1	1	WEISS, PETER D MD	2/22/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	48941	None	None	0	In state provider	None	1010 MURRAY AVE	None	SAN LUIS OBISPO	CA	93405	1806	40	06079	35.292168	-120.6658665	San Luis Obispo County
81120	Fee-for-Service	1891826210	1891826210	1	1	WALLIS, STEVEN B OD	2/1/1994	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15972 TUSCOLA RD	STE 101	APPLE VALLEY	CA	92307	1267	36	06071	34.54144171	-117.2692593	San Bernardino County
81188	Fee-for-Service	1992951347	1992951347	1	1	WASHINGTON, THERESSIA L MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104439	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
81325	Fee-for-Service	1518071984	1518071984	1	1	WAHLIG, RONALD J MD INC	5/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	76939	05	Anesthesiology	0	In state provider	None	2476 OVERLAND AVE	STE 305	LOS ANGELES	CA	90064	3375	19	06037	34.04049861	-118.4237778	Los Angeles County
81331	Fee-for-Service	1407279656	1407279656	1	1	WOHLANDER, KIRBY N LCSW	11/17/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
81394	Fee-for-Service	1316928997	1316928997	1	1	WINTEMUTE, GAREN J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38793	08	Family Practice	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
81481	Fee-for-Service	1437279759	1437279759	1	1	WOLPERT, ERIK J	8/1/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25830 MCBEAN PKWY	None	VALENICIA	CA	91355	2004	19	06037	34.40360638	-118.5522028	Los Angeles County
81544	Fee-for-Service	1659957751	1659957751	1	1	WANG, SUSAN MD	10/23/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184180	08	Family Practice	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
81631	Fee-for-Service	1467458000	1467458000	1	1	WOLFSON, JACK M DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CARDIOVASCULAR CONSLTNTS	16601 N 40TH ST	STE 204	PHOENIX	AZ	85032	3356	00	None	33.637356	-111.995514	Maricopa County
81669	Fee-for-Service	1073891990	1073891990	1	1	WILLHAM, KAITLIN A MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138228	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
81685	Fee-for-Service	1235206384	1235206384	1	1	WEST, KATHLEEN	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3624 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4006	07	06013	38.00418494	-121.8432075	Contra Costa County
81710	Fee-for-Service	1518549328	1518549328	1	1	WONG, DUSTIN DO	1/29/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22709	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
81763	Fee-for-Service	1699863597	1699863597	1	1	WATTS, TREVOR M PT	10/30/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	392 SIERRA ST	None	KINGSBURG	CA	93631	1706	10	06019	36.5178297	-119.5717648	Fresno County
81790	Fee-for-Service	1679506315	1679506315	1	1	WASEF, RASHAD MD	5/31/1980	207R00000X	NA	Other	026	PHYSICIANS	32546	41	Internal Medicine	0	In state provider	None	25 S RAYMOND AVE	STE 202	ALHAMBRA	CA	91801	7144	19	06037	34.09042452	-118.1450725	Los Angeles County
81814	Fee-for-Service	1326383894	1326383894	1	1	WONG, SAI-KIT DO PC	12/17/2012	207L00000X	NA	Other	026	PHYSICIANS	10075	05	Anesthesiology	0	In state provider	None	2701 S BRISTOL STREET	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
81824	Fee-for-Service	1376519751	1376519751	1	1	WALSH, JOHN T MD	2/22/2022	207L00000X	NA	Other	026	PHYSICIANS	154878	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
81903	Fee-for-Service	1760409080	1760409080	1	1	WALMART INC	10/7/1993	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7150 CAMINO ARROYO	None	GILROY	CA	95020	7351	43	06085	37.008549	-121.551147	Santa Clara County
81919	Fee-for-Service	1104152412	1104152412	1	1	WILEY, BRANDON M MD	9/2/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	116066	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
81920	Fee-for-Service	1801918396	1801918396	1	1	WARPINSKI, AMY DO	7/9/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	18500	30	Radiology	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
81954	Fee-for-Service	1841740123	1841740123	1	1	WELLS, LAVONA	10/12/2016	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	578 W FIGUEROA DR	None	ALTADENA	CA	91001	5276	19	06037	34.18747113	-118.1621549	Los Angeles County
81981	Fee-for-Service	1396024600	1396024600	1	1	WU, EIJEAN MD	7/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117540	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1377 E HERNDON AVE	SUITE 104	FRESNO	CA	93720	3309	10	06019	36.83704387	-119.7641113	Fresno County
82075	Fee-for-Service	1851422166	1851422166	1	1	WESTCARE CALIFORNIA, INC	12/11/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1550 HERNDON AVENUE	None	CLOVIS	CA	93661	0569	10	06019	36.83737951	-119.6871885	Fresno County
82087	Fee-for-Service	1295807014	1295807014	1	1	WADHERA, RUBICA MD	1/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80744	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
82113	Fee-for-Service	1952389686	1952389686	1	1	WU, THEODORE MD	1/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90766	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
82161	Fee-for-Service	1689250235	1689250235	1	1	WALIA, GURJOT MD	9/25/2023	207R00000X	NA	Other	026	PHYSICIANS	188720	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
82181	Fee-for-Service	1134651573	1134651573	1	2	WLED WAZNI, M.D. MEDICAL COR	5/17/2022	2084V0102X	NA	Neurology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PORATION	1050 LINDEN AVE	None	LONG BEACH	CA	90813	3321	19	06037	33.78003775	-118.1866604	Los Angeles County
82193	Fee-for-Service	1972689826	1972689826	1	1	WEBB, KENNETH G LMFT	9/24/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1809 W. REDLANDS BLVD	None	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
82223	Fee-for-Service	1508942863	1508942863	1	1	WOLFF, LEONARD M LMFT	8/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	1062 G ST	SUITE D	ARCATA	CA	95521	5922	12	06023	40.87008261	-124.0852546	Humboldt County
82243	Fee-for-Service	1841740123	1841740123	1	1	WELLS, LAVONA	10/12/2016	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	578 W FIGUEROA DR	None	ALTADENA	CA	91001	5276	19	06037	34.18747113	-118.1621549	Los Angeles County
82277	Fee-for-Service	1639328412	1639328412	1	1	WILSONMANIGAT, BRANDYE V MD	12/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	95658	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
82300	Fee-for-Service	1477500585	1477500585	1	1	WEST COUNTY RADIOLOGICAL	2/3/2014	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	1	Border provider	GROUP, INC	615 S NEW BALLAS RD	None	ST LOUIS	MO	63141	8221	00	None	38.644902	-90.4462065	St. Louis County
82337	Fee-for-Service	1598713968	1598713968	1	1	WILLIAM M PACE MD INC	3/11/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	42	Nuclear Medicine	0	In state provider	None	2438 N PONDEROSA DR	SUITE C-210	CAMARILLO	CA	93010	2369	56	06111	34.24219545	-119.0227012	Ventura County
82351	Fee-for-Service	1962585570	1962585570	1	1	WILLOUGHBY, DARRYL A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54030	20	Orthopedic Surgery	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
82358	Fee-for-Service	1851369706	1851369706	1	1	WRIGHT, DANIEL R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	14502 W MEEKER BLVD	None	SUN CITY WEST	AZ	85375	5282	00	None	33.660657	-112.3736175	Maricopa County
82378	Fee-for-Service	1245608058	1245608058	1	1	WESTMINSTER VILLA, INC.	12/16/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13881 DAWSON STREET	None	GARDEN GROVE	CA	92843	3166	30	06059	33.76113653	-117.9510032	Orange County
82459	Fee-for-Service	1952729543	1952729543	1	1	WASEF, PHILIP MD	1/18/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	191957	36	Psychiatry	0	In state provider	None	350 E COMMERCIAL ROAD	STE 112	SAN BERNARDINO	CA	92408	3764	36	06071	34.05584763	-117.2773573	San Bernardino County
82485	Fee-for-Service	1003041559	1003041559	1	1	WRIGHT, MATTHEW A MD	10/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131194	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
82567	Fee-for-Service	1699793869	1699793869	1	1	WASKA, ROBERT E JR MFT	1/7/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3329 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1911	38	06075	37.78809053	-122.4474648	San Francisco County
82594	Fee-for-Service	1780662403	1780662403	1	1	WEISS, LEE R MD	12/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87130	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
82676	Fee-for-Service	1003108879	1003108879	1	1	WEINSTEIN, JACQUELINE E MD	8/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149924	04	Otology, Laryngology, Rhinology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
82731	Fee-for-Service	1447859897	1447859897	1	1	WILLIAMS CARE SERVICES INC	7/23/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6622 AMETRINE COURT	None	MIRA LOMA	CA	91752	4445	33	06065	33.96765637	-117.5423647	Riverside County
82741	Fee-for-Service	1891700803	1891700803	1	1	WALGREEN CO	10/21/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3339 E ANAHEIM ST	None	LONG BEACH	CA	90804	4032	19	06037	33.78262848	-118.15317	Los Angeles County
82746	Fee-for-Service	1659749745	1659749745	1	1	WEST EYECARE OPTOMETRY PC	1/26/2016	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2525 WESTMINSTER AVE	STE D	SANTA ANA	CA	92706	2143	30	06059	33.75996952	-117.904104	Orange County
82748	Fee-for-Service	1952729543	1952729543	1	1	WASEF, PHILIP MD	1/18/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	191957	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	350 E COMMERCIAL ROAD	STE 112	SAN BERNARDINO	CA	92408	3764	36	06071	34.05584763	-117.2773573	San Bernardino County
82756	Fee-for-Service	1073683918	1073683918	1	1	WALGREEN CO	4/18/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2875 MAIN ST	None	SUSANVILLE	CA	96130	4739	18	06035	40.41007292	-120.6355924	Lassen County
82776	Fee-for-Service	1811381866	1811381866	1	1	WILLIAMS, ERIKA D OT	8/4/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	15928 VENTURA BLVD	STE 218	ENCINO	CA	91436	4413	19	06037	34.15585301	-118.4801465	Los Angeles County
82793	Fee-for-Service	1356549331	1356549331	1	1	WANG, LISA SHING-E LU MD	12/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98434	78	Neoplastic Diseases/Oncology	0	In state provider	None	18111 BROOKHURST ST	STE 6100	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
82832	Fee-for-Service	1528035979	1528035979	1	1	WALLACH, ANDREW B MD	11/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	41883	08	Family Practice	0	In state provider	None	500 SAN PABLO AVE	STE 300	ALBANY	CA	94706	1127	01	06001	37.89781848	-122.3014067	Alameda County
82837	Fee-for-Service	1780849588	1780849588	1	1	WALGREEN CO.	9/22/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5504 BALBOA AVE.	None	SAN DIEGO	CA	92111	2704	37	06073	32.81973233	-117.1810836	San Diego County
82911	Fee-for-Service	1346557691	1346557691	1	2	WHOLE FAMILY HEALTH PC	2/12/2018	261QP2300X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1030 S GLENDALE AVE	200	GLENDALE	CA	91205	2866	19	06037	34.13381535	-118.2519184	Los Angeles County
82960	Fee-for-Service	1487713830	1487713830	1	1	WAGMEISTER, ROBERT MD	5/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	41624	02	General Surgery	0	In state provider	INC	2001 SANTA MONICA BLVD	# 690W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
82974	Fee-for-Service	1427390517	1427390517	1	1	WABUKE, CHARITY LMFT	8/15/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	87592	-	NOT APPLICABLE	0	In state provider	None	11600 ELDRIDGE AVE	None	LAKE VIEW TERRACE	CA	91342	6506	19	06037	34.28038404	-118.3838708	Los Angeles County
82983	Fee-for-Service	1912202946	1912202946	1	1	WESTHEIMER, GABRIEL I NP	3/22/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
83000	Fee-for-Service	1942037510	1942037510	1	1	WEIMER, BRYANA D NP	10/23/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
83050	Fee-for-Service	1659357200	1659357200	1	1	WILSON, DARRELL M MD	1/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	38484	40	Pediatrics	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
83074	Fee-for-Service	1215398722	1215398722	1	1	WALLACE, PATRICIA C PSYD	2/26/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8240 BEVERLY BLVD	SUITE 8	WEST HOLLYWOOD	CA	90048	4529	19	06037	34.07605149	-118.369494	Los Angeles County
83081	Fee-for-Service	1356549331	1356549331	1	1	WANG, LISA SHING-E LU MD	12/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98434	68	Hematology	0	In state provider	None	18111 BROOKHURST ST	STE 6100	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
83084	Fee-for-Service	1831278712	1831278712	1	1	WARDI, DHIA A M AL MD	2/28/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	25184	13	Neurology (M.D. only)	0	In state provider	A PROFESSIONAL CORP	225 W MAIN ST	None	ALHAMBRA	CA	91801	3403	19	06037	34.0939256	-118.1295402	Los Angeles County
83098	Fee-for-Service	1225131170	1225131170	1	1	WANG, CHRISTINA MD	5/31/1992	207RE0101X	NA	Endocrinology	026	PHYSICIANS	49348	67	Endocrinology	0	In state provider	None	8723 ALDEN DR	None	LOS ANGELES	CA	90048	3812	19	06037	34.07532856	-118.3822124	Los Angeles County
83145	Fee-for-Service	1013094820	1013094820	1	1	WEISS,ANN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	0000	00	None	43.654374	-116.694738	Canyon County
83148	Fee-for-Service	1851596498	1851596498	1	1	WILSON, STEPHANIE D MD	5/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142237	36	Psychiatry	0	In state provider	None	2340 CLAY ST	7TH FLOOR	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
83246	Fee-for-Service	1396131074	1396131074	1	1	WOOD, RICHARD MD	3/11/2025	208C00000X	NA	General Surgery	026	PHYSICIANS	-	85	Surgery-Pediatric	2	Out of state provider	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
83339	Fee-for-Service	1659357200	1659357200	1	1	WILSON, DARRELL M MD	1/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	38484	67	Endocrinology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
83367	Fee-for-Service	1356549331	1356549331	1	1	WANG, LISA SHING-E LU MD	12/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98434	41	Internal Medicine	0	In state provider	None	18111 BROOKHURST ST	STE 6100	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
83386	Fee-for-Service	1164721932	1164721932	1	1	WINTZ, DIANE A MD	10/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138581	89	Surgery-Traumatic	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
83427	Fee-for-Service	1326571654	1326571654	1	1	WONG, MARCUS MD	11/1/2020	207P00000X	NA	Other	026	PHYSICIANS	169829	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
83433	Fee-for-Service	1346557014	1346557014	1	11	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	FOUNDATION	2299 MOWRY AVE	STE 3C	FREMONT	CA	94538	1621	01	06001	37.55671415	-121.9817758	Alameda County
83484	Fee-for-Service	1144388109	1144388109	1	1	WHITMORE, EMMA	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
83502	Fee-for-Service	1831410695	1831410695	1	1	WOOD, ARTHUR W MD	6/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113297	05	Anesthesiology	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
83504	Fee-for-Service	1447234224	1447234224	1	1	WHITMER, JAMES R MD	1/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6490 S MCCARRAN BLVD	STE 13	RENO	NV	89509	6120	00	None	39.47672552	-119.796471	Washoe County
83598	Fee-for-Service	1326074139	1326074139	1	1	WOLF, SHELDON M MD	2/1/1984	2084N0400X	NA	Neurology	026	PHYSICIANS	6721	13	Neurology (M.D. only)	0	In state provider	None	4900 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5814	19	06037	34.0981225	-118.2965085	Los Angeles County
83604	Fee-for-Service	1740226695	1740226695	1	1	WAJSMAN, DAN MD	8/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79021	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
83626	Fee-for-Service	1083870562	1083870562	1	1	WANG, HARRISON F MD	11/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110071	None	None	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
83664	Fee-for-Service	1700891074	1700891074	1	1	WALGREENS #00900	1/1/1966	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2105 MORRILL AVE	None	SAN JOSE	CA	95132	1130	43	06085	37.4139393	-121.8742316	Santa Clara County
83670	Fee-for-Service	1639483167	1639483167	1	1	WHITLOCK, GAYLE LMFT	11/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
83673	Fee-for-Service	1528014792	1528014792	1	1	WATTS, GARY M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1034 N 500 W	None	PROVO	UT	84604	3380	00	None	40.248072	-111.6673905	Utah County
83675	Fee-for-Service	1164721932	1164721932	1	1	WINTZ, DIANE A MD	10/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138581	02	General Surgery	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
83681	Fee-for-Service	1154402352	1154402352	1	1	WOODHOUSE, SHERYL E LMFT	11/15/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	38832	-	NOT APPLICABLE	0	In state provider	None	5 MAREBLU	STE 100, 200, 250	ALISO VIEJO	CA	92656	3014	30	06059	33.57250566	-117.7027366	Orange County
83709	Fee-for-Service	1336155910	1336155910	1	1	WALGREEN CO	8/4/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1640 R ST	None	MERCED	CA	95340	4527	24	06047	37.30406774	-120.4927895	Merced County
83723	Fee-for-Service	1679702039	1679702039	1	1	WU, TUNG-YUN D MD	10/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142706	44	Public Health	0	In state provider	None	3555 WHIPPLE RD	2ND FLOOR	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
83741	Fee-for-Service	1770728016	1770728016	1	1	WANG, CHUN-YEH MD	5/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	72065	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 WEST HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
83745	Fee-for-Service	1528271145	1528271145	1	1	WILDER, JOANN LCSW	9/25/2008	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	145 S FIG ST	STE J	ESCONDIDO	CA	92025	4453	37	06073	33.12414749	-117.0725627	San Diego County
83751	Fee-for-Service	1184892770	1184892770	1	1	WHITE, DANIEL V MD	10/17/2007	193400000X	NA	Other	026	PHYSICIANS	87387	14	Neurological Surgery	0	In state provider	None	296 H ST	303	CHULA VISTA	CA	91910	4779	37	06073	32.63445985	-117.0769184	San Diego County
83765	Fee-for-Service	1821709643	1821709643	1	1	WINTERS HEALTHCARE FNDTN	10/18/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	17340 YOLO AVE	None	ESPARTO	CA	95627	2265	57	06113	38.68981813	-122.0174868	Yolo County
83781	Fee-for-Service	1083936660	1083936660	1	1	WILLIAMS, NICOLE G MD	3/2/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	173753	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
83786	Fee-for-Service	1770538662	1770538662	1	1	WYCLIFFE, BEENA E MD	3/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82400	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
83826	Fee-for-Service	1922261247	1922261247	1	1	WOO, ALICE B W MD	7/11/2017	2086S0122X	NA	General Surgery	026	PHYSICIANS	112701	24	Plastic Surgery	0	In state provider	None	234 CLAY ST	2ND 3RD AND 4TH FLS	SAN FRANCISCO	CA	91145	1932	38	06075	37.79530701	-122.3983711	San Francisco County
83880	Fee-for-Service	1922738137	1922738137	1	1	WAYNE, ALEXANDRIA MSW LCSW	6/13/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
83893	Fee-for-Service	1881212256	1881212256	1	1	WELLCARE MEDICAL TRANSPORTAT	9/17/2020	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ION,INC.	6428 1/2 COLDWATER CANYO	None	NORTH HOLLYWOOD	CA	91606	1113	19	06037	34.18757276	-118.4137803	Los Angeles County
83919	Fee-for-Service	1053605691	1053605691	1	1	WU, GEENA MD	10/13/2017	208600000X	NA	General Surgery	026	PHYSICIANS	127342	02	General Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
83995	Fee-for-Service	1841353968	1841353968	1	1	WILCOX, GEORGE E MD	7/3/2018	207ZP0102X	NA	Other	026	PHYSICIANS	141474	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
84032	Fee-for-Service	1073073037	1073073037	1	1	WALIA, NEAL MD	7/1/2022	390200000X	NA	Other	026	PHYSICIANS	176654	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
84046	Fee-for-Service	1780779108	1780779108	1	1	WAN, CECILIA W MD	2/28/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	63265	41	Internal Medicine	0	In state provider	None	1001 SNEATH LN	STE 300	SAN BRUNO	CA	94066	2349	41	06081	37.63462925	-122.4259247	San Mateo County
84047	Fee-for-Service	1457463150	1457463150	1	1	WAGNER, WILLIAM S OD	11/26/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
84048	Fee-for-Service	1578662888	1578662888	1	1	WARM SPRINGS ROAD CVS LLC	11/14/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	4595 E FLAMINGO RD	None	LAS VEGAS	NV	89121	4738	00	None	36.11488473	-115.0742808	Clark County
84052	Fee-for-Service	1821709643	1821709643	1	1	WINTERS HEALTHCARE FNDTN	10/30/2023	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	17340 YOLO AVE	None	ESPARTO	CA	95627	2265	57	06113	38.68981813	-122.0174868	Yolo County
84158	Fee-for-Service	1619700887	1619700887	1	1	WALSH, CHRISTOPHER LCSW	9/13/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
84193	Fee-for-Service	1235720368	1235720368	1	1	WILLIAMS, LISA E LMFT	8/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
84259	Fee-for-Service	1346481884	1346481884	1	1	WILLIAMS, CANDICE J MD	10/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110292	05	Anesthesiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
84282	Fee-for-Service	1205033974	1205033974	1	1	WALKER, CHERYL R	5/3/2011	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
84299	Fee-for-Service	1790799047	1790799047	1	1	WATSONVILLE SURGEONS	1/23/2003	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	GROUP	160 GREEN VALLEY RD	STE 101	FREEDOM	CA	95019	3160	44	06087	36.93732602	-121.7715374	Santa Cruz County
84327	Fee-for-Service	1770670556	1770670556	1	1	WATANABE, TAKENORI MD	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	107382	01	General Practice	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
84340	Fee-for-Service	1821709643	1821709643	1	1	WINTERS HEALTHCARE FNDTN	10/18/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	17340 YOLO AVE	None	ESPARTO	CA	95627	2265	57	06113	38.68981813	-122.0174868	Yolo County
84390	Fee-for-Service	1457418766	1457418766	1	1	WEBSTER, WILLIAM LCSW	10/23/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
84428	Fee-for-Service	1871507483	1871507483	2	1	WEI, CHAU-PO MD	3/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	30134	18	Ophthalmology	0	In state provider	None	616 N GARFIELD AVE	SUITE 305	MONTEREY PARK	CA	91754	1101	19	06037	34.06916465	-118.1229039	Los Angeles County
84445	Fee-for-Service	1205811171	1205811171	1	1	WHITE-VANCE, CHERYL MD	4/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	43063	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
84446	Fee-for-Service	1497916464	1497916464	1	1	WALKER, PAUL C MD	7/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131003	04	Otology, Laryngology, Rhinology	0	In state provider	None	11370 ANDERSON STREET	SUITE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
84466	Fee-for-Service	1659471621	1659471621	1	1	WOODEN, TERESA C	11/29/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3087	31	06061	38.76566391	-121.2457432	Placer County
84470	Fee-for-Service	1932286861	1932286861	1	1	WU, JOHN WEN WEI MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	79121	30	Radiology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
84493	Fee-for-Service	1972577021	1972577021	1	1	WAKE, MARY W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88533	36	Psychiatry	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
84570	Fee-for-Service	1902224850	1902224850	1	1	WONG, BRANDON J MD	7/13/2018	207WX0009X	NA	Ophthalmology	026	PHYSICIANS	139727	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
84579	Fee-for-Service	1275586935	1275586935	1	1	WEBER, ALISON M PHD	2/8/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1100 TRANCAS ST	STE 206	NAPA	CA	94558	2904	28	06055	38.32316569	-122.2981938	Napa County
84649	Fee-for-Service	1336335322	1336335322	1	1	WIDJAJA, ARMAND MD	8/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98710	40	Pediatrics	0	In state provider	None	2650 S BRISTOL ST	#101	SANTA ANA	CA	92704	5751	30	06059	33.71118647	-117.885452	Orange County
84686	Fee-for-Service	1043301740	1043301740	1	1	WALSH, ALEXANDER C MD	6/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	79504	18	Ophthalmology	0	In state provider	None	1127 WILSHIRE BLVD	STE 1620	LOS ANGELES	CA	90017	4007	19	06037	34.05270508	-118.2641005	Los Angeles County
84695	Fee-for-Service	1891942108	1891942108	1	1	WALGREEN CO	11/18/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1285 S MISSION RD	None	FALLBROOK	CA	92028	4005	37	06073	33.37002334	-117.251391	San Diego County
84732	Fee-for-Service	1891917753	1891917753	1	1	WESTSIDE UNION ELEM SD	10/2/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	41914 50TH ST WEST	None	QUARTZ HILL	CA	93536	2963	19	06037	34.644744	-118.2184015	Los Angeles County
84741	Fee-for-Service	1629158977	1629158977	1	1	WILFONG, ANGUS A MD	7/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	79	Neurology-Child	2	Out of state provider	None	1919 E THOMAS RD	AMBULATORY	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
84752	Fee-for-Service	1205903184	1205903184	1	1	WU, VICTOR MD	3/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54236	10	Gastroenterology (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
84770	Fee-for-Service	1134385453	1134385453	1	1	WALGREEN CO	11/25/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3571 N 1ST STREET	None	SAN JOSE	CA	95134	1803	43	06085	37.40770226	-121.9439259	Santa Clara County
84772	Fee-for-Service	1790701225	1790701225	1	1	WILLIAMS, KRISTIN A MD	6/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	83480	01	General Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.76344756	-122.4581992	San Francisco County
84799	Fee-for-Service	1821282310	1821282310	1	1	WILKES, ERIN E MD	7/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106293	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
84840	Fee-for-Service	1164614970	1164614970	1	1	WANG, CLIFFORD T MD	5/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99611	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
84875	Fee-for-Service	1760418602	1760418602	1	1	WIGHT, DIANE B MD	4/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	42969	01	General Practice	0	In state provider	None	2621 SHADELANDS DR	None	WALNUT CREEK	CA	94598	2512	07	06013	37.92734436	-122.0231145	Contra Costa County
84879	Fee-for-Service	1649341744	1649341744	1	1	WARD, MICHAEL P DO	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	101 CIVIC CENTER LN	None	LK HAVASU CTY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
84955	Fee-for-Service	1235591686	1235591686	1	1	WOLFE-MODUPE, FOLASHADE MD	7/9/2019	390200000X	NA	Other	026	PHYSICIANS	152435	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
84958	Fee-for-Service	1235591181	1235591181	1	1	WANG, BRIAN DO	9/9/2021	207RN0300X	NA	Nephrology	026	PHYSICIANS	16174	None	None	0	In state provider	None	1501 SUPERIOR AVE	205	NEWPORT BEACH	CA	92663	3640	30	06059	33.62918676	-117.9305675	Orange County
84968	Fee-for-Service	1740432764	1740432764	1	1	WU, EFREN F MD	1/2/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	121278	01	General Practice	0	In state provider	None	44100 JEFFERSON ST	STE E507	INDIO	CA	92201	2715	33	06065	33.72753404	-116.2687204	Riverside County
84971	Fee-for-Service	1184494049	1184494049	1	1	WECARE HEALTHCARE GROUP LLC	2/6/2025	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	301 E J ST	None	CHULA VISTA	CA	91910	6223	37	06073	32.63397192	-117.0515714	San Diego County
85012	Fee-for-Service	1063747152	1063747152	1	1	WU, ALEX K MD	7/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111908	34	Urology and Urological Surgery	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94612	3208	41	06081	37.65894608	-122.440161	San Mateo County
85019	Fee-for-Service	1215307053	1215307053	1	1	WALGREEN CO.	11/20/2015	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16368	3745 S LA BREA AVE.	SUITE C-D	LOS ANGELES	CA	90016	5357	19	06037	34.018623	-118.355616	Los Angeles County
85027	Fee-for-Service	1235156654	1235156654	1	1	WAL-MART STORES, INC	7/18/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101660	40130 10TH ST W	None	PALMDALE	CA	93551	3005	19	06037	34.611579	-118.145376	Los Angeles County
85029	Fee-for-Service	1629158977	1629158977	1	1	WILFONG, ANGUS A MD	7/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	13	Neurology (M.D. only)	2	Out of state provider	None	1919 E THOMAS RD	AMBULATORY	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
85038	Fee-for-Service	1205903184	1205903184	1	1	WU, VICTOR MD	3/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54236	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
85214	Fee-for-Service	1740675495	1740675495	1	1	WANG, JESSICA S MD	8/9/2018	207R00000X	NA	Other	026	PHYSICIANS	147884	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
85237	Fee-for-Service	1730194010	1730194010	1	1	WALGREEN CO	4/11/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1661 MCKEE BLVD	None	SAN JOSE	CA	95116	1236	43	06085	37.35773116	-121.8613412	Santa Clara County
85247	Fee-for-Service	1811244098	1811244098	1	1	WIGGINS, CHAUNTEL M PHD	12/30/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
85274	Fee-for-Service	1669574059	1669574059	2	1	WU, ROBERT K MD	7/31/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	74241	84	Surgery-Head and Neck	0	In state provider	None	13847 E14TH STREET	SUITE 200	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
85293	Fee-for-Service	1245306760	1245306760	1	1	WAIT, DAVID B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 LINCOLN WAY	None	COEUR D ALENE	ID	83814	2611	00	None	47.69465937	-116.7917936	Kootenai County
85301	Fee-for-Service	1942704259	1942704259	1	1	WINGE, CARL GUSTAF MARTEN M	6/8/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	173872	None	None	0	In state provider	D	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
85334	Fee-for-Service	1982602579	1982602579	1	1	WANG, ROGER H MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	44667	08	Family Practice	0	In state provider	None	1125 E 17TH ST	STE W239	SANTA ANA	CA	92701	2205	30	06059	33.76004145	-117.854838	Orange County
85366	Fee-for-Service	1144377334	1144377334	1	1	WEISS, HALI E MD	4/4/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	76354	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
85382	Fee-for-Service	1013914456	1013914456	1	1	WOLFSTEIN, JUDITH MD	8/15/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
85397	Fee-for-Service	1407957582	1407957582	1	1	WATANABE, TERUO OD INC	2/9/1976	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PLAZA VISION OPTOMETRY	525 S MYRTLE AVE	STE 107	MONROVIA	CA	91016	5192	19	06037	34.1463384	-118.0010142	Los Angeles County
85437	Fee-for-Service	1841204179	1841204179	1	1	WALGREEN CO.	8/14/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1086 W ARROW HWY	None	SAN DIMAS	CA	91773	2492	19	06037	34.10658454	-117.828342	Los Angeles County
85460	Fee-for-Service	1710055785	1710055785	1	1	WEISSKOPF, MATTHEW D PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2423 CAMINO DEL RIO S	STE 102	SAN DIEGO	CA	92108	3734	37	06073	32.76759179	-117.1387533	San Diego County
85476	Fee-for-Service	1578578845	1578578845	1	1	WALGREEN CO.	8/14/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	456 MISSION ST	None	SAN FRANCISCO	CA	94105	2502	38	06075	37.79028395	-122.3973981	San Francisco County
85488	Fee-for-Service	1134205222	1134205222	1	1	WOODGLEN RECOVERY	9/18/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	JUNCTION INC	329 E COMMONWEALTH AVE	None	FULLERTON	CA	92832	2016	30	06059	33.87042737	-117.9185217	Orange County
85522	Fee-for-Service	1275502171	1275502171	1	1	WADIWALA, ISMAIL	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42925	10	Gastroenterology (M.D. only)	0	In state provider	None	210 FREMONT AVE	None	MANTECA	CA	95336	0000	39	06077	37.79553777	-121.2095676	San Joaquin County
85555	Fee-for-Service	1659447118	1659447118	1	1	WELLS, DAVID L MD	6/3/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	145620	30	Radiology	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
85600	Fee-for-Service	1205853538	1205853538	1	1	WAL-MART PHRMCY 10-2044	2/24/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2044 FOREST AVE	None	CHICO	CA	95928	7619	04	06007	39.723327	-121.804947	Butte County
85680	Fee-for-Service	1669575643	1669575643	1	1	WATSON, NATHAN T MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72931	66	Emergency Medicine (Urgent Care)	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
85733	Fee-for-Service	1972636975	1972636975	1	1	WILLIAMS, SHANETTE R LMFT	10/17/2019	101YP2500X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	250 S OAK AVE	SUITE A-1	OAKDALE	CA	95361	3572	50	06099	37.75888818	-120.8609099	Stanislaus County
85735	Fee-for-Service	1568664209	1568664209	1	1	WHANG, SEON H MD INC	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38291	83	Rheumatology	0	In state provider	None	3663 W 6TH ST	STE 100	LOS ANGELES	CA	90020	3047	19	06037	34.06360557	-118.30199	Los Angeles County
85741	Fee-for-Service	1558881292	1558881292	1	1	WONG, THEODORA MD	9/10/2024	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	187282	39	Preventive (M.D. only)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
85775	Fee-for-Service	1346448990	1346448990	1	1	WARD, JILL-ARMANDA LMFT	7/6/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	53625	-	NOT APPLICABLE	0	In state provider	None	1506 MARKET STREET	None	REDDING	CA	96001	1023	45	06089	40.58403672	-122.3908469	Shasta County
85807	Fee-for-Service	1275502171	1275502171	1	1	WADIWALA, ISMAIL	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42925	41	Internal Medicine	0	In state provider	None	210 FREMONT AVE	None	MANTECA	CA	95336	0000	39	06077	37.79553777	-121.2095676	San Joaquin County
85886	Fee-for-Service	1295265072	1295265072	1	1	WAL-MART STORES INC	1/10/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	44100 JEFFERSON ST	STE F	INDIO	CA	92201	2715	33	06065	33.72753404	-116.2687204	Riverside County
85903	Fee-for-Service	1518136951	1518136951	1	1	WONG, ERIC E MD	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130746	None	None	0	In state provider	None	1516 COTNER AVE	None	LOS ANGELES	CA	90025	3303	19	06037	34.04905416	-118.4477438	Los Angeles County
85916	Fee-for-Service	1023301330	1023301330	1	1	WILLIS, JEFFREY R MD	6/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123650	18	Ophthalmology	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
85954	Fee-for-Service	1548789050	1548789050	1	3	WELLSPACE HEALTH	7/28/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	631 H STREET	None	SACRAMENTO	CA	95814	2302	34	06067	38.5839	-121.4969085	Sacramento County
85994	Fee-for-Service	1366853103	1366853103	1	1	WAQAR, MOMINA MD	11/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146133	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
86025	Fee-for-Service	1568664209	1568664209	1	1	WHANG, SEON H MD INC	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38291	41	Internal Medicine	0	In state provider	None	3663 W 6TH ST	STE 100	LOS ANGELES	CA	90020	3047	19	06037	34.06360557	-118.30199	Los Angeles County
86056	Fee-for-Service	1013411404	1013411404	1	1	WEISS, MASSUD R MD	12/16/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173590	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
86072	Fee-for-Service	1235995184	1235995184	1	1	WINTERS HEALTHCARE FOUNDATIO	4/2/2024	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY	17340 YOLO AVE	None	ESPARTO	CA	95627	2265	57	06113	38.68981813	-122.0174868	Yolo County
86076	Fee-for-Service	1891187035	1891187035	1	1	WEST COVINA MEDICAL CENTER,	4/4/2015	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	INC	725 S ORANGE AVE	None	WEST COVINA	CA	91790	2614	19	06037	34.07079634	-117.9445034	Los Angeles County
86077	Fee-for-Service	1417048059	1417048059	1	1	WU, MING H MD	8/22/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54992	08	Family Practice	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
86129	Fee-for-Service	1487641650	1487641650	1	1	WILLIAM UZELMEIER MD	7/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	23900 KATY FWY	None	KATY	TX	77494	1323	00	None	29.78594112	-95.78613398	Harris County
86243	Fee-for-Service	1548789050	1548789050	1	3	WELLSPACE HEALTH	7/8/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	631 H STREET	None	SACRAMENTO	CA	95814	2302	34	06067	38.5839	-121.4969085	Sacramento County
86311	Fee-for-Service	1790860963	1790860963	1	1	WAHBAH, MARY M MD	2/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81181	01	General Practice	0	In state provider	None	18021 SKY PARK CIR	BLDG 68	IRVINE	CA	92614	6523	30	06059	33.68904995	-117.8542045	Orange County
86326	Fee-for-Service	1831804657	1831804657	1	1	WP ENTERPRISE LLC	8/17/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	11860 CONFLUENCE DR	None	JURUPA VALLEY	CA	91752	2785	33	06065	33.96128248	-117.5416902	Riverside County
86366	Fee-for-Service	1891187035	1891187035	1	1	WEST COVINA MEDICAL CENTER,	4/4/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	INC	725 S ORANGE AVE	None	WEST COVINA	CA	91790	2614	19	06037	34.07079634	-117.9445034	Los Angeles County
86377	Fee-for-Service	1376637637	1376637637	1	1	WILLIAMS, JAMES H MD	1/1/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	44722	01	General Practice	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
86415	Fee-for-Service	1487014817	1487014817	1	1	WILLIAMS, KIMBERLY E LCSW	4/30/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	81094	-	NOT APPLICABLE	0	In state provider	None	3115 REDHILL AVENUE	None	COSTA MESA	CA	92626	4517	30	06059	33.6763772	-117.8776418	Orange County
86573	Fee-for-Service	1396999355	1396999355	1	1	WILSON, KATRINA E	1/24/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
86633	Fee-for-Service	1740618065	1740618065	1	1	WILEY, ANNEMARIE J CRNA	12/2/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
86642	Fee-for-Service	1053504902	1053504902	1	1	WONG, GRACE I MD	3/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96700	41	Internal Medicine	0	In state provider	None	210 W SAN BERNARDINO RD	None	COVINA	CA	91722	5108	19	06037	34.088004	-117.893475	Los Angeles County
86771	Fee-for-Service	1942697966	1942697966	1	1	WASSIE, EMNET A MD	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	150357	41	Internal Medicine	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
86826	Fee-for-Service	1427063437	1427063437	1	1	WALGREEN CO	11/22/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 W SUNSET BLVD	None	LOS ANGELES	CA	90026	4226	19	06037	34.0770959	-118.2580592	Los Angeles County
86846	Fee-for-Service	1003242744	1003242744	1	1	WU, JAMES MD	12/24/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	17262	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
86857	Fee-for-Service	1154381218	1154381218	1	1	WU,JIANWEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	GILBERT HOSPITAL	5656 S POWER RD	None	GILBERT	AZ	85295	8487	00	None	33.31386	-111.6877185	Maricopa County
86893	Fee-for-Service	1184641318	1184641318	1	1	WAL-MART STORES INC	8/20/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHRMCY 10-3276	4001 HALLMARK PKWY	None	SAN BERNARDINO	CA	92407	1876	36	06071	34.16311738	-117.3353622	San Bernardino County
86917	Fee-for-Service	1437602919	1437602919	1	1	WHITE MEDICAL GROUP, INC.	8/13/2023	193400000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	.	2152 E. COPPER AVE	111	FRESNO	CA	93730	5404	10	06019	36.89572301	-119.7435024	Fresno County
86955	Fee-for-Service	1942208467	1942208467	1	1	WEXLER, KEITH S MD	3/2/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	134758	None	None	0	In state provider	None	559 ABBOTT ST	None	SALINAS	CA	93901	4325	27	06053	36.66284132	-121.6420108	Monterey County
86987	Fee-for-Service	1295496990	1295496990	1	1	WEINER, CARRIE LMFT	7/27/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
87002	Fee-for-Service	1831748714	1831748714	1	1	WINDSOR CYPRESS GARDENS HEAL	9/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9025 COLORADO AVE	None	RIVERSIDE	CA	92503	2157	33	06065	33.93786954	-117.4477996	Riverside County
87112	Fee-for-Service	1174036750	1174036750	1	1	WARD, HEATHER LMFT	8/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	801 S GRAND STREET	SUITE 780	LOS ANGELES	CA	90017	8590	19	06037	34.04532806	-118.258462	Los Angeles County
87125	Fee-for-Service	1508804881	1508804881	1	1	WILLIAMS, JOANNE MD	7/21/1995	207P00000X	NA	Other	026	PHYSICIANS	51753	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7300 MEDICAL CENTER DR	None	CANOGA PARK	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
87137	Fee-for-Service	1558418392	1558418392	1	1	WEST CONTRA COSTA USD	7/1/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1108 BISSELL AVE	None	RICHMOND	CA	94801	3135	07	06013	37.93404647	-122.3585886	Contra Costa County
87143	Fee-for-Service	1235217845	1235217845	1	1	WOO, DEWEY L MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	61021	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
87151	Fee-for-Service	1386179562	1386179562	1	1	WU, SHIROU MD	6/21/2021	208M00000X	NA	Other	026	PHYSICIANS	171647	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
87182	Fee-for-Service	1881844678	1881844678	1	1	WHITE, JOSIE LMFT	4/27/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	50358	-	NOT APPLICABLE	0	In state provider	None	161 WEST VICTORIA STREET	SUITE 255	LONG BEACH	CA	90805	2175	19	06037	33.86489618	-118.2026866	Los Angeles County
87211	Fee-for-Service	1346744414	1346744414	1	1	WONG, TAMMY C	10/28/2022	207RS0012X	NA	Other	026	PHYSICIANS	163917	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
87237	Fee-for-Service	1407873995	1407873995	1	1	WU, JAMES T MD	7/29/2012	208G00000X	NA	General Surgery	026	PHYSICIANS	95821	02	General Surgery	0	In state provider	None	224 S SANTA ANITA AVE	None	ARCADIA	CA	91006	3521	19	06037	34.13714303	-118.0312992	Los Angeles County
87249	Fee-for-Service	1649825696	1649825696	1	1	WHITE, MATTHEW M NP	1/16/2020	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1560 E CHEVY CHASE DR	STE 130	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
87259	Fee-for-Service	1508885245	1508885245	1	1	WOOD, THURMAN E OD	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4900 COMMERCE DR	None	BAKERSFIELD	CA	93309	0418	15	06029	35.3696013	-119.0558857	Kern County
87278	Fee-for-Service	1952325698	1952325698	1	2	WEBB, DARRELL A DO	1/8/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	7333	-	NOT APPLICABLE	0	In state provider	None	8741 LAUREL CANYON BLVD	None	SUN VALLEY	CA	91352	4580	19	06037	34.2284836	-118.4000486	Los Angeles County
87348	Fee-for-Service	1235272071	1235272071	1	1	WESTERN MEDICAL SERVICES	5/5/1982	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	18726 S WESTERN AVE	STE 204	GARDENA	CA	90248	3813	19	06037	33.860511	-118.309141	Los Angeles County
87393	Fee-for-Service	1679590996	1679590996	1	1	WAL-MART PHARMACY 102030	10/18/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 SANGUINETTI RD	None	SONORA	CA	95370	6214	55	06109	37.971684	-120.365865	Tuolumne County
87395	Fee-for-Service	1184644213	1184644213	1	1	WOO, HAWKIN E MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60209	41	Internal Medicine	0	In state provider	None	100 MEDICAL PLAZA SUITE	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
87405	Fee-for-Service	1922203546	1922203546	1	1	WRIGHT, KATHRYN J MD	9/11/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	103178	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18460 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22071454	-118.5357375	Los Angeles County
87419	Fee-for-Service	1356369888	1356369888	1	1	WAL-MART STORES, INC.	6/14/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101645	250 S. 12TH AVE.	None	HANFORD	CA	93230	6176	16	06031	36.321678	-119.6763255	Kings County
87528	Fee-for-Service	1407873995	1407873995	1	1	WU, JAMES T MD	7/29/2012	208G00000X	NA	General Surgery	026	PHYSICIANS	95821	33	Thoracic Surgery	0	In state provider	None	224 S SANTA ANITA AVE	None	ARCADIA	CA	91006	3521	19	06037	34.13714303	-118.0312992	Los Angeles County
87545	Fee-for-Service	1538175997	1538175997	1	1	WEST BEVERLY PODIATRY	6/30/1993	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	638 W DUARTE RD	STE 7	ARCADIA	CA	91007	9201	19	06037	34.12629888	-118.0532077	Los Angeles County
87572	Fee-for-Service	1497773964	1497773964	1	1	WAL-MART STORES, INC	8/28/1996	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102333	20251 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2953	36	06071	34.5268915	-117.2219838	San Bernardino County
87614	Fee-for-Service	1790990836	1790990836	1	1	WALGREEN CO.	10/29/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 N AZUSA AVE	None	COVINA	CA	91722	3609	19	06037	34.08845439	-117.9079036	Los Angeles County
87631	Fee-for-Service	1912981267	1912981267	1	1	WOLFSON, MARTHA J NP	10/31/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 N 15TH STREET W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
87668	Fee-for-Service	1831131754	1831131754	1	1	WARA, WILLIAM M MD	12/1/1997	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	23764	30	Radiology	0	In state provider	None	505 PARNASSUS AVE	# L75	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
87681	Fee-for-Service	1447517503	1447517503	1	1	WAQAS AHMAD QAMAR	12/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4530 E MUIRWOOD DR	STE 105	PHOENIX	AZ	85048	7693	00	None	33.303006	-111.9855375	Maricopa County
87767	Fee-for-Service	1699788828	1699788828	1	1	WHITE, JANET E MD	9/1/1994	174400000X	NA	Other	026	PHYSICIANS	77276	01	General Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
87768	Fee-for-Service	1578588588	1578588588	1	1	WONG, LISA K MD	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
87806	Fee-for-Service	1396002390	1396002390	1	1	WADA, KIMBERLY R MD	12/9/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	127132	40	Pediatrics	0	In state provider	None	2151 N HARBOR BLVD	None	FULLERTON	CA	92835	3801	30	06059	33.89443025	-117.9288328	Orange County
87826	Fee-for-Service	1922492792	1922492792	1	1	WAL-MART STORES, INC.	6/15/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5625 CALLOWAY DR	None	BAKERSFIELD	CA	93312	9726	15	06029	35.41185	-119.112516	Kern County
87888	Fee-for-Service	1689011611	1689011611	1	1	WYATT, CHRISTOPHER LCSW	8/30/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41593 WINCHESTER RD	215	TEMECULA	CA	92590	4860	33	06065	33.52030169	-117.1659061	Riverside County
87919	Fee-for-Service	1730584129	1730584129	1	2	WOODLAND GARDEN I & II LLC	8/14/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1709 KATY PLACE	None	ESCONDIDO	CA	92026	1855	37	06073	33.15413149	-117.1235054	San Diego County
87979	Fee-for-Service	1518180330	1518180330	1	2	WEISER, PENNY H	1/1/2001	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	815 3RD AVE	STE 107	CHULA VISTA	CA	91911	1308	37	06073	32.62337313	-117.072841	San Diego County
88022	Fee-for-Service	1891760716	1891760716	1	1	WERNER, REX A	2/5/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2650 JAMACHA RD	STE 155	EL CAJON	CA	92019	4319	37	06073	32.74399718	-116.9320709	San Diego County
88043	Fee-for-Service	1043299175	1043299175	1	1	WILLIAM CAMPBELL	8/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	222 N LAFAYETTE ST	STE 1	SHELBY	NC	28150	4450	00	None	35.294076	-81.539613	Cleveland County
88055	Fee-for-Service	1699788828	1699788828	1	1	WHITE, JANET E MD	9/1/1994	174400000X	NA	Other	026	PHYSICIANS	77276	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
88060	Fee-for-Service	1003039538	1003039538	1	1	WOOLLEY, BROOK A MD	9/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102474	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
88080	Fee-for-Service	1538376140	1538376140	1	1	WATKINS, JAMIE A LCSW	3/16/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
88096	Fee-for-Service	1043225139	1043225139	1	1	WALGREEN CO	8/1/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8900 WASHINGTON BLVD	None	PICO RIVERA	CA	90660	3765	19	06037	33.98348209	-118.0976934	Los Angeles County
88105	Fee-for-Service	1376048314	1376048314	1	1	WU, SWAY MD	3/11/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165455	None	None	0	In state provider	None	1450 TREAT BLVD	STE 160	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
88144	Fee-for-Service	1134335060	1134335060	1	1	WHITLOCK, MATTHEW C MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117923	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
88145	Fee-for-Service	1992883094	1992883094	1	1	WISKOCIL, ROBERT L MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	35989	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
88184	Fee-for-Service	1255312880	1255312880	1	1	WU, MEIWEN MD	11/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73496	30	Radiology	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
88301	Fee-for-Service	1487174777	1487174777	1	1	WHEATON, BRITTANEE LCSW	5/3/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
88314	Fee-for-Service	1174712137	1174712137	1	1	WEST, AMY PHD	10/2/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
88361	Fee-for-Service	1669450219	1669450219	1	1	WANG, ROBERT C MD	11/26/2007	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	-	04	Otology, Laryngology, Rhinology	1	Border provider	None	1707 W CHARLESTON BLVD	STE 120	LAS VEGAS	NV	89102	2352	00	None	36.15879353	-115.1643015	Clark County
88373	Fee-for-Service	1770960668	1770960668	1	1	WANG, RYAN Y MD	7/23/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	161636	36	Psychiatry	0	In state provider	None	11878 AVENUE OF INDUSTRY	None	SAN DIEGO	CA	92128	3423	37	06073	32.99058739	-117.0752486	San Diego County
88425	Fee-for-Service	1922165802	1922165802	1	1	WORKU, TSEGAMLAK T LMFT	6/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
88432	Fee-for-Service	1134335060	1134335060	1	1	WHITLOCK, MATTHEW C MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117923	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
88437	Fee-for-Service	1164561619	1164561619	1	1	WELCH, MARK T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 SUNNVIEW LANE	None	KAISPELL	MT	59901	0000	00	None	48.214773	-114.3236925	Flathead County
88473	Fee-for-Service	1255312880	1255312880	1	1	WU, MEIWEN MD	11/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73496	78	Neoplastic Diseases/Oncology	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
88478	Fee-for-Service	1184682254	1184682254	1	1	WILLIAMS, ROBERT ROY MD	12/5/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	62642	None	None	0	In state provider	None	445 W EATON AVE	None	TRACY	CA	95376	3420	39	06077	37.743354	-121.432495	San Joaquin County
88593	Fee-for-Service	1568191245	1568191245	1	1	WRIGHT, ANTHONY L NP	10/6/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
88613	Fee-for-Service	1245818889	1245818889	1	1	WROTEN, ASHLEIGH LMFT	8/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14500 ROSCOE BLVD.	400	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
88647	Fee-for-Service	1134257058	1134257058	1	1	WANG, JEFFREY C MD	7/31/1995	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	76303	20	Orthopedic Surgery	0	In state provider	None	200 MEDICAL PLAZA	ROOM 140	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
88669	Fee-for-Service	1750454856	1750454856	1	1	WEBER, KENNETH M MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	66310	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
88824	Fee-for-Service	1104824994	1104824994	1	1	WAXMAN, JACK MD	2/10/2000	207RR0500X	NA	Other	026	PHYSICIANS	23398	83	Rheumatology	0	In state provider	None	3536 MENDOCINO AVE	STE 200	SANTA ROSA	CA	95403	3634	49	06097	38.473326	-122.725935	Sonoma County
88853	Fee-for-Service	1548583396	1548583396	1	1	WATTIER, RACHEL L MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113934	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
88951	Fee-for-Service	1548378235	1548378235	1	1	WASHINGTON HOSPITAL CTR	12/29/2003	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	110 IRVING ST NW	None	WASHINGTON	DC	20010	2975	00	None	38.929554	-77.0163435	District of Columbia
88954	Fee-for-Service	1750454856	1750454856	1	1	WEBER, KENNETH M MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	66310	66	Emergency Medicine (Urgent Care)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
89027	Fee-for-Service	1811162456	1811162456	1	1	WINESBURG, JENNIFER J DO	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11535	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
89052	Fee-for-Service	1427285014	1427285014	1	1	WONG, KRISTIN M MD	1/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108029	40	Pediatrics	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
89054	Fee-for-Service	1598738395	1598738395	1	1	WELLSPRING MEDICAL GROUP INC	9/14/2010	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	45 CASTRO ST	STE 423	SAN FRANCISCO	CA	94114	1027	38	06075	37.76829732	-122.4357056	San Francisco County
89072	Fee-for-Service	1134226590	1134226590	1	1	WALKER, RONALD R MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51470	08	Family Practice	0	In state provider	None	16250 MAIN ST	STE A	LOWER LAKE	CA	95457	0000	17	06033	38.91037047	-122.608881	Lake County
89075	Fee-for-Service	1669434395	1669434395	1	1	WINKLER, CAREY MD	11/27/2023	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	70078	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
89149	Fee-for-Service	1831619139	1831619139	1	1	WANG, DIANA J LCSW	9/9/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
89173	Fee-for-Service	1982640496	1982640496	1	1	WEITZBUCH, SANFORD J DPM	2/5/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	16311 VENTURA BLVD	STE 650	ENCINO	CA	91436	4320	19	06037	34.15706864	-118.4885978	Los Angeles County
89176	Fee-for-Service	1255894481	1255894481	1	1	WAGNER, JEFFREY R MD	7/15/2022	207R00000X	NA	Other	026	PHYSICIANS	179712	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
89178	Fee-for-Service	1003895822	1003895822	1	1	WINSTON, MICHAEL S MD	7/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	20812	05	Anesthesiology	0	In state provider	None	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
89188	Fee-for-Service	1386142263	1386142263	1	1	WOOTEN, SARAH	7/21/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
89193	Fee-for-Service	1558312579	1558312579	1	1	WAGNER, ELLIOTT J MD	1/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49698	30	Radiology	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 103	GARDEN GROVE	CA	92843	1915	30	06059	33.77450141	-117.9123364	Orange County
89243	Fee-for-Service	1548378235	1548378235	1	1	WASHINGTON HOSPITAL CTR	6/6/2006	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	110 IRVING ST NW	None	WASHINGTON	DC	20010	2975	00	None	38.929554	-77.0163435	District of Columbia
89333	Fee-for-Service	1982875704	1982875704	1	1	WOLNISTY, CARL MD INC	2/1/2011	207R00000X	NA	Other	026	PHYSICIANS	5804	10	Gastroenterology (M.D. only)	0	In state provider	None	3838 SHERMAN DR	STE 7	RIVERSIDE	CA	92503	4089	33	06065	33.92678822	-117.4368632	Riverside County
89356	Fee-for-Service	1134226590	1134226590	1	1	WALKER, RONALD R MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51470	01	General Practice	0	In state provider	None	16250 MAIN ST	STE A	LOWER LAKE	CA	95457	0000	17	06033	38.91037047	-122.608881	Lake County
89381	Fee-for-Service	1003859448	1003859448	1	1	WELLS, COLIN J MD	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	34921	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
89398	Fee-for-Service	1609340991	1609340991	1	1	WINOGRAD GOMEZ, VERA MD	6/27/2024	207LP3000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
89418	Fee-for-Service	1306955166	1306955166	1	1	WANG, CHIA C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HARBORVIEW MEDICAL CTR	325 9TH AVE	None	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
89480	Fee-for-Service	1306976261	1306976261	1	1	WALKER, DANIELLE M MD	10/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53822	41	Internal Medicine	0	In state provider	None	1375 SUTTER STREET	SUITE 308	SAN FRANCISCO	CA	94109	5466	38	06075	37.78738239	-122.4229066	San Francisco County
89482	Fee-for-Service	1588742068	1588742068	1	1	WOLFORD, HEATHER Y MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95895	23	Peripheral Vascular Disease or Surgery (D.O. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
89520	Fee-for-Service	1093702151	1093702151	1	1	WONG, EDWARD K MD	11/5/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	69030	41	Internal Medicine	0	In state provider	None	14911 NATIONAL AVE	STE 1	LOS GATOS	CA	95032	2632	43	06085	37.25172742	-121.951483	Santa Clara County
89591	Fee-for-Service	1093776908	1093776908	1	1	WEBER, CHARLES A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	202 S PARK ST	None	MADISON	WI	53715	0000	00	None	43.0654364	-89.40092987	Dane County
89604	Fee-for-Service	1912912247	1912912247	1	1	WALGREEN CO	1/9/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	660 W MARCH LN	None	STOCKTON	CA	95207	6200	39	06077	37.99097141	-121.3136213	San Joaquin County
89615	Fee-for-Service	1477653889	1477653889	1	1	WINSLOW MEMORIAL HOSPITAL	8/24/2008	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	1501 N. WILLIAMSON AVE	None	WINSLOW	AZ	86047	2735	00	None	35.03553286	-110.6918143	Navajo County
89622	Fee-for-Service	1982875704	1982875704	1	1	WOLNISTY, CARL MD INC	2/1/2011	207R00000X	NA	Other	026	PHYSICIANS	5804	41	Internal Medicine	0	In state provider	None	3838 SHERMAN DR	STE 7	RIVERSIDE	CA	92503	4089	33	06065	33.92678822	-117.4368632	Riverside County
89653	Fee-for-Service	1871818484	1871818484	1	1	WAGNER, JUSTIN P MD	5/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117746	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
89672	Fee-for-Service	1982259925	1982259925	1	1	WATSON, MOLLIE	3/28/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2830 G ST	STE C1	EUREKA	CA	95501	4446	12	06023	40.78218776	-124.1624709	Humboldt County
89686	Fee-for-Service	1609340991	1609340991	1	1	WINOGRAD GOMEZ, VERA MD	6/27/2024	207LP3000X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
89745	Fee-for-Service	1659716876	1659716876	1	1	WIRTSCHAFTER, ERIC D MD	8/9/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	133509	68	Hematology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
89764	Fee-for-Service	1255350138	1255350138	1	1	WU, ELSIE EH-SHE MD	2/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80623	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1048 S GARFIELD AVE	STE 300	ALHAMBRA	CA	91801	4768	19	06037	34.083009	-118.123041	Los Angeles County
89765	Fee-for-Service	1972048551	1972048551	1	1	WEED, ALLISON CNP	2/22/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
89773	Fee-for-Service	1255594727	1255594727	1	1	WILKES, NATHAN C MD	3/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110154	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
89832	Fee-for-Service	1558446179	1558446179	2	1	WELLSPACE HEALTH	3/12/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4343 WILLIAMSBOURGH DRIV	None	SACRAMENTO	CA	95823	2006	34	06067	38.498202	-121.457682	Sacramento County
89887	Fee-for-Service	1871660209	1871660209	1	1	WAYMENT, DON M DO	9/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	SUITE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
89898	Fee-for-Service	1174755540	1174755540	1	1	WEXLER, GERI S PHD	9/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
89909	Fee-for-Service	1689769374	1689769374	1	1	WHITE MEMORIAL MED GRP	12/1/1983	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC	1701 E CESAR E CHAVEZ AV	STE 100	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
89947	Fee-for-Service	1558342634	1558342634	1	1	WILLINGHAM, ALEX C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5101 MEDICAL DR	None	SAN ANTONIO	TX	78229	4801	00	None	29.514015	-98.5868955	Bexar County
89978	Fee-for-Service	1104805837	1104805837	1	1	WIECHMANN, MICHAEL L MD	9/24/2014	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	58530	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	40	06079	35.27804785	-120.649711	San Luis Obispo County
89999	Fee-for-Service	1750801932	1750801932	1	1	WILLIAMS, BRYAN LCSW	10/12/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	44-374 PALM STREET	None	INDIO	CA	92201	3117	33	06065	33.72380849	-116.227381	Riverside County
90009	Fee-for-Service	1720174345	1720174345	1	1	WILSON, TARA L MD	5/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80520	02	General Surgery	0	In state provider	None	1902 FULLERTON AVE	FL 1	CORONA	CA	92881	3105	33	06065	33.85828347	-117.5503481	Riverside County
90021	Fee-for-Service	1952472425	1952472425	1	1	WENG, BRUCE H DO	8/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13770	77	Infectious Disease	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
90029	Fee-for-Service	1760732036	1760732036	1	1	WUNG, JOHN MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127492	01	General Practice	0	In state provider	None	1000 FRANKLIN PKWY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
90053	Fee-for-Service	1154692473	1154692473	1	1	WONG, VICTOR MD	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119433	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
90106	Fee-for-Service	1245295781	1245295781	1	1	WOOLSON, STEVEN T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	39802	20	Orthopedic Surgery	0	In state provider	None	1220 UNIVERSITY DR	STE 202	MENLO PARK	CA	94025	4259	41	06081	37.45094703	-122.1880886	San Mateo County
90135	Fee-for-Service	1003421470	1003421470	1	1	WORLD HOME HEALTH INC	11/11/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 499	ENCINO	CA	91436	2914	19	06037	34.15524484	-118.4756687	Los Angeles County
90152	Fee-for-Service	1013964592	1013964592	1	1	WALGREEN CO	10/10/2007	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	28460 HASKELL CANYON RD	None	SANTA CLARITA	CA	91390	5203	19	06037	34.46016626	-118.5117022	Los Angeles County
90155	Fee-for-Service	1427518257	1427518257	1	1	WARREN, ERIC C DO	9/27/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20232	None	None	0	In state provider	None	147 BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
90195	Fee-for-Service	1093790305	1093790305	1	3	WARDEN, NANCY MD	2/22/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	47331	None	None	0	In state provider	None	1850 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	18	06035	40.43814074	-120.6259249	Lassen County
90205	Fee-for-Service	1609286343	1609286343	1	1	WONG, STEPHANIE E MD	8/10/2020	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	138983	20	Orthopedic Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
90224	Fee-for-Service	1104449933	1104449933	1	1	WANG, ROCHELLE P MD	9/20/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	189455	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
90266	Fee-for-Service	1104805837	1104805837	1	1	WIECHMANN, MICHAEL L MD	9/24/2014	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	58530	41	Internal Medicine	0	In state provider	None	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	40	06079	35.27804785	-120.649711	San Luis Obispo County
90340	Fee-for-Service	1154692473	1154692473	1	1	WONG, VICTOR MD	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119433	78	Neoplastic Diseases/Oncology	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
90360	Fee-for-Service	1801445077	1801445077	1	1	WOLF, JACOB CRNA	2/19/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
90381	Fee-for-Service	1376089219	1376089219	1	1	WAIRERI, ANDREW N NP	4/9/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	202 W WILLOW AVE	SUITE 302	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
90385	Fee-for-Service	1801808043	1801808043	1	1	WYNNE, HOWARD E MD	7/31/1995	174400000X	NA	Other	026	PHYSICIANS	54852	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
90393	Fee-for-Service	1992000871	1992000871	1	1	WHITACRE, EDWINA NP	11/2/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2701 OLD EUREKA WAY	1E	REDDING	CA	96001	0228	45	06089	40.58555878	-122.4101367	Shasta County
90446	Fee-for-Service	1326575226	1326575226	1	1	WANG, NATHAN MD	7/29/2021	207P00000X	NA	Other	026	PHYSICIANS	159815	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
90471	Fee-for-Service	1043252919	1043252919	1	1	WALLACE, JAMES D MD	1/1/1982	207RR0500X	NA	Other	026	PHYSICIANS	24760	83	Rheumatology	0	In state provider	None	2865 ATLANTIC AVE	# 11	LONG BEACH	CA	90806	1740	19	06037	33.809418	-118.185058	Los Angeles County
90556	Fee-for-Service	1700375599	1700375599	1	1	WALTER, MIRIAM F PSYD	5/29/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY STREET	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
90561	Fee-for-Service	1144257734	1144257734	1	1	WANG, STEVEN J MD	7/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	62460	04	Otology, Laryngology, Rhinology	0	In state provider	None	1001 POTRERO AVE	RM 4M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
90630	Fee-for-Service	1154692473	1154692473	1	1	WONG, VICTOR MD	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119433	68	Hematology	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
90633	Fee-for-Service	1093101073	1093101073	1	1	WOZNIAK, PATRICIA PA-C	4/28/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1207 EAST FRUIT STREET	A, B, B2, B3, C, D, E, F	SANTA ANA	CA	92701	4206	30	06059	33.75238847	-117.8539245	Orange County
90658	Fee-for-Service	1831224450	1831224450	1	1	WONG, ALLAN M MD	3/8/2019	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	74464	40	Pediatrics	0	In state provider	None	1120 W LA VETA AVE	STE 125	ORANGE	CA	92868	4235	30	06059	33.78029455	-117.864369	Orange County
90673	Fee-for-Service	1134540859	1134540859	1	1	WANG, SIAO-YI MD	6/30/2023	207R00000X	NA	Other	026	PHYSICIANS	186824	None	None	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
90680	Fee-for-Service	1003444233	1003444233	1	1	WU, AUSTIN MD	8/19/2024	207L00000X	NA	Other	026	PHYSICIANS	188856	05	Anesthesiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
90685	Fee-for-Service	1811064785	1811064785	1	1	WEISBERGER, CALVIN L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29082	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
90785	Fee-for-Service	1871537308	1871537308	1	1	WILSON, JOHN S JR MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27483	30	Radiology	0	In state provider	None	88 N SAN MATEO DR	None	SAN MATEO	CA	94401	2824	41	06081	37.56804187	-122.3278806	San Mateo County
90791	Fee-for-Service	1376883660	1376883660	2	1	WEST COAST DME & SUPPLIES LL	7/3/2017	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1835 CHICAGO AVE	UNIT A	RIVERSIDE	CA	92507	2309	33	06065	33.99444	-117.3485395	Riverside County
90819	Fee-for-Service	1922298553	1922298553	1	1	WONG, MAIDA MD	8/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91962	83	Rheumatology	0	In state provider	None	1245 16TH ST	STE 307	SANTA MONICA	CA	90404	1239	19	06037	34.02726451	-118.4857138	Los Angeles County
90830	Fee-for-Service	1770661530	1770661530	1	1	WILLIAMS, MARK E MD	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72120	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIA BLVD	None	HAYWARD	CA	94545	0000	01	06001	37.63011596	-122.0960694	Alameda County
90836	Fee-for-Service	1417513276	1417513276	1	1	WHITTEMORE, CASEY LMFT	1/25/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
90841	Fee-for-Service	1396705356	1396705356	1	1	WONG, CHING Y MD	2/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144795	42	Nuclear Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
90846	Fee-for-Service	1306376983	1306376983	1	1	WIPPEL, BRITTANY M MD	12/27/2022	207P00000X	NA	Other	026	PHYSICIANS	177642	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
90894	Fee-for-Service	1699030940	1699030940	1	1	WONG, JUSTIN W OD	8/8/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2280 E CARSON ST	None	LONG BEACH	CA	90807	3044	19	06037	33.83241248	-118.164456	Los Angeles County
90903	Fee-for-Service	1598394496	1598394496	1	1	WOODRUFF, GILLIAN R MD	12/14/2023	207R00000X	NA	Other	026	PHYSICIANS	192204	None	None	0	In state provider	None	5800 HOLLIS ST	None	EMERYVILLE	CA	94608	2016	01	06001	37.84043576	-122.2894291	Alameda County
90920	Fee-for-Service	1134135700	1134135700	1	1	WALGREEN CO	5/3/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17522 BEACH BLVD	None	HUNTINGTON BEACH	CA	92647	6802	30	06059	33.707925	-117.989074	Orange County
90977	Fee-for-Service	1114301496	1114301496	1	1	WELCH, ELIZABETH A LMFT	11/8/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
90988	Fee-for-Service	1013964220	1013964220	1	1	WILDWOOD MEDICAL A MEDICAL	4/20/2009	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	CORPORATION	11244 PLEASANT VALLEY RD	None	PENN VALLEY	CA	95946	9413	29	06057	39.22267045	-121.2039605	Nevada County
90994	Fee-for-Service	1447324918	1447324918	1	1	WANG, KAREN SS MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72711	40	Pediatrics	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
91006	Fee-for-Service	1144229600	1144229600	1	1	WALLACE, CHARLES D MD	2/28/1998	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	67953	20	Orthopedic Surgery	0	In state provider	None	750 CORONA AVE	None	CORONA	CA	92879	1074	33	06065	33.89161431	-117.559582	Riverside County
91046	Fee-for-Service	1093714743	1093714743	1	1	WAISSBLUTH, ALVARO D MD	7/1/2019	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	154770	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
91081	Fee-for-Service	1376883660	1376883660	2	1	WEST COAST DME & SUPPLIES LL	4/30/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1835 CHICAGO AVE	UNIT A	RIVERSIDE	CA	92507	2309	33	06065	33.99444	-117.3485395	Riverside County
91082	Fee-for-Service	1336220318	1336220318	1	1	WANG, JAW J MD	4/24/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	26671	40	Pediatrics	0	In state provider	None	111 W BEVERLY BLVD	STE 2	MONTEBELLO	CA	90640	4312	19	06037	34.01572372	-118.0991599	Los Angeles County
91101	Fee-for-Service	1528770385	1528770385	1	1	WESTERN SPECIALTY GROUP L.P.	5/20/2024	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	37	06073	32.79493052	-117.155268	San Diego County
91106	Fee-for-Service	1922298553	1922298553	1	1	WONG, MAIDA MD	8/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91962	41	Internal Medicine	0	In state provider	None	1245 16TH ST	STE 307	SANTA MONICA	CA	90404	1239	19	06037	34.02726451	-118.4857138	Los Angeles County
91107	Fee-for-Service	1790168649	1790168649	1	1	WAL-MART STORES, INC	1/13/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 N CENTRAL AVE	None	WASCO	CA	93280	0000	15	06029	35.6042963	-119.3581119	Kern County
91169	Fee-for-Service	1619926078	1619926078	1	1	WANG, FAIR H MD	12/1/2003	207L00000X	NA	Other	026	PHYSICIANS	63831	05	Anesthesiology	0	In state provider	None	20998 REDWOOD RD	None	CASTRO VALLEY	CA	94546	5918	01	06001	37.69338464	-122.0737355	Alameda County
91179	Fee-for-Service	1508933375	1508933375	1	1	WALBURG, RICHARD A	10/1/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
91200	Fee-for-Service	1144235417	1144235417	1	1	WALGREEN CO	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	216 WESTLAKE CENTER	None	DALY CITY	CA	94015	1430	41	06081	37.70123591	-122.4833751	San Mateo County
91205	Fee-for-Service	1902388119	1902388119	1	1	WALGREEN CO .	12/13/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#21195	28311 MARGUERITE PKWY	B-1	MISSION VIEJO	CA	92692	3700	30	06059	33.55177913	-117.6709579	Orange County
91278	Fee-for-Service	1235362823	1235362823	1	1	WILMINGTON ISLAND DME INC	4/27/2016	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1890 WEST BAY DRIVE	STE W-4	LARGO	FL	33770	3019	00	None	27.91678847	-82.807461	Pinellas County
91284	Fee-for-Service	1134298185	1134298185	1	1	WONG, KUAN POK MD INC	5/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	10230 ARTESIA BLVD	STE 102	BELLFLOWER	CA	90706	6768	19	06037	33.8728276	-118.1160403	Los Angeles County
91293	Fee-for-Service	1144229600	1144229600	1	1	WALLACE, CHARLES D MD	1/1/2005	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	750 CORONA AVE	None	CORONA	CA	92879	1074	33	06065	33.89161431	-117.559582	Riverside County
91325	Fee-for-Service	1841284312	1841284312	1	1	WINBERG, CARL D MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36854	22	Pathology (M.D. only)	0	In state provider	None	4929 VAN NUYS BLVD	None	VAN NUYS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
91348	Fee-for-Service	1609574086	1609574086	1	1	WAITARA, EDDAH WANGECI	8/9/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2389 LEIGHTON WAY	None	ROSEVILLE	CA	95747	8838	31	06061	38.7803845	-121.3618455	Placer County
91369	Fee-for-Service	1932280666	1932280666	1	1	WESTCHESTER COUNTY HEALTH	2/21/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CARE CORPORATION	100 WOODS ROAD	None	VALHALLA	NY	10595	1530	00	None	41.08902532	-73.80449573	Westchester County
91374	Fee-for-Service	1194733428	1194733428	1	1	WOLFE, JAMES D MD	6/22/1979	207K00000X	NA	Other	026	PHYSICIANS	25149	03	Allergy	0	In state provider	None	4155 MOORPARK AVE	STE 3	SAN JOSE	CA	95117	1714	43	06085	37.31587947	-121.974255	Santa Clara County
91388	Fee-for-Service	1528770385	1528770385	1	1	WESTERN SPECIALTY GROUP L.P.	5/20/2024	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	37	06073	32.79493052	-117.155268	San Diego County
91397	Fee-for-Service	1871836056	1871836056	1	1	WANG, TIANYI MD	6/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135149	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
91416	Fee-for-Service	1417515412	1417515412	1	1	WILKINSON, NATHAN	3/11/2024	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
91426	Fee-for-Service	1265640940	1265640940	1	1	WAHLERS, MICHAEL MD	2/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106542	05	Anesthesiology	0	In state provider	None	1555 SOQUEL DRIVE	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
91489	Fee-for-Service	1679669147	1679669147	1	1	WEAVER, MICHELLE L NP	11/14/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
91514	Fee-for-Service	1164462420	1164462420	1	1	WARNER, FREDERICK T MD	12/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 S AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
91524	Fee-for-Service	1134156953	1134156953	1	1	WONG, JULIANA C MD	12/1/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	61741	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
91528	Fee-for-Service	1215950068	1215950068	1	1	WONG, DORMING M MD	11/15/1990	207L00000X	NA	Other	026	PHYSICIANS	42273	05	Anesthesiology	0	In state provider	None	23201 LAKE CENTER DR	STE 214	EL TORO	CA	92630	6808	30	06059	33.6255281	-117.7160257	Orange County
91557	Fee-for-Service	1306463542	1306463542	1	1	WELLHAVEN PRIMARY CARE	7/29/2020	261QP2300X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	5555 RESERVOIR DR	303	SAN DIEGO	CA	92120	5181	37	06073	32.77628471	-117.0563688	San Diego County
91571	Fee-for-Service	1821565573	1821565573	1	1	WEISBERG, RUTH T CCC-SLP	7/10/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
91573	Fee-for-Service	1134298185	1134298185	1	1	WONG, KUAN POK MD INC	5/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	10230 ARTESIA BLVD	STE 102	BELLFLOWER	CA	90706	6768	19	06037	33.8728276	-118.1160403	Los Angeles County
91636	Fee-for-Service	1609574086	1609574086	1	1	WAITARA, EDDAH WANGECI	8/9/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2389 LEIGHTON WAY	None	ROSEVILLE	CA	95747	8838	31	06061	38.7803845	-121.3618455	Placer County
91650	Fee-for-Service	1689056251	1689056251	1	1	WEILL, HILIARY C MD	9/14/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	154981	08	Family Practice	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
91653	Fee-for-Service	1932280666	1932280666	1	1	WESTCHESTER COUNTY HEALTH	2/21/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CARE CORPORATION	100 WOODS ROAD	None	VALHALLA	NY	10595	1530	00	None	41.08902532	-73.80449573	Westchester County
91676	Fee-for-Service	1386134484	1386134484	1	1	WITHAM, CARISSA LCSW	11/21/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
91718	Fee-for-Service	1548336688	1548336688	1	1	WEBSTER, KAREN M MD	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	46274	01	General Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
91725	Fee-for-Service	1093031247	1093031247	1	1	WU, TIANYUN	10/12/2018	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	885 A OLIVE AVE	None	NOVATO	CA	94945	2024	21	06041	38.11097063	-122.567526	Marin County
91744	Fee-for-Service	1982884359	1982884359	1	1	WINN, HENRY MD	8/1/1993	207R00000X	NA	Other	026	PHYSICIANS	42958	01	General Practice	0	In state provider	None	15651 IMPERIAL HWY	STE 102B	LA MIRADA	CA	90638	1600	19	06037	33.91736136	-117.9972197	Los Angeles County
91753	Fee-for-Service	1316977978	1316977978	1	1	WEST, JEFFREY A MD	11/30/1991	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	71311	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2900 WHIPPLE AVE	None	REDWOOD CITY	CA	94062	2843	41	06081	37.4783072	-122.2551089	San Mateo County
91761	Fee-for-Service	1073714572	1073714572	1	1	WRIGHT-AVESON, DIANA LMFT	9/27/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
91820	Fee-for-Service	1437341518	1437341518	1	1	WAISMAN, NORBERTO S MD INC	8/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	35479	41	Internal Medicine	0	In state provider	None	480 4TH AVE	STE 500	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
91826	Fee-for-Service	1710191309	1710191309	1	1	WEAVER UNION SCHOOL DIST	8/1/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1240 D STREET	None	MERCED	CA	95341	6248	24	06047	37.29196045	-120.4742796	Merced County
91834	Fee-for-Service	1992162242	1992162242	1	1	WALLS, KEN C	2/13/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19453	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
91869	Fee-for-Service	1306399738	1306399738	1	1	WINTERS, SABRINA NP	8/16/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
91879	Fee-for-Service	1841486131	1841486131	1	1	WILBORN, KATHEY LCSW	7/8/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
91886	Fee-for-Service	1659387025	1659387025	2	1	WALGREEN CO	10/29/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16201 HARBOR BLVD	STE A	FOUNTAIN VALLEY	CA	92708	1383	30	06059	33.728085	-117.9215595	Orange County
91979	Fee-for-Service	1457569162	1457569162	1	1	WEISS, STEVEN J MD	5/31/1981	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	39288	10	Gastroenterology (M.D. only)	0	In state provider	#401	11411 BROOKSHIRE AVE	STE 401	DOWNEY	CA	90241	5084	19	06037	33.93667091	-118.1309273	Los Angeles County
91990	Fee-for-Service	1194379917	1194379917	1	1	WANG, YIYI OD	5/23/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
92034	Fee-for-Service	1982884359	1982884359	1	1	WINN, HENRY MD	8/1/1993	207R00000X	NA	Other	026	PHYSICIANS	42958	41	Internal Medicine	0	In state provider	None	15651 IMPERIAL HWY	STE 102B	LA MIRADA	CA	90638	1600	19	06037	33.91736136	-117.9972197	Los Angeles County
92052	Fee-for-Service	1124365291	1124365291	1	1	WEINTRAUB, SUZANNE A CCC-SLP	12/10/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	621 W MICHELTORENA	STE B	SANTA BARBARA	CA	93101	4195	42	06083	34.41914194	-119.7157341	Santa Barbara County
92098	Fee-for-Service	1861416661	1861416661	1	1	WALL III, NORMAN M DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7180	01	General Practice	0	In state provider	None	1370 RAILROAD AVE	None	SAINT HELENA	CA	94574	1124	28	06055	38.50573142	-122.4693436	Napa County
92127	Fee-for-Service	1790990042	1790990042	1	1	WALGREEN CO	8/2/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #01813	18568 W VENTURA BLVD	None	TARZANA	CA	91356	4146	19	06037	34.16940375	-118.5377537	Los Angeles County
92183	Fee-for-Service	1942306188	1942306188	1	1	WELLBOUND OF EMERYVILLE	10/4/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	2629 MARCONI AVENUE	None	SACRAMENTO	CA	95821	5105	34	06067	38.619288	-121.399884	Sacramento County
92193	Fee-for-Service	1285728543	1285728543	1	1	WONG, ANNE B MD	5/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	41371	05	Anesthesiology	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
92196	Fee-for-Service	1033172903	1033172903	2	1	WADA, GARRETT S OD	1/4/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	936 S BROOKHURST ST	None	ANAHEIM	CA	92804	4305	30	06059	33.819075	-117.9589105	Orange County
92204	Fee-for-Service	1275943318	1275943318	1	1	WANG, BEILIN MD	10/19/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	139423	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
92289	Fee-for-Service	1891793923	1891793923	1	1	WALLACE, ANTHONY PT	12/1/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5255 EL CAMINO REAL	SUITE C	ATASCADERO	CA	93422	3351	40	06079	35.49280107	-120.6762923	San Luis Obispo County
92307	Fee-for-Service	1396063053	1396063053	1	1	WONG, ANDREW L PHD/PSYD	1/23/2019	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
92315	Fee-for-Service	1689019010	1689019010	1	1	WANG, DAVID H MD	8/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131794	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
92322	Fee-for-Service	1487732384	1487732384	1	1	WILSON, ALAN M MD	2/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	44366	45	Nephrology (Renal-Kidney)	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
92337	Fee-for-Service	1275537227	1275537227	1	1	WEINSTEIN, PAUL B MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	37610	41	Internal Medicine	0	In state provider	None	2720 N HARBOR BLVD	STE 130	FULLERTON	CA	92835	2625	30	06059	33.90126238	-117.9292154	Orange County
92355	Fee-for-Service	1558509398	1558509398	1	1	WOLFF, SETH CRNA	12/12/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 CHESTER AVE.	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
92368	Fee-for-Service	1093753899	1093753899	1	1	WOLBERS, LINDA L MD	10/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	80646	01	General Practice	0	In state provider	None	45 NIELSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7925859	Santa Cruz County
92369	Fee-for-Service	1255776258	1255776258	1	1	WILSON, KEITH G MD	7/1/2018	207P00000X	NA	Other	026	PHYSICIANS	132622	None	None	0	In state provider	None	6501 COYLE AVENUE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
92381	Fee-for-Service	1861416661	1861416661	1	1	WALL III, NORMAN M DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7180	05	Anesthesiology	0	In state provider	None	1370 RAILROAD AVE	None	SAINT HELENA	CA	94574	1124	28	06055	38.50573142	-122.4693436	Napa County
92418	Fee-for-Service	1972681773	1972681773	1	1	WIRGANOWICZ, PHILIP Z MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	73671	20	Orthopedic Surgery	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
92440	Fee-for-Service	1306067897	1306067897	1	2	WALKER, MICHELLE L LMFT	10/18/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	135 CARMEN LANE	None	SANTA MARIA	CA	93458	7729	42	06083	34.92484952	-120.4374645	Santa Barbara County
92443	Fee-for-Service	1730728783	1730728783	1	1	WENNINGER, LISA LPCC	1/25/2025	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1580 EASTMAN LN	None	PETALUMA	CA	94952	1683	49	06097	38.23543117	-122.6857511	Sonoma County
92483	Fee-for-Service	1275924417	1275924417	1	1	WARREN, DAVID NP	12/5/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
92524	Fee-for-Service	1942606744	1942606744	1	1	WOUND MD PC	12/22/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	590 S INDIAN HILL BLVD	None	CLAREMONT	CA	91711	5212	19	06037	34.085313	-117.7191945	Los Angeles County
92598	Fee-for-Service	1548789050	1548789050	1	4	WELLSPACE HEALTH	7/28/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1820 J STREET	None	SACRAMENTO	CA	95811	3010	34	06067	38.57688	-121.4816625	Sacramento County
92608	Fee-for-Service	1487732384	1487732384	1	1	WILSON, ALAN M MD	2/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	44366	41	Internal Medicine	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
92624	Fee-for-Service	1508200429	1508200429	1	1	WALSH, KEVIN M MD	11/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125366	40	Pediatrics	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
92636	Fee-for-Service	1508205154	1508205154	1	1	WYATT, JESSE R MD	4/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126356	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3899	36	06071	34.04824949	-117.2401425	San Bernardino County
92667	Fee-for-Service	1225297492	1225297492	1	1	WILLIAMS, EVAN M	8/2/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	172182	None	None	0	In state provider	None	TWO MEDICAL PLAZA	STE 180	ROSEVILLE	CA	95661	3049	31	06061	38.76507948	-121.2477476	Placer County
92675	Fee-for-Service	1336443548	1336443548	1	1	WAN, CHOK P M D INC	10/26/2010	207R00000X	NA	Other	026	PHYSICIANS	67228	41	Internal Medicine	0	In state provider	None	2153 PACIFIC AVE	None	LONG BEACH	CA	90806	4513	19	06037	33.796332	-118.1937995	Los Angeles County
92681	Fee-for-Service	1376612713	1376612713	1	1	WANG, ELLEN Y MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88771	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
92683	Fee-for-Service	1306955125	1306955125	1	1	WHELAN, AILEEN M MD	12/31/1990	207R00000X	NA	Other	026	PHYSICIANS	70278	41	Internal Medicine	0	In state provider	None	1860 EL CAMINO REAL	#321	BURLINGAME	CA	94010	3114	41	06081	37.59615729	-122.3846379	San Mateo County
92692	Fee-for-Service	1154873370	1154873370	1	1	WARDA, JESSE J A	6/4/2018	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	807 DOUGLAS BLVD	SUITE 100	ROSEVILLE	CA	95678	2763	31	06061	38.74397347	-121.2811425	Placer County
92737	Fee-for-Service	1437244159	1437244159	1	1	WOODGLEN RECOVERY	9/18/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	JUNCTION INC	771 W ORANGETHORPE AVE	None	FULLERTON	CA	92832	2016	30	06059	33.85956604	-117.9393193	Orange County
92783	Fee-for-Service	1013907203	1013907203	1	1	WALTERS, JOHN R MD	7/31/1996	207R00000X	NA	Other	026	PHYSICIANS	36595	41	Internal Medicine	0	In state provider	None	703 N A ST	None	OXNARD	CA	93030	4309	56	06111	34.209063	-119.1784975	Ventura County
92812	Fee-for-Service	1942606744	1942606744	1	1	WOUND MD PC	12/22/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	590 S INDIAN HILL BLVD	None	CLAREMONT	CA	91711	5212	19	06037	34.085313	-117.7191945	Los Angeles County
92821	Fee-for-Service	1164816252	1164816252	1	1	WILLIAMS, ESTRELANIA S MD	10/10/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	165780	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 DOYLE PARK	STE 103	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
92835	Fee-for-Service	1477130219	1477130219	1	1	WANG, JESSICA DO	5/10/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22282	08	Family Practice	0	In state provider	None	10250 SANTA MONICA BLVD	2440	LOS ANGELES	CA	90067	6469	19	06037	34.05998846	-118.4200204	Los Angeles County
92836	Fee-for-Service	1316926488	1316926488	1	1	WONG, BRIAN K MD	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	47290	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	20911 EARL ST	STE 340	TORRANCE	CA	90503	4355	19	06037	33.840459	-118.3580985	Los Angeles County
92858	Fee-for-Service	1427359488	1427359488	1	1	WOOLSEY, NATHAN W MD	10/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116222	02	General Surgery	0	In state provider	None	1345 A PAUL BUNYAN RD	None	SUSANVILLE	CA	96130	3159	18	06035	40.43531297	-120.6557201	Lassen County
92860	Fee-for-Service	1427067693	1427067693	1	1	WU, DONG	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	750 N HILL ST	STE J	LOS ANGELES	CA	90012	2383	19	06037	34.06209072	-118.2398687	Los Angeles County
92870	Fee-for-Service	1245446129	1245446129	1	1	WRIGHT, ROBERT C LAC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	935 TRANCAS ST	STE 4A	NAPA	CA	94558	2942	28	06055	38.32367324	-122.294977	Napa County
92885	Fee-for-Service	1548789050	1548789050	1	4	WELLSPACE HEALTH	7/28/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1820 J STREET	None	SACRAMENTO	CA	95811	3010	34	06067	38.57688	-121.4816625	Sacramento County
92896	Fee-for-Service	1326448499	1326448499	1	1	WAL-MART STORES INC	6/12/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3111 NORTH CHESTER	None	BAKERSFIELD	CA	93308	1716	15	06029	35.43451214	-119.0214184	Kern County
92956	Fee-for-Service	1437637121	1437637121	1	1	WEISS, TODD I RCP	12/13/2023	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
93009	Fee-for-Service	1750948063	1750948063	1	1	WU, DANIEL DO	8/29/2024	207R00000X	NA	Other	026	PHYSICIANS	19774	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
93036	Fee-for-Service	1972539179	1972539179	1	1	WITZLING, SANDY MD	2/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	30242	02	General Surgery	0	In state provider	None	2840 LONG BEACH BLVD	STE 345	LONG BEACH	CA	90806	7511	19	06037	33.808743	-118.189341	Los Angeles County
93070	Fee-for-Service	1790945046	1790945046	1	1	WU, ALBERT Y P MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150144	18	Ophthalmology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
93072	Fee-for-Service	1922694579	1922694579	1	1	WILLIAMS, ALISA LCSW	4/30/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
93098	Fee-for-Service	1497086128	1497086128	1	1	WALGREEN CO	8/13/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	828 NEWVILLE RD	None	ORLAND	CA	95963	1109	11	06021	39.74883854	-122.2008838	Glenn County
93100	Fee-for-Service	1942606744	1942606744	1	1	WOUND MD PC	12/22/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	24	Plastic Surgery	0	In state provider	None	590 S INDIAN HILL BLVD	None	CLAREMONT	CA	91711	5212	19	06037	34.085313	-117.7191945	Los Angeles County
93125	Fee-for-Service	1316926488	1316926488	1	1	WONG, BRIAN K MD	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	47290	41	Internal Medicine	0	In state provider	None	20911 EARL ST	STE 340	TORRANCE	CA	90503	4355	19	06037	33.840459	-118.3580985	Los Angeles County
93179	Fee-for-Service	1689712747	1689712747	1	1	WASTRACK, ANGELA	12/15/2014	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1835 EL CAJON BLVD	SUITE A	SAN DIEGO	CA	92103	2591	37	06073	32.75515551	-117.1453277	San Diego County
93183	Fee-for-Service	1255345401	1255345401	1	1	WU, AMY C MD	11/29/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82651	30	Radiology	0	In state provider	None	330 LEWIS ST	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
93221	Fee-for-Service	1235206137	1235206137	1	1	WU, IVAN Y MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74112	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
93227	Fee-for-Service	1871519694	1871519694	1	1	WHITCOMB, EMILY L MD	11/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87926	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
93245	Fee-for-Service	1285090290	1285090290	1	1	WASSERMANN, JUDITH L	1/11/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11100 COLOMA ROAD	None	RANCHO CORDOVA	CA	95670	2804	34	06067	38.616606	-121.271949	Sacramento County
93255	Fee-for-Service	1437166949	1437166949	1	1	WANG-CHENG, REBEKAH M MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	42270	41	Internal Medicine	0	In state provider	None	660 SANITARIUM RD	STE 202	DEER PARK	CA	94576	9714	28	06055	38.54206023	-122.47561	Napa County
93260	Fee-for-Service	1457341851	1457341851	2	1	WESTPAC LABS, INC.	2/1/2011	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	820 34TH STREET	SUITE 103	BAKERSFIELD	CA	93301	2268	15	06029	35.39053308	-119.0117133	Kern County
93266	Fee-for-Service	1306051362	1306051362	1	1	WAGNER, JUSTIN B MD	9/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101997	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
93318	Fee-for-Service	1902921513	1902921513	1	1	WILLIAMS, STACEE E LCSW	10/11/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	70965	-	NOT APPLICABLE	0	In state provider	None	12021 S WILMINGTON AVE	BUILDING 18, SUITE 300	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
93355	Fee-for-Service	1043238835	1043238835	1	1	WYMORE, DWIGHT A MD	1/1/1996	207L00000X	NA	Other	026	PHYSICIANS	51222	05	Anesthesiology	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
93357	Fee-for-Service	1184861163	1184861163	1	1	WHITE, JEFFREY W DR	7/29/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORPORATION	715 N IRWIN ST	None	HANFORD	CA	93230	3813	16	06031	36.33246623	-119.6476443	Kings County
93366	Fee-for-Service	1457597247	1457597247	1	1	WHITE, NATASHA D MD	11/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106271	40	Pediatrics	0	In state provider	None	6555 COYLE AVE	STE 200	CARMICHAEL	CA	95608	0303	34	06067	38.66859	-121.3118055	Sacramento County
93387	Fee-for-Service	1528320678	1528320678	1	1	WILSON, CHANTAL M LMFT	8/17/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3130 5TH AVE	8	SAN DIEGO	CA	92103	5839	37	06073	32.73813729	-117.1603812	San Diego County
93416	Fee-for-Service	1487961256	1487961256	1	1	WADDELL, DENNIS E LMFT	9/14/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
93451	Fee-for-Service	1245595107	1245595107	1	1	WELCH, NINA J CCC-SLP	4/1/2012	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
93505	Fee-for-Service	1811520224	1811520224	1	1	WILLOW BROOK CRITICAL CARE M	3/1/2020	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP, INC	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
93543	Fee-for-Service	1437166949	1437166949	1	1	WANG-CHENG, REBEKAH M MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	42270	01	General Practice	0	In state provider	None	660 SANITARIUM RD	STE 202	DEER PARK	CA	94576	9714	28	06055	38.54206023	-122.47561	Napa County
93574	Fee-for-Service	1669636411	1669636411	1	1	WILL, TONI I	6/19/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
93584	Fee-for-Service	1568822427	1568822427	1	1	WYANT, RACHELE E	4/22/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2700 N MAIN STREET	SUITE 945	SANTA ANA	CA	92705	6678	30	06059	33.7737545	-117.8687284	Orange County
93693	Fee-for-Service	1457341851	1457341851	2	4	WESTPAC LABS, INC.	9/12/2017	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	10200 PIONEER BLVD	STE 500	SANTA FE SPRINGS	CA	90670	6008	19	06037	33.94318106	-118.0817316	Los Angeles County
93729	Fee-for-Service	1598163891	1598163891	1	1	WALKER, TODD	11/21/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14500 ROSCOE BLVD STE 40	None	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
93761	Fee-for-Service	1154369890	1154369890	1	1	WEINTRUB, PEGGY SUE MD	1/1/1990	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	43603	70	Clinic (mixed specialty)	0	In state provider	U C MEDICAL CTR	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
93779	Fee-for-Service	1598424269	1598424269	1	1	WONG, NATALIE PT	4/25/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
93787	Fee-for-Service	1386845485	1386845485	1	1	WOOD, KENNETH AU	8/18/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	747 PLUMAS ST	None	YUBA CITY	CA	95991	4437	51	06101	39.1387503	-121.6168359	Sutter County
93788	Fee-for-Service	1811520224	1811520224	1	1	WILLOW BROOK CRITICAL CARE M	5/6/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	EDICAL GROUP, INC	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
93822	Fee-for-Service	1568450104	1568450104	1	1	WATSON, FREDERICK S	3/31/1989	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	48257	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1430 ESPLANADE	STE 6	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
93823	Fee-for-Service	1407971476	1407971476	1	1	WOODWARD, ANNE M MD	1/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
93842	Fee-for-Service	1003469560	1003469560	1	1	WONG, AUDREY A NP	1/17/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
93851	Fee-for-Service	1578775011	1578775011	1	1	WATERS, DIANE M LCSW	12/19/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4164 BROCKTON AVE	None	RIVERSIDE	CA	92501	3400	33	06065	33.98077024	-117.3813862	Riverside County
93885	Fee-for-Service	1154981041	1154981041	1	1	WANG, AARON S MD	9/12/2022	208M00000X	NA	Other	026	PHYSICIANS	178833	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
93888	Fee-for-Service	1962579813	1962579813	1	1	WYSZOMIRSKI-WITKOWSKI,	1/30/1991	2084P0800X	NA	Psychiatry	026	PHYSICIANS	45887	36	Psychiatry	0	In state provider	JOANNE T MD	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
93889	Fee-for-Service	1376757518	1376757518	1	1	WOON, IRENE	2/27/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
93894	Fee-for-Service	1962550749	1962550749	1	1	WAN, GRACE A MD	4/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77677	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
93986	Fee-for-Service	1871777631	1871777631	1	1	WILLIAMSON, MARY K LCSW	11/13/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8880 CAL CENTER DR	SUITE 400	SACRAMENTO	CA	95826	3889	34	06067	38.55771	-121.376412	Sacramento County
94002	Fee-for-Service	1730179011	1730179011	1	1	WOLINSKY, PHILIP MD	1/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86362	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
94007	Fee-for-Service	1861457327	1861457327	1	1	WANG, JOHN Z MD INC	3/1/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1535 W MERCED AVE	STE 206	WEST COVINA	CA	91790	3404	19	06037	34.06295577	-117.9482872	Los Angeles County
94036	Fee-for-Service	1881609154	1881609154	2	1	WALGREEN CO	7/20/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19001 BROOKHURST ST	None	HUNTINGTON BEACH	CA	92646	2551	30	06059	33.6863847	-117.9541714	Orange County
94049	Fee-for-Service	1568922185	1568922185	1	1	WEILAND, DAVID MD	11/9/2023	390200000X	NA	Other	026	PHYSICIANS	186418	None	None	0	In state provider	None	16200 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.6617581	-117.7736362	Orange County
94050	Fee-for-Service	1972546331	1972546331	3	1	WISINGER DAVID B	5/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
94087	Fee-for-Service	1912032541	1912032541	1	1	WELCOME PHARMACY, INC	6/3/2004	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HALLIBURTON PROF PHCY	15932 HALLIBURTON RD	None	HACIENDA HEIGHTS	CA	91745	3505	19	06037	33.9963673	-117.9640278	Los Angeles County
94103	Fee-for-Service	1366685752	1366685752	1	1	WEATHERSPOON, LA SEAN A LMFT	6/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
94148	Fee-for-Service	1003342759	1003342759	1	1	WELLNESS TRANSIT LLC	3/11/2020	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1807 W KATELLA AVE STE 2	209	ANAHEIM	CA	92804	6691	30	06059	33.80322548	-117.946044	Orange County
94213	Fee-for-Service	1912010497	1912010497	1	1	WALGREEN CO	10/18/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	102 N JACK TONE RD	None	RIPON	CA	95366	9513	39	06077	37.740006	-121.1422125	San Joaquin County
94227	Fee-for-Service	1285828152	1285828152	1	1	WALGREEN CO.	6/24/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3250 LAKESHORE AVE	STE.B	OAKLAND	CA	94610	2720	01	06001	37.81051525	-122.2446621	Alameda County
94232	Fee-for-Service	1790704245	1790704245	1	1	WONG, HELEN W MD	6/1/1994	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	74823	41	Internal Medicine	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
94263	Fee-for-Service	1649783192	1649783192	1	1	WONG, DAVID	3/6/2019	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	420 B ST	None	YUBA CITY	CA	95991	5070	51	06101	39.13415904	-121.6121453	Sutter County
94265	Fee-for-Service	1861650731	1861650731	1	1	WEST, TIMOTHY W MD	4/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103577	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.76344756	-122.4581992	San Francisco County
94271	Fee-for-Service	1013089861	1013089861	1	1	WHEELER, CALVIN B MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40575	13	Neurology (M.D. only)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
94293	Fee-for-Service	1861457327	1861457327	1	1	WANG, JOHN Z MD INC	3/1/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1535 W MERCED AVE	STE 206	WEST COVINA	CA	91790	3404	19	06037	34.06295577	-117.9482872	Los Angeles County
94320	Fee-for-Service	1053507335	1053507335	1	1	WEINER, BARRY E DPM INC	6/18/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3939 J STREET	SUITE 270	SACRAMENTO	CA	95819	3666	34	06067	38.570211	-121.45374	Sacramento County
94379	Fee-for-Service	1851477376	1851477376	1	1	WATANABE, GARRETT L MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74445	36	Psychiatry	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
94392	Fee-for-Service	1659875672	1659875672	1	1	WANG, BELINDA MD	5/7/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	164278	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
94449	Fee-for-Service	1326514084	1326514084	1	1	WU, NANCY CNP	3/25/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	26891 ALISO CREEK RD	None	ALISO VIEJO	CA	92656	3392	30	06059	33.5723715	-117.7235968	Orange County
94488	Fee-for-Service	1538387915	1538387915	1	1	WASHLAKE, ALYSSA	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	None	None	0	In state provider	None	121 S GLENOAKS BLVD	SUITE 3	BURBANK	CA	91502	1315	19	06037	34.18291031	-118.3058877	Los Angeles County
94499	Fee-for-Service	1629581764	1629581764	1	1	WILLIAMS, MACKENZIE NP	2/3/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10538 MISSION GORGE RD	100	SANTEE	CA	92071	3154	37	06073	32.8384953	-116.9677746	San Diego County
94517	Fee-for-Service	1124839386	1124839386	1	1	WILSON, MEGAN C	4/22/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	49	06097	0	0	None
94522	Fee-for-Service	1205327111	1205327111	1	1	WUBBEN, BRANDON MD	2/26/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
94590	Fee-for-Service	1558669085	1558669085	1	1	WESTMAN, AMY C MD	2/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115392	40	Pediatrics	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
94610	Fee-for-Service	1952888141	1952888141	1	1	WALKER, ABIGAIL LMFT	7/19/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
94612	Fee-for-Service	1831383132	1831383132	1	1	WALBY, JULIE A S MD	5/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	96745	22	Pathology (M.D. only)	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
94650	Fee-for-Service	1982627238	1982627238	1	1	WILLIAM CHAEFFER	3/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	UNM MEDICAL GROUP INC	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2719	00	None	35.08771808	-106.6192188	Bernalillo County
94685	Fee-for-Service	1558345249	1558345249	1	1	WONG, ANGELA M MD	8/31/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	61687	08	Family Practice	0	In state provider	None	212 SAN JOSE ST	STE 101	SALINAS	CA	93901	3928	27	06053	36.65853377	-121.6476066	Monterey County
94687	Fee-for-Service	1346557014	1346557014	1	19	WASHINGTON TOWNSHIP MEDICAL	7/9/2021	207XX0005X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	FOUNDATION	38690 STIVERS ST	None	FREMONT	CA	94536	5279	01	06001	37.55724607	-121.9830866	Alameda County
94726	Fee-for-Service	1043515182	1043515182	1	1	WALGREEN CO	4/25/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4935 WARNER AVE	None	HUNTINGTON BEACH	CA	92649	4406	30	06059	33.71540451	-118.042119	Orange County
94734	Fee-for-Service	1104365147	1104365147	1	1	WLASIUK, NADINE R NP	3/9/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
94737	Fee-for-Service	1619430196	1619430196	1	1	WINTER, CATHERINE L MD	1/16/2025	2083P0500X	NA	Adult Primary Care	026	PHYSICIANS	183617	39	Preventive (M.D. only)	0	In state provider	None	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
94763	Fee-for-Service	1891941944	1891941944	1	1	WALGREEN CO.	1/21/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	265 FORREST ST.	None	FRESNO	CA	93210	1929	10	06019	36.13208379	-120.3633471	Fresno
94777	Fee-for-Service	1457410078	1457410078	1	1	WANG, JOHN Y MD	9/6/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54649	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
94898	Fee-for-Service	1083674469	1083674469	1	1	WILCOX, GRACIELA M MD	1/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140630	40	Pediatrics	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
94985	Fee-for-Service	1871664763	1871664763	1	1	WONG, ALISON L MD	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74111	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
95011	Fee-for-Service	1285618330	1285618330	1	1	WRIGHT, TRICIA E MD	8/13/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	161495	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
95041	Fee-for-Service	1154335750	1154335750	1	1	WILKINSON, LESLEY D MD	6/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74239	08	Family Practice	0	In state provider	None	200 MEDICAL PLAZA 220	None	LOS ANGELES	CA	90024	0000	19	06037	34.065126	-118.446237	Los Angeles County
95048	Fee-for-Service	1356645543	1356645543	1	1	WIN, SOE S MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115454	77	Infectious Disease	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
95107	Fee-for-Service	1689750382	1689750382	1	1	WU, JAMES C MD	9/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83800	None	None	0	In state provider	None	1500 E CHEVY CHASE DR	STE 104	GLENDALE	CA	91206	4106	19	06037	34.15201194	-118.2322051	Los Angeles County
95108	Fee-for-Service	1790852507	1790852507	1	1	WEN, ROBERT S MD	12/20/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	82085	41	Internal Medicine	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
95132	Fee-for-Service	1932390051	1932390051	1	1	WRIGHT, KELLY N MD	6/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147143	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	None	W HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
95134	Fee-for-Service	1396242129	1396242129	1	1	WEINFELD, MICHAEL E MD	10/20/2022	207L00000X	NA	Other	026	PHYSICIANS	176168	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
95140	Fee-for-Service	1154484384	1154484384	1	1	WASSERMAN LLOYD IAN	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
95164	Fee-for-Service	1861570616	1861570616	1	1	WEI, DAVID MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69684	05	Anesthesiology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
95177	Fee-for-Service	1396751962	1396751962	1	1	WALGREEN COMPANY	7/13/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4810 E KINGS CANYON RD	None	FRESNO	CA	93727	3809	10	06019	36.73584348	-119.735658	Fresno County
95193	Fee-for-Service	1447238936	1447238936	1	1	WIGGINS, JAMES J DO INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	6833	08	Family Practice	0	In state provider	None	1201 ROSE AVE	None	SELMA	CA	93662	3227	10	06019	36.56881154	-119.5998255	Fresno County
95271	Fee-for-Service	1679590095	1679590095	1	1	WAL-MART STORES, INC	2/23/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101922	12549 FOOTHILL BLVD	None	RANCHO CUCAMONGA	CA	91739	9317	36	06071	34.103448	-117.5314725	San Bernardino County
95318	Fee-for-Service	1811038649	1811038649	1	1	WONG, RANDOLPH W	7/31/1993	208600000X	NA	General Surgery	026	PHYSICIANS	76113	01	General Practice	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
95334	Fee-for-Service	1356645543	1356645543	1	1	WIN, SOE S MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115454	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
95338	Fee-for-Service	1033297858	1033297858	1	1	WILLIS-SHORE, JASON MD	8/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86113	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
95352	Fee-for-Service	1881371052	1881371052	1	1	WOODWARD, SYDNEY R LMFT	10/18/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
95362	Fee-for-Service	1699138891	1699138891	1	1	WILSON, MATTHEW DPM	11/10/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5555 RESERVOIR DR	STE 104	SAN DIEGO	CA	92120	5198	37	06073	32.77628471	-117.0563688	San Diego County
95379	Fee-for-Service	1871645978	1871645978	1	1	WALKER, JOHN W OD	8/15/1997	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9071 CONDE LANE	None	WINDSOR	CA	95492	7419	49	06097	38.54705708	-122.8109573	Sonoma County
95396	Fee-for-Service	1790852507	1790852507	1	1	WEN, ROBERT S MD	12/20/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	82085	10	Gastroenterology (M.D. only)	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
95407	Fee-for-Service	1477211225	1477211225	1	1	WHITE, SARA J NP	5/3/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
95449	Fee-for-Service	1538243126	1538243126	1	1	WILLIAMS, CLEO T MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	52191	08	Family Practice	0	In state provider	None	960 E GREEN ST	STE 208	PASADENA	CA	91106	2401	19	06037	34.14451994	-118.1301695	Los Angeles County
95479	Fee-for-Service	1396932828	1396932828	1	1	WAY, BOBBIE LMFT	12/22/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
95500	Fee-for-Service	1801248257	1801248257	1	1	WILLIAMS, LAUREN A NP	9/11/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
95506	Fee-for-Service	1346279924	1346279924	1	1	WEBER, MELISSA J PT	12/18/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	830 S CITRUS AVE	SUITE 203	AZUSA	CA	91702	5942	19	06037	34.108074	-117.8902345	Los Angeles County
95510	Fee-for-Service	1104998855	1104998855	1	1	WALTON, STACIE L MD	9/18/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69089	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
95558	Fee-for-Service	1104128123	1104128123	1	1	WOMENS RECOVERY SERVICES, A	3/22/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	UNIQUE PLACE	98, 112, 122, 140	HENDLEY ST	SANTA ROSA	CA	95404	5205	49	06097	0	0	None
95620	Fee-for-Service	1649650276	1649650276	1	1	WILDING, STEVEN MD	8/1/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
95623	Fee-for-Service	1356645543	1356645543	1	1	WIN, SOE S MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115454	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
95648	Fee-for-Service	1174571566	1174571566	1	1	WESTSIDE PROFESSIONAL	2/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	12414	30	Radiology	0	In state provider	None	2428 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2045	19	06037	34.0317559	-118.4762013	Los Angeles County
95652	Fee-for-Service	1962065466	1962065466	1	1	WADE, GEOFFREY	2/15/2025	207P00000X	NA	Other	026	PHYSICIANS	-	70	Clinic (mixed specialty)	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
95675	Fee-for-Service	1710984364	1710984364	1	1	WANG, RITA L MD	9/30/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	79174	40	Pediatrics	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
95704	Fee-for-Service	1528396223	1528396223	1	1	WHETSTONE, SARA MD	8/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	116664	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 POTRERO AVE	RM 6D	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
95714	Fee-for-Service	1215134358	1215134358	1	1	WOLK, BRIAN J MD	7/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119990	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	SUITE 108	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
95733	Fee-for-Service	1578585915	1578585915	1	1	WONG, PETRA A MD	11/29/1988	207R00000X	NA	Other	026	PHYSICIANS	39865	41	Internal Medicine	0	In state provider	None	19151 BLOOMFIELD AVE	None	CERRITOS	CA	90703	7104	19	06037	33.85713982	-118.0636939	Los Angeles County
95758	Fee-for-Service	1124153721	1124153721	1	1	WICKENHEISER, RICHARD MD	5/2/1983	207R00000X	NA	Other	026	PHYSICIANS	49852	41	Internal Medicine	0	In state provider	None	2580 SR MARY COLUMBIA DR	None	RED BLUFF	CA	96080	0000	52	06103	40.14842672	-122.2180085	Tehama County
95813	Fee-for-Service	1720028939	1720028939	1	1	WONG, EVELYN M MD	12/3/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73067	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
95842	Fee-for-Service	1811104797	1811104797	1	1	WOODLAND RESIDENTIAL	1/16/2003	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	303 ELLIOT ST	None	WOODLAND	CA	95695	3223	57	06113	38.68111847	-121.7776725	Yolo County
95857	Fee-for-Service	1407921109	1407921109	1	1	WEINGARTEN, ZELMAN G MD	2/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	26589	10	Gastroenterology (M.D. only)	0	In state provider	None	880 S ATLANTIC BLVD	STE G10	MONTEREY PARK	CA	91754	4700	19	06037	34.05038485	-118.1383456	Los Angeles County
95889	Fee-for-Service	1154513240	1154513240	1	1	WASHBURN, STEPHANIE E MD	3/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97960	40	Pediatrics	0	In state provider	None	4647 ZION AVENUE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
95890	Fee-for-Service	1487810321	1487810321	1	1	WADE, ELLIOT L MD	3/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	97317	41	Internal Medicine	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
95898	Fee-for-Service	1275566424	1275566424	1	1	WAIANAE COAST COMP HEALTH	5/22/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	86-260 FARRINGTON HWY	None	WAIANAE	HI	96792	3199	00	None	21.42944095	-158.1807437	Honolulu County
95907	Fee-for-Service	1609133453	1609133453	1	1	WONG, MUN Y MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142600	05	Anesthesiology	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
95938	Fee-for-Service	1205058849	1205058849	1	1	WIERZBICKI, ANDRZEJ MD	11/7/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	162866	30	Radiology	0	In state provider	None	2450 WASHINGTON AVE	STE 120	SAN LEANDRO	CA	94577	5996	01	06001	37.7139863	-122.1490905	Alameda County
95939	Fee-for-Service	1962065466	1962065466	1	1	WADE, GEOFFREY	2/15/2025	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
95947	Fee-for-Service	1174965123	1174965123	1	1	WILLIAMS, NAVAIN LMFT	11/11/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	355 GRAND AVE	2450	LOS ANGELES	CA	90071	1560	19	06037	34.05193094	-118.2524437	Los Angeles County
95959	Fee-for-Service	1215570973	1215570973	1	1	WEST HILLS ADHC LLC	3/2/2022	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	22104 SHERMAN WAY	None	CANOGA PARK	CA	91303	0000	19	06037	34.2009965	-118.608354	Los Angeles County
95967	Fee-for-Service	1801274436	1801274436	1	1	WATKINS, RENECIA A MD	10/7/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	161170	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
95982	Fee-for-Service	1437372521	1437372521	1	1	WESTERN NEUROLOGY	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3303 S LINDSAY RD	STE 118	GILBERT	AZ	85297	2100	00	None	33.28992	-111.7734975	Maricopa County
96009	Fee-for-Service	1922263979	1922263979	1	1	WANG, ANDY C MD	2/10/2021	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	170961	None	None	0	In state provider	None	300 WEST HUNTINGTON DRIV	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
96022	Fee-for-Service	1720328487	1720328487	1	1	WEISS, KAREN L NP	3/26/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
96024	Fee-for-Service	1669487997	1669487997	1	1	WALGREEN CO	7/18/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20505 SHERMAN WAY	None	CANOGA PARK	CA	91306	3427	19	06037	34.20115951	-118.5802425	Los Angeles County
96069	Fee-for-Service	1063790483	1063790483	1	1	WILLIAMS, JESSICA F PHD	1/4/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
96088	Fee-for-Service	1457013021	1457013021	1	1	WOODS, KATHARINE CNP	9/13/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
96097	Fee-for-Service	1427033901	1427033901	1	1	WOLFF, KARL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RADIOLOGY & IMAGING CNSL	155 PRINTERS PARKWAY	None	COLORADO SPRINGS	CO	80910	0000	00	None	38.83046662	-104.7875857	El Paso County
96109	Fee-for-Service	1366869893	1366869893	1	1	WOLD, STEPHEN J DPM	8/12/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
96134	Fee-for-Service	1588315345	1588315345	1	1	WISDOM HOME HEALTH CARE INC	11/26/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1522 W GLENOAKS BLVD	SUITE H	GLENDALE	CA	91201	1913	19	06037	34.16881134	-118.2867712	Los Angeles County
96151	Fee-for-Service	1649277302	1649277302	1	1	WELLING, LYNN E MD	7/31/1992	207P00000X	NA	Other	026	PHYSICIANS	69840	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER COURT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
96157	Fee-for-Service	1982619268	1982619268	1	1	WALGREEN CO	1/19/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #04997	226 RESERVATION RD	None	MARINA	CA	93933	3083	27	06053	36.68634976	-121.7972217	Monterey County
96168	Fee-for-Service	1619164753	1619164753	1	1	WANG, YI MD	5/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98547	08	Family Practice	0	In state provider	None	1661 HANOVER ROAD	#201	CITY OF INDUSTRY	CA	91748	1733	19	06037	33.99109665	-117.920988	Los Angeles County
96193	Fee-for-Service	1962895532	1962895532	1	2	WINGS SPEECH AND LANGUAGE CE	8/20/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	NTER INC	12021 JACARANDA AVE.	301	HESPERIA	CA	92345	4978	36	06071	34.46963618	-117.263267	San Bernardino County
96224	Fee-for-Service	1225609944	1225609944	1	1	WERTHEIM, SASHA CCC-SLP	12/18/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1502 10TH ST	None	BERKELEY	CA	94710	1513	01	06001	37.87596753	-122.2956104	Alameda County
96235	Fee-for-Service	1275548554	1275548554	1	1	WALGREEN CO	12/17/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2177 SUNSET BLVD	None	ROCKLIN	CA	95765	4743	31	06061	38.80527905	-121.2731306	Placer County
96262	Fee-for-Service	1922103142	1922103142	2	2	WILSHIRE PHARMCARE INC	12/10/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	26611 CABOT RD.	STE. B	LAGUNA HILLS	CA	92653	7018	30	06059	33.57641259	-117.6745103	Orange County
96281	Fee-for-Service	1134455165	1134455165	1	1	WILSON, JENNIFER G MD	9/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110811	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
96286	Fee-for-Service	1023144656	1023144656	1	1	WREN, FRANCIS J MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50779	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
96369	Fee-for-Service	1831262203	1831262203	2	2	WATANABE, BRIAN I MD	7/23/2018	2086S0129X	NA	General Surgery	026	PHYSICIANS	83423	None	None	0	In state provider	None	24953 PASEO DE VALENCIA	STE 15C	LAGUNA HILLS	CA	92653	4342	30	06059	33.60028568	-117.7010887	Orange County
96376	Fee-for-Service	1538149919	1538149919	1	1	WU, KONG-TAY MD	8/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	30553	40	Pediatrics	0	In state provider	None	437 N CAMPUS AVE	None	ONTARIO	CA	91764	4229	36	06071	34.06797	-117.6415695	San Bernardino County
96402	Fee-for-Service	1346557014	1346557014	1	13	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	33077 ALVARADO NILES RD	None	UNION CITY	CA	94587	3109	01	06001	37.59324793	-122.0436351	Alameda County
96438	Fee-for-Service	1801085535	1801085535	1	1	WALGREENS CO	8/5/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #10703	82-900 AVE 42	BLDG D	INDIO	CA	92201	9658	33	06065	33.73945036	-116.2602779	Riverside County
96448	Fee-for-Service	1164447991	1164447991	1	1	WADHWA, ANUPAMA N MD	8/21/2018	207L00000X	NA	Other	026	PHYSICIANS	148575	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
96503	Fee-for-Service	1023190733	1023190733	1	1	WONG, MONICA A MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63973	01	General Practice	0	In state provider	None	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	19	06037	33.929829	-118.157607	Los Angeles County
96528	Fee-for-Service	1902986920	1902986920	2	1	WONG, SHI YIN MD	8/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	34772	01	General Practice	0	In state provider	None	407 W COLLEGE ST	None	LOS ANGELES	CA	90012	2313	19	06037	34.06413934	-118.237719	Los Angeles County
96529	Fee-for-Service	1033214796	1033214796	1	1	WHITE, DANIEL V MD	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87387	14	Neurological Surgery	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3195	27	06053	36.696987	-121.633164	Monterey County
96585	Fee-for-Service	1285683664	1285683664	1	1	WILLIAMS, HUGH H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	220 SOUTH CLAYBROOK #314	None	MEMPHIS	TN	38104	0000	00	None	35.13614042	-90.01790599	Shelby County
96593	Fee-for-Service	1417962424	1417962424	1	1	WALGREEN CO	9/12/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8052 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	3303	30	06059	33.75925468	-117.988843	Orange County
96605	Fee-for-Service	1124096409	1124096409	1	1	WIRGA, ALEKSANDRA MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74338	36	Psychiatry	0	In state provider	None	4510 E PACIFIC COAST HWY	STE 120	LONG BEACH	CA	90804	6939	19	06037	33.78815204	-118.1400821	Los Angeles County
96667	Fee-for-Service	1851307367	1851307367	1	1	WILDING, BRANDON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1055 N CURTIS RD	None	BOISE	ID	83706	1309	00	None	43.61455048	-116.256231	Ada County
96686	Fee-for-Service	1346557014	1346557014	1	13	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	FOUNDATION	33077 ALVARADO NILES RD	None	UNION CITY	CA	94587	3109	01	06001	37.59324793	-122.0436351	Alameda County
96700	Fee-for-Service	1598239386	1598239386	1	1	WELLSTART MEDICAL, LLC	8/29/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	9156 S US HIGHWAY 1	None	PORT SAINT LUCIE	FL	34952	3490	00	None	27.300213	-80.3025	St. Lucie County
96749	Fee-for-Service	1184085425	1184085425	1	1	WIN, THAN HTUT MD	12/11/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	168482	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
96786	Fee-for-Service	1184675597	1184675597	1	1	WAHLEN, JOHN E MD	6/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66173	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
96788	Fee-for-Service	1558388801	1558388801	1	1	WAL-MART STORES, INC	10/30/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-3477	7250 CARSON BLVD	None	LONG BEACH	CA	90808	2358	19	06037	33.829335	-118.0906155	Los Angeles County
96815	Fee-for-Service	1104245257	1104245257	1	1	WON, SHARON K MD	8/1/2021	2080P0204X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
96819	Fee-for-Service	1144422536	1144422536	1	1	WANG, AMY Y	4/7/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
96833	Fee-for-Service	1891874541	1891874541	1	1	WONG, TIMOTHY K MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	61688	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
96841	Fee-for-Service	1073903142	1073903142	1	1	WU, NAN MD	8/29/2018	208600000X	NA	General Surgery	026	PHYSICIANS	149749	02	General Surgery	0	In state provider	None	1409 E BRIGGSMORE AVE	None	MODESTO	CA	95355	2707	50	06099	37.66742737	-120.9731413	Stanislaus County
96842	Fee-for-Service	1568734291	1568734291	1	1	WOODARD, JENNIFER CPO	7/18/2016	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1968 VIA CENTRE DRIVE	None	VISTA	CA	92081	6056	37	06073	33.183991	-117.2839002	San Diego County
96868	Fee-for-Service	1417408873	1417408873	1	1	WALKER, ROBIN R LPCC	2/11/2025	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
96879	Fee-for-Service	1992855191	1992855191	1	1	WONG, ANTONIO LCSW	11/10/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
96894	Fee-for-Service	1770880189	1770880189	1	1	WILLIAMS, KELLY LMFT	12/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
96936	Fee-for-Service	1477752095	1477752095	1	1	WESTNEY, JULIE LMFT	2/17/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
96969	Fee-for-Service	1023041423	1023041423	1	1	WANG, CHUN-YEH MD	1/1/2002	193400000X	NA	Other	026	PHYSICIANS	72065	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	PHD, A PROFESSIONAL CORP	416 W LAS TUNAS DR	STE 306	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
97011	Fee-for-Service	1063451243	1063451243	1	1	WENGANG, ZHANG MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65147	41	Internal Medicine	0	In state provider	None	2220 GLADSTONE DR	None	PITTSBURG	CA	94565	5123	07	06013	38.00689525	-121.8661724	Contra Costa County
97029	Fee-for-Service	1588788483	1588788483	1	1	WICKI, TED A LMFT	9/24/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1809 W. REDLANDS BLVD	None	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
97031	Fee-for-Service	1629231147	1629231147	1	1	WILEY, CHRISTI L MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98378	08	Family Practice	0	In state provider	None	7430 CHERRY AVENUE	STE 100	FONTANA	CA	92336	4255	36	06071	34.1190419	-117.4886699	San Bernardino County
97050	Fee-for-Service	1205818739	1205818739	1	1	WALKER, DAPHNE K MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	44360	40	Pediatrics	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
97061	Fee-for-Service	1255893095	1255893095	1	1	WANG, ABBY MD	1/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180881	None	None	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
97068	Fee-for-Service	1255494688	1255494688	1	1	WILSON, MARGARET PHD	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
97075	Fee-for-Service	1699162024	1699162024	1	1	WANG, JAMES B MD	7/31/2020	208600000X	NA	General Surgery	026	PHYSICIANS	168964	None	None	0	In state provider	None	106 LYNCH CREEK WY	STE 9B	PETALUMA	CA	94954	2356	49	06097	38.25206172	-122.634113	Sonoma County
97099	Fee-for-Service	1205946365	1205946365	1	2	WESTERN DIAGNOSTIC IMG	12/14/2005	247100000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	MODEER, SOLMAZ	1635 3RD AVE	STE G	CHULA VISTA	CA	91911	5884	37	06073	32.59663479	-117.064444	San Diego County
97104	Fee-for-Service	1871733329	1871733329	1	1	WORSWICK, SCOTT D MD	6/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110421	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	BLDG 465	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
97135	Fee-for-Service	1346557691	1346557691	1	1	WHOLE FAMILY HEALTH PC	5/2/2011	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	10630	08	Family Practice	0	In state provider	None	801 S CHEVY CHASE DR	STE 103	GLENDALE	CA	91205	4437	19	06037	34.136757	-118.2396195	Los Angeles County
97180	Fee-for-Service	1770780835	1770780835	1	1	WALLACE, DAVID J MD	10/16/2020	207RC0200X	NA	Other	026	PHYSICIANS	170028	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
97205	Fee-for-Service	1659649440	1659649440	1	1	WILLIAMS, NEVILLE W N MD INC	7/2/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34071	34	Urology and Urological Surgery	0	In state provider	None	10 CONGRESS STREET	SUITE 210	PASADENA	CA	91105	3058	19	06037	34.13396893	-118.1528162	Los Angeles County
97209	Fee-for-Service	1255764122	1255764122	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	25500 RANCHO NIGUEL RD	STE 140	LAGUNA NIGUEL	CA	92677	7373	30	06059	33.55578198	-117.6849338	Orange County
97222	Fee-for-Service	1194772525	1194772525	1	1	WILSON, SONE-SEERE A MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	59162	01	General Practice	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
97223	Fee-for-Service	1366427221	1366427221	1	1	WETZEL, PAUL D MD	7/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71477	10	Gastroenterology (M.D. only)	0	In state provider	None	234 HEATHER CT	STE 101	TEMPLETON	CA	93465	8765	40	06079	35.55398686	-120.7176543	San Luis Obispo County
97268	Fee-for-Service	1518390350	1518390350	1	1	WORTMAN, KRISTEN M PHD	2/23/2021	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
97274	Fee-for-Service	1235466343	1235466343	1	1	WU, WINNIE MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	116477	22	Pathology (M.D. only)	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2032	19	06037	34.02980528	-118.4786605	Los Angeles County
97338	Fee-for-Service	1205818739	1205818739	1	1	WALKER, DAPHNE K MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	44360	30	Radiology	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
97348	Fee-for-Service	1144235474	1144235474	1	1	WALGREEN CO	5/20/1987	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #02081	1760 STORY RD	None	SAN JOSE	CA	95122	1921	43	06085	37.34121313	-121.8410221	Santa Clara County
97354	Fee-for-Service	1205667524	1205667524	1	1	WATER OF LIFE COMMUNITY CHUR	8/21/2024	171M00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	CH	7625 EAST AVE	None	FONTANA	CA	92336	2901	36	06071	34.114842	-117.514554	San Bernardino County
97397	Fee-for-Service	1033197835	1033197835	1	1	WEHRLE, PAUL ALLEN	5/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	33706	83	Rheumatology	0	In state provider	None	27800 MEDICAL CENTER RD	STE 202	MISSION VIEJO	CA	92691	6408	30	06059	33.55952733	-117.6645199	Orange County
97413	Fee-for-Service	1558578195	1558578195	1	1	WU, FREDERICK D MD	12/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93500	None	None	0	In state provider	None	501 WASHINGTON ST	STE 600	SAN DIEGO	CA	92103	2239	37	06073	32.74986289	-117.1599343	San Diego County
97475	Fee-for-Service	1275039299	1275039299	1	1	WHEATLAND APOTHECARY LLC	7/11/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2780 OLIVE HWY	None	OROVILLE	CA	95966	6104	04	06007	39.50393146	-121.541223	Butte County
97506	Fee-for-Service	1194772525	1194772525	1	1	WILSON, SONE-SEERE A MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	59162	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
97511	Fee-for-Service	1184719270	1184719270	1	1	WILSON, SHANNA L LMFT	1/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
97568	Fee-for-Service	1669487930	1669487930	1	1	WALGREEN CO	11/9/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3315 S H ST	None	BAKERSFIELD	CA	93304	6533	15	06029	35.32441296	-119.0213709	Kern County
97575	Fee-for-Service	1407986995	1407986995	1	1	WILVANG, GINA L DPM	3/17/2020	213EP1101X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	300 N EUCLID ST	STE A	FULLERTON	CA	92832	1623	30	06059	33.87250373	-117.9419615	Orange County
97614	Fee-for-Service	1528562121	1528562121	1	1	WANG, XUANJI MD	7/20/2023	208600000X	NA	General Surgery	026	PHYSICIANS	186146	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
97631	Fee-for-Service	1992258537	1992258537	1	1	WOOLEY, LEILA R LPCC	9/20/2020	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
97680	Fee-for-Service	1114441300	1114441300	1	1	WELLNESS HEALTHCARE INC	8/5/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12444 VICTORY BLVD	STE 102	NORTH HOLLYWOOD	CA	91606	3156	19	06037	34.18663951	-118.4043555	Los Angeles County
97682	Fee-for-Service	1396064614	1396064614	1	1	WU, VINCENT C DO	1/24/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	9350 FLAIR DR	STE 102	EL MONTE	CA	91731	2828	19	06037	34.07192066	-118.0649488	Los Angeles County
97759	Fee-for-Service	1003091539	1003091539	1	1	WOO, KIHO MD	7/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96349	38	Geriatrics	0	In state provider	None	433 W BASTANCHURY RD	None	FULLERTON	CA	92835	3473	30	06059	33.89344341	-117.9338865	Orange County
97777	Fee-for-Service	1619971090	1619971090	1	1	WILSON, REX D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	86692	41	Internal Medicine	0	In state provider	None	2005 COURT ST	STE H	REDDING	CA	96001	1807	45	06089	40.57842204	-122.3936969	Shasta County
97788	Fee-for-Service	1710415179	1710415179	1	1	WALLER, SIMRAN MD	11/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187918	None	None	0	In state provider	None	3000 LAS POSITAS	None	LIVERMORE	CA	94551	9627	01	06001	37.69960369	-121.7628917	Alameda County
97815	Fee-for-Service	1790074805	1790074805	1	1	WILSON, ERIKA L NP	6/19/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
97861	Fee-for-Service	1669742953	1669742953	1	1	WHITEMORE, ALISON LCSW	7/18/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27699	-	NOT APPLICABLE	0	In state provider	None	144 STONY POINT RD	None	SANTA ROSA	CA	95401	4122	49	06097	38.440494	-122.74353	Sonoma County
97862	Fee-for-Service	1578586301	1578586301	1	1	WANG, JUN MD	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	56481	22	Pathology (M.D. only)	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
97891	Fee-for-Service	1982052635	1982052635	1	1	WATSON, CHRISTOPHER G PSYD	1/13/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	30200 AGOURA RD	SUITE 190	AGOURA HILLS	CA	91301	5434	19	06037	34.14513267	-118.7821377	Los Angeles County
97892	Fee-for-Service	1346557014	1346557014	1	18	WASHINGTON TOWNSHIP MEDICAL	7/9/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	FOUNDATION	39300 CIVIC CENTER DR	200	FREMONT	CA	94538	2338	01	06001	37.55485407	-121.9772883	Alameda County
97930	Fee-for-Service	1063514115	1063514115	1	1	WILSON, ROCHELLE L DO	8/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	26510 CRENSHAW BLVD	None	PLS VRDS PNSL	CA	90274	3970	19	06037	33.78181789	-118.3524794	Los Angeles County
97941	Fee-for-Service	1154649846	1154649846	1	1	WILLIAMS, CLOTYL MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131839	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
97946	Fee-for-Service	1205853546	1205853546	1	1	WAL-MART STORES, INC	12/16/1996	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102536	1110 E PROSPERITY AVE	None	TULARE	CA	93274	8029	54	06107	36.228582	-119.3290425	Tulare County
97955	Fee-for-Service	1437213675	1437213675	1	1	WASHINGTON, JOAN D H LCSW	4/5/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
97975	Fee-for-Service	1184988644	1184988644	1	1	WOODMAN, RYAN S DO	8/1/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	16863	67	Endocrinology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
98010	Fee-for-Service	1841455235	1841455235	1	1	WADIA, RAJEEV S MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101744	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
98029	Fee-for-Service	1891297974	1891297974	1	1	WELL-BEING HOME HEALTH INC	11/27/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5315 LAUREL CANYON BLVD	SUITE 200	VALLEY VILLAGE	CA	91607	4919	19	06037	34.16713798	-118.3965446	Los Angeles County
98070	Fee-for-Service	1962474163	1962474163	1	1	WESOLOWSKI, JEFFREY R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 E MEDICAL CENTER DR	None	ANN ARBOR	MI	48109	5000	00	None	42.28391347	-83.72716554	Washtenaw County
98089	Fee-for-Service	1740433275	1740433275	1	1	WENG, LIANGPING MD	1/7/2020	207RX0202X	NA	Oncology	026	PHYSICIANS	166727	68	Hematology	0	In state provider	None	11480 BROOKSHIRE AVE	STE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
98105	Fee-for-Service	1912438920	1912438920	1	1	WANG, JACKIE Y MD	8/18/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	156999	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
98116	Fee-for-Service	1205946365	1205946365	1	1	WESTERN DIAGNOSTIC IMG	12/14/2005	247100000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	MODEER, SOLMAZ	3490 PALM AVE	None	SAN DIEGO	CA	92154	1664	37	06073	32.58391748	-117.0594012	San Diego County
98126	Fee-for-Service	1013326578	1013326578	1	1	WELLLOVED INC	9/10/2014	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1212 W WASHINGTON AVE	APT 7	SUNNYVALE	CA	94086	6999	43	06085	37.38068549	-122.054346	Santa Clara County
98156	Fee-for-Service	1720519861	1720519861	1	1	WOO, GRACE DO	8/25/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16822	08	Family Practice	0	In state provider	None	15785 LAGUNA CANYON RD	STE 310	IRVINE	CA	92618	3178	30	06059	33.66542536	-117.7615537	Orange County
98160	Fee-for-Service	1346689684	1346689684	1	1	WAL-MART STORES, INC.	6/8/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	215 CALIFORNIA ST	None	WOODLAND	CA	95695	2910	57	06113	38.68065788	-121.788563	Yolo County
98209	Fee-for-Service	1215394226	1215394226	1	1	WINGS OF HOPE HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	345 W PEARL AVE	SUITE 240	REDLANDS	CA	92374	3174	36	06071	34.0612707	-117.1861033	San Bernardino County
98228	Fee-for-Service	1518459320	1518459320	1	1	WEBB, MADISON LMFT	5/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
98231	Fee-for-Service	1184767261	1184767261	1	1	WU, MONTY M OD	11/30/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1239 E VALLEY BLVD	None	ALHAMBRA	CA	91801	5235	19	06037	34.07926357	-118.1108064	Los Angeles County
98264	Fee-for-Service	1184988644	1184988644	1	1	WOODMAN, RYAN S DO	8/1/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	16863	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
98272	Fee-for-Service	1164700738	1164700738	1	1	WRIGHT, KEVIN MD	5/5/2020	207ND0900X	NA	Dermatology	026	PHYSICIANS	163770	07	Dermatology	0	In state provider	None	6605 NANCY RIDGE DR	None	SAN DIEGO	CA	92121	2253	37	06073	32.88682438	-117.1796133	San Diego County
98279	Fee-for-Service	1467646950	1467646950	1	1	WYN, BRIAN A MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
98314	Fee-for-Service	1043695174	1043695174	1	1	WANG, ELIZABETH MD	5/17/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	164401	None	None	0	In state provider	None	910 MAPLE ST	None	REDWOOD CITY	CA	94063	2034	41	06081	37.48867968	-122.2222351	San Mateo County
98371	Fee-for-Service	1356933196	1356933196	1	1	WASHINGTON, BRANDON R LCSW	9/13/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
98416	Fee-for-Service	1346557014	1346557014	1	7	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FOUNDATION	2557 MOWRY AVE	STE 12	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
98419	Fee-for-Service	1346557014	1346557014	1	22	WASHINGTON TOWNSHIP MEDICAL	10/18/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	46690 MOHAVE DR	None	FREMONT	CA	94539	7001	01	06001	37.49166118	-121.9261313	Alameda County
98458	Fee-for-Service	1194705848	1194705848	1	1	WINN, NIYATI M	6/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99181	None	None	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
98460	Fee-for-Service	1578665790	1578665790	1	1	WCHS, INC	3/16/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	TREATMENT CENTER	40700 CALIFORNIA OAKS RD	# 201/202/203	MURRIETA	CA	92562	5789	33	06065	33.57067363	-117.2045035	Riverside County
98464	Fee-for-Service	1528297009	1528297009	1	1	WAZNI, WLED CA	6/7/2018	2084V0102X	NA	Neurology	026	PHYSICIANS	147166	13	Neurology (M.D. only)	0	In state provider	None	1015 N 1ST AVE	STE A	ARCADIA	CA	91006	7401	19	06037	34.15065339	-118.0285869	Los Angeles County
98476	Fee-for-Service	1265662290	1265662290	1	1	WANG, AMY S MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74955	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
98496	Fee-for-Service	1215394226	1215394226	1	1	WINGS OF HOPE HOSPICE INC	1/26/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	345 W PEARL AVE	SUITE 240	REDLANDS	CA	92374	3174	36	06071	34.0612707	-117.1861033	San Bernardino County
98549	Fee-for-Service	1285004028	1285004028	1	1	WALKER, KATHRYN M LMFT	1/2/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5199 E PACIFIC COAST HWY	STE 604	LONG BEACH	CA	90804	3363	19	06037	33.78293818	-118.1329326	Los Angeles County
98641	Fee-for-Service	1851461065	1851461065	1	1	WONG, TIMOTHY OD APC	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6430 W SUNSET BLVD	STE 703	HOLLYWOOD	CA	90028	7910	19	06037	34.09797681	-118.3299393	Los Angeles County
98687	Fee-for-Service	1164522165	1164522165	1	1	WANG, ROGER R DO	5/6/2010	207RA0201X	NA	Other	026	PHYSICIANS	10816	83	Rheumatology	0	In state provider	None	950 STOCKTON STREET	SUITE 399	SAN FRANCISCO	CA	94108	1618	38	06075	37.79469747	-122.4079497	San Francisco County
98707	Fee-for-Service	1346557014	1346557014	1	22	WASHINGTON TOWNSHIP MEDICAL	10/18/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	FOUNDATION	46690 MOHAVE DR	None	FREMONT	CA	94539	7001	01	06001	37.49166118	-121.9261313	Alameda County
98709	Fee-for-Service	1508014317	1508014317	1	1	WINEGARDEN, BABBI J	9/26/2008	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
98749	Fee-for-Service	1578665790	1578665790	1	1	WCHS, INC	7/31/2006	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	TREATMENT CENTER	40700 CALIFORNIA OAKS RD	# 201/202/203	MURRIETA	CA	92562	5789	33	06065	33.57067363	-117.2045035	Riverside County
98758	Fee-for-Service	1518004183	1518004183	1	1	WOOD, MARY LEE CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
98779	Fee-for-Service	1891135562	1891135562	1	1	WELLS COMPREHENSIVE CARE	9/11/2013	193400000X	NA	Other	026	PHYSICIANS	93456	41	Internal Medicine	0	In state provider	SYSTEM & CLINICS INC	207 S SANTA ANITA ST	STE G18	SAN GABRIEL	CA	91776	1146	19	06037	34.10072807	-118.1066296	Los Angeles County
98796	Fee-for-Service	1497785794	1497785794	1	1	WEBB, HILLARD S MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51632	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
98801	Fee-for-Service	1225484025	1225484025	1	1	WANG, STEPHANIE Y MD	6/4/2021	207R00000X	NA	Other	026	PHYSICIANS	155015	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
98857	Fee-for-Service	1215947775	1215947775	1	2	WCHS, INC	3/16/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1330 N INDIAN CANYON DR	SUITE A,B,C	PALM SPRINGS	CA	92262	4880	33	06065	33.84144	-116.5455715	Riverside County
98870	Fee-for-Service	1386797884	1386797884	1	1	WU, JOSEPH K DO	8/22/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5414 WALNUT AVE	STE B	IRVINE	CA	92604	2522	30	06059	33.68908239	-117.7705473	Orange County
98887	Fee-for-Service	1942348669	1942348669	1	1	WITTE, AMY L LMFT	3/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9700 FAIR OAKS BLVD	SU. G-H	FAIR OAKS	CA	95628	7079	34	06067	38.638854	-121.2776145	Sacramento County
98936	Fee-for-Service	1023035441	1023035441	1	1	WAL-MART STORES, INC	10/21/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101697	8465 ELK GROVE BLVD	None	ELK GROVE	CA	95758	9573	34	06067	38.411343	-121.3911405	Sacramento County
98940	Fee-for-Service	1154338150	1154338150	1	1	WALGREEN CO	2/24/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4142 PACIFIC COAST HWY	None	TORRANCE	CA	90505	5714	19	06037	33.80719256	-118.3568844	Los Angeles County
98960	Fee-for-Service	1013477843	1013477843	1	1	WOO, DENNIS M MD	9/20/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176999	None	None	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
98975	Fee-for-Service	1164522165	1164522165	1	1	WANG, ROGER R DO	5/6/2010	207RA0201X	NA	Other	026	PHYSICIANS	10816	03	Allergy	0	In state provider	None	950 STOCKTON STREET	SUITE 399	SAN FRANCISCO	CA	94108	1618	38	06075	37.79469747	-122.4079497	San Francisco County
98999	Fee-for-Service	1063755874	1063755874	1	1	WONG, ALTON S Y MD	10/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134289	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
99003	Fee-for-Service	1245790427	1245790427	1	1	WALDEN, LAUREN MD	10/27/2023	207L00000X	NA	Other	026	PHYSICIANS	182286	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
99038	Fee-for-Service	1265089957	1265089957	1	1	WU, WAYNE PT	7/8/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3925 ROSEMEAD BLVD	#102	ROSEMEAD	CA	91770	1933	19	06037	34.07930385	-118.0732531	Los Angeles County
99067	Fee-for-Service	1427063759	1427063759	1	1	WALGREEN CO.	10/3/1985	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3232 FOOTHILL BLVD	None	OAKLAND	CA	94601	3113	01	06001	37.78344416	-122.2218117	Alameda County
99068	Fee-for-Service	1891135562	1891135562	1	1	WELLS COMPREHENSIVE CARE	9/11/2013	193400000X	NA	Other	026	PHYSICIANS	93456	45	Nephrology (Renal-Kidney)	0	In state provider	SYSTEM & CLINICS INC	207 S SANTA ANITA ST	STE G18	SAN GABRIEL	CA	91776	1146	19	06037	34.10072807	-118.1066296	Los Angeles County
99085	Fee-for-Service	1497785794	1497785794	1	1	WEBB, HILLARD S MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51632	08	Family Practice	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
99102	Fee-for-Service	1336788249	1336788249	1	1	WEISSMAN, SHAUN PT	9/21/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
99118	Fee-for-Service	1245450634	1245450634	1	1	WRIGHT, KIMBER M LCSW	8/30/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
99143	Fee-for-Service	1215947775	1215947775	1	2	WCHS, INC	8/20/2019	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1330 N INDIAN CANYON DR	SUITE A,B,C	PALM SPRINGS	CA	92262	4880	33	06065	33.84144	-116.5455715	Riverside County
99161	Fee-for-Service	1467482737	1467482737	1	1	WU, JOANNA Q DPM	12/19/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5970 S CENTRAL AVE	None	LOS ANGELES	CA	90001	1150	19	06037	33.985584	-118.256433	Los Angeles County
99176	Fee-for-Service	1104867308	1104867308	1	1	WARD, KELLI M DO	12/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	101 CIVIC CTR LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
99196	Fee-for-Service	1205171030	1205171030	1	1	WILCOX, LORINE L MD	8/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137772	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
99249	Fee-for-Service	1225129158	1225129158	1	1	WATSON, BRENT T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2132 N 1700 W	STE 230	LAYTON	UT	84041	7060	00	None	41.09101732	-111.9972155	Davis County
99262	Fee-for-Service	1629750096	1629750096	1	1	WINNETKA HOME CARE, INC	9/26/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	19733 HEMMINGWAY STREET	None	WINNETKA	CA	91306	2323	19	06037	34.21406283	-118.5635233	Los Angeles County
99269	Fee-for-Service	1588843486	1588843486	1	1	WINTERNITZ, WILLIAM W MD	4/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51348	20	Orthopedic Surgery	0	In state provider	INC	12630 MONTE VISTA RD	STE 105	POWAY	CA	92064	2526	37	06073	32.99533582	-117.0560031	San Diego County
99392	Fee-for-Service	1235216193	1235216193	1	1	WONG, CARLENE J MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71359	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	RM 6E	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
99393	Fee-for-Service	1750422341	1750422341	1	3	WHEELCARE EXPRESS INC.	6/23/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	300 SAN LEANDRO BLVD	None	SAN LEANDRO	CA	94577	1525	01	06001	37.73069101	-122.1688279	Alameda County
99423	Fee-for-Service	1023143757	1023143757	1	2	WESTERN FOOT & ANKLE CENTER	7/16/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	INC	966 S WESTERN AVE	205	LOS ANGELES	CA	90006	1015	19	06037	34.053777	-118.3090505	Los Angeles County
99433	Fee-for-Service	1114192390	1114192390	1	1	WALSH MEDICAL GROUP,A PROFES	7/28/2022	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	947 S. ANAHEIM BLVD	115	ANAHEIM	CA	92805	5582	30	06059	33.82164135	-117.909385	Orange County
99442	Fee-for-Service	1174844104	1174844104	1	1	WANG, JENNY DO	11/16/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	14970	None	None	0	In state provider	None	845 LA VETA	STE 108	ORANGE	CA	92868	3930	30	06059	33.78064548	-117.8611107	Orange County
99617	Fee-for-Service	1275024820	1275024820	1	1	WADSWORTH, ZACHARY MD	7/11/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	188036	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
99665	Fee-for-Service	1407998545	1407998545	1	1	WEST COVINA UNIFIED SD	4/29/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1717 W MERCED AVE	None	WEST COVINA	CA	91790	3406	19	06037	34.06416254	-117.9499231	Los Angeles County
99668	Fee-for-Service	1902805294	1902805294	1	1	WONG, CALBERT A MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	52812	41	Internal Medicine	0	In state provider	None	2438 PONDEROSA DR NORTH	C101	CAMARILLO	CA	93010	2369	56	06111	34.24219545	-119.0227012	Ventura County
99685	Fee-for-Service	1073071825	1073071825	1	1	WILLIAMS, AMANDA D	1/30/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	TWO MEDICAL PLAZA	STE 180	ROSEVILLE	CA	95661	3049	31	06061	38.76507948	-121.2477476	Placer County
99688	Fee-for-Service	1639880149	1639880149	1	1	WELLSPRING INTEGRATIVE HEALT	2/1/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	H & ACUPUNCTURE	130 PETALUMA AVE	STE 2E	SEBASTOPOL	CA	95472	4234	49	06097	38.40200716	-122.8229065	Sonoma County
99702	Fee-for-Service	1548310634	1548310634	1	1	WINTHROP, STUART R MD	2/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SANTA BARBARA EYE SURG	515 E MICHELTORENA ST	STE D	SANTA BARBARA	CA	93103	4224	42	06083	34.43172339	-119.7024817	Santa Barbara County
99724	Fee-for-Service	1962629071	1962629071	1	1	WILSON, ERICA G PHD	9/14/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
99755	Fee-for-Service	1689163081	1689163081	1	1	WANG, SIMENG MD	7/10/2024	208600000X	NA	General Surgery	026	PHYSICIANS	186155	89	Surgery-Traumatic	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
99766	Fee-for-Service	1477930980	1477930980	1	1	WEST VALLEY CONGREGATE	5/4/2017	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	8035 OAKDALE AVENUE	None	WINNETKA	CA	91306	1932	19	06037	34.21652299	-118.56671	Los Angeles County
99784	Fee-for-Service	1396707485	1396707485	1	1	WENDER, PAUL MD	8/31/1994	207L00000X	NA	Other	026	PHYSICIANS	76861	05	Anesthesiology	0	In state provider	None	2140 COTNER AVE	None	LOS ANGELES	CA	90025	5714	19	06037	34.03972174	-118.4396878	Los Angeles County
99845	Fee-for-Service	1063046993	1063046993	1	1	WOO, CONNIE M OD	12/28/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10525 S DE ANZA BLVD	STE 190	CUPERTINO	CA	95014	4448	43	06085	37.31526	-122.032408	Santa Clara County
99850	Fee-for-Service	1669558334	1669558334	1	1	WU, HUIQUING MD	5/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91344	22	Pathology (M.D. only)	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
99858	Fee-for-Service	1689735284	1689735284	1	1	WONG, JORGE PHD	12/4/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21180	-	NOT APPLICABLE	0	In state provider	None	2400 MOORPARK AVE	SUITE 300	SAN JOSE	CA	95128	2631	43	06085	37.3160785	-121.937121	Santa Clara County
99902	Fee-for-Service	1447556774	1447556774	1	1	WHITTON, CHRISTINA E LMFT	11/2/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	157 GRAND AVE.	208A	PACIFIC GROVE	CA	93950	2752	27	06053	36.62198903	-121.9166381	Monterey County
99916	Fee-for-Service	1992841688	1992841688	1	1	WAECHTER, ANASTASIA C MD	4/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90352	10	Gastroenterology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
99946	Fee-for-Service	1821434036	1821434036	1	1	WRIGHT, BETH LMFT	9/9/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	5870 ARLINGTON AVE	SUITE 103	RIVERSIDE	CA	92504	2037	33	06065	33.94592702	-117.4313099	Riverside County
99949	Fee-for-Service	1114315934	1114315934	1	1	WINDER, GEOFFREY A MD	4/27/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	143108	08	Family Practice	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
99957	Fee-for-Service	1902805294	1902805294	1	1	WONG, CALBERT A MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	52812	45	Nephrology (Renal-Kidney)	0	In state provider	None	2438 PONDEROSA DR NORTH	C101	CAMARILLO	CA	93010	2369	56	06111	34.24219545	-119.0227012	Ventura County
99963	Fee-for-Service	1376921809	1376921809	1	1	WILSON, EDWARD T DO	12/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16373	41	Internal Medicine	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3226	04	06007	39.74248474	-121.8493369	Butte County
99998	Fee-for-Service	1295724011	1295724011	1	1	WEINSTEIN, MARC S MD	6/21/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	165660	None	None	0	In state provider	None	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
100000	Fee-for-Service	1093929630	1093929630	1	1	WILLIAMS, TROY C	1/12/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	103922	None	None	0	In state provider	None	1240 S WESTLAKE BLVD	STE 137	WESTLAKE VILLAGE	CA	91361	1988	56	06111	34.14966879	-118.8378084	Ventura County
100003	Fee-for-Service	1023052230	1023052230	1	1	WILLIAMS, JEREMY D MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76509	None	None	0	In state provider	None	1050 LINDEN AVE	None	LONG BEACH	CA	90813	3321	19	06037	33.78003775	-118.1866604	Los Angeles County
100020	Fee-for-Service	1528221843	1528221843	1	1	WARAICH, UZMA A MD	6/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117581	None	None	0	In state provider	None	1818N ORANGE GROVE AVE	# 204	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
100033	Fee-for-Service	1881685527	1881685527	1	2	WESTERN RADIATION	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONCOLOGY INC APC	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
100052	Fee-for-Service	1306962550	1306962550	1	1	WADAD, SHALHUB J PHD	12/28/2007	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1127 WILSHIRE BLVD	#901	LOS ANGELES	CA	90017	3910	19	06037	34.05270508	-118.2641005	Los Angeles County
100095	Fee-for-Service	1609173517	1609173517	1	1	WANG, HONGTAO MD	8/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125458	41	Internal Medicine	0	In state provider	None	2335 E. KASHIAN LANE	#450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
100127	Fee-for-Service	1770708562	1770708562	1	1	WILLIAMS, KIM M LMFT	7/19/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
100142	Fee-for-Service	1457375958	1457375958	1	1	WRIGHT, GAIL E MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51662	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
100165	Fee-for-Service	1255302097	1255302097	1	1	WONG, WILSON S MD	2/1/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	39963	30	Radiology	0	In state provider	None	50 BELLEFONTAINE ST	STE 104	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
100205	Fee-for-Service	1457422214	1457422214	1	1	WOZNIAK, PAUL R MD	1/31/1984	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	47209	40	Pediatrics	0	In state provider	None	225 DICKINSON ST	# H201	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
100231	Fee-for-Service	1922663004	1922663004	1	1	WHITCHER, GREGORY H MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	176897	None	None	0	In state provider	None	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
100249	Fee-for-Service	1306863634	1306863634	1	1	WAL-MART STORES, INC	10/11/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102039	3055 LOUGHBOROUGH DR	None	MERCED	CA	95348	1119	24	06047	37.31815521	-120.4998247	Merced County
100261	Fee-for-Service	1386845485	1386845485	1	2	WOOD, KENNETH AU	1/28/2025	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	416 CENTER STREET	None	YUBA CITY	CA	95991	4506	51	06101	39.13716188	-121.6146365	Sutter County
100280	Fee-for-Service	1164714614	1164714614	1	1	WONG, EMILY W MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134678	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
100310	Fee-for-Service	1780068841	1780068841	1	1	WADHWANI, KOMAL DO	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16464	41	Internal Medicine	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91346	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
100330	Fee-for-Service	1912256603	1912256603	1	1	WARD, KAREN P LCSW	3/19/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
100352	Fee-for-Service	1477523991	1477523991	1	1	WONG, KEVIN M MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	79696	41	Internal Medicine	0	In state provider	None	901 CAMPUS DR	STE 208	DALY CITY	CA	94015	4930	41	06081	37.66535778	-122.4763793	San Mateo County
100355	Fee-for-Service	1881844678	1881844678	1	2	WHITE, JOSIE LMFT	9/23/2021	1041C0700X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
100414	Fee-for-Service	1609061431	1609061431	1	1	WOSK, SAMUEL MD	6/15/2007	207R00000X	NA	Other	026	PHYSICIANS	56374	41	Internal Medicine	0	In state provider	LA PROVIDENCIA MED INC	3412 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	19	06037	34.02750605	-118.2004003	Los Angeles County
100430	Fee-for-Service	1457375958	1457375958	1	1	WRIGHT, GAIL E MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51662	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
100455	Fee-for-Service	1730770728	1730770728	1	1	WAVE ACUPUNCTURE & ORIENTAL	5/16/2021	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	7737 MEANY AVE	B3	BAKERSFIELD	CA	93308	5267	15	06029	35.39423549	-119.0882835	Kern County
100475	Fee-for-Service	1427125277	1427125277	1	1	WILLIAMS, LEAH M NP	9/30/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	12100 EUCLID ST	None	GARDEN GROVE	CA	92840	3304	30	06059	33.786882	-117.9410535	Orange County
100493	Fee-for-Service	1457422214	1457422214	1	1	WOZNIAK, PAUL R MD	1/31/1984	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	47209	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 DICKINSON ST	# H201	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
100551	Fee-for-Service	1891086278	1891086278	1	1	WILLIAMS, RYAN A MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123068	04	Otology, Laryngology, Rhinology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
100581	Fee-for-Service	1801813688	1801813688	1	1	WAHLSTROM, HAKAN E MD	1/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	37140	02	General Surgery	0	In state provider	RIVERSIDE TRANSPLANTATIO	4000 14TH ST	STE 512	RIVERSIDE	CA	92501	4019	33	06065	33.97771007	-117.3818381	Riverside County
100595	Fee-for-Service	1831204627	1831204627	1	1	WANAGAT, JONATHAN M MD	5/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107495	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
100635	Fee-for-Service	1275717761	1275717761	1	1	WANG, YU PING T MD	10/24/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
100650	Fee-for-Service	1679932412	1679932412	1	1	WHALEN, MICHELLE	1/21/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	41769 ENTERPRISE CIR N	STE 104	TEMECULA	CA	92590	5626	33	06065	33.51823541	-117.1701538	Riverside County
100663	Fee-for-Service	1518076314	1518076314	1	1	WEISMAN, SCOTT L	7/1/1996	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3520 E SHIELDS AVE	STE 102	FRESNO	CA	93726	6923	10	06019	36.77947947	-119.765781	Fresno County
100691	Fee-for-Service	1215190509	1215190509	1	1	WALFORD, HANNAH H MD	11/21/2019	207K00000X	NA	Other	026	PHYSICIANS	109746	03	Allergy	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
100697	Fee-for-Service	1194941104	1194941104	1	1	WONG, DERRICK MD	1/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82274	68	Hematology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
100736	Fee-for-Service	1568756039	1568756039	1	1	WALGREEN CO	1/10/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1050 N HIGHLAND AVENUE	None	LOS ANGELES	CA	90038	2407	19	06037	34.090398	-118.338573	Los Angeles County
100755	Fee-for-Service	1487214128	1487214128	1	1	WILSON, ELISE M	6/5/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	186276	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
100774	Fee-for-Service	1588832281	1588832281	1	1	WILLS, ANTHONY L MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99718	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
100844	Fee-for-Service	1639214257	1639214257	1	1	WILKER, MOSHE MD	1/11/2011	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	100370	20	Orthopedic Surgery	0	In state provider	None	11980 SAN VICENTE BLVD	STE 114	LOS ANGELES	CA	90049	5012	19	06037	34.05221538	-118.4721745	Los Angeles County
100870	Fee-for-Service	1417098427	1417098427	1	1	WETTER, ALBERT L MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	51501	02	General Surgery	0	In state provider	None	101 S SAN MATEO DR	STE 112	SAN MATEO	CA	94401	3840	41	06081	37.56590481	-122.325549	San Mateo County
100880	Fee-for-Service	1831204627	1831204627	1	1	WANAGAT, JONATHAN M MD	5/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107495	38	Geriatrics	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
100927	Fee-for-Service	1598312928	1598312928	1	1	WONDROUS LOVE HOSPICE CARE	4/28/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	LLC	1811 W KATELLA AVE	STE 109	ANAHEIM	CA	92804	6657	30	06059	33.80322346	-117.9464535	Orange County
100983	Fee-for-Service	1194941104	1194941104	1	1	WONG, DERRICK MD	1/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82274	78	Neoplastic Diseases/Oncology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
101008	Fee-for-Service	1467841007	1467841007	1	1	WONG, ANDREA K CRNA	2/18/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
101052	Fee-for-Service	1518368059	1518368059	1	1	WILLIAMS, KENA S NP	10/22/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 N 15TH W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
101073	Fee-for-Service	1174837447	1174837447	1	1	WRENN, JOANNE M PSYD	3/3/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
101096	Fee-for-Service	1255585303	1255585303	1	1	WILKES BARRE HOSPITAL	5/4/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COMPANY LLC	575 N RIVER ST	None	WILKES BARRE	PA	18764	0999	00	None	41.25805459	-75.86822941	Luzerne County
101105	Fee-for-Service	1427041078	1427041078	1	1	WIENER, ISAAC MD	1/1/1982	207ZC0500X	NA	Other	026	PHYSICIANS	46722	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	15243 VANOWEN ST	STE 202	VAN NUYS	CA	91405	3645	19	06037	34.19394848	-118.4654115	Los Angeles County
101111	Fee-for-Service	1316968894	1316968894	1	1	WENIGER, JENNIFER PHD	12/2/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4110 EDISON AVE	206A	CHINO	CA	91710	8417	36	06071	33.99723746	-117.7140555	San Bernardino County
101123	Fee-for-Service	1700978400	1700978400	1	1	WEIRICH, ERICA E MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70387	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
101131	Fee-for-Service	1114973344	1114973344	1	1	WOOD, LE MONTE A	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	62336	05	Anesthesiology	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
101150	Fee-for-Service	1699731513	1699731513	1	1	WARNER, ALLEN S MD	11/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	34765	41	Internal Medicine	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
101151	Fee-for-Service	1467440081	1467440081	1	1	WRIGHT, JANET S MD	6/30/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	41120	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1430 ESPLANADE	STE 6	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
101184	Fee-for-Service	1891105706	1891105706	1	1	WANG, NANCY N MD	8/21/2020	208800000X	NA	Other	026	PHYSICIANS	139252	34	Urology and Urological Surgery	0	In state provider	None	1071 BLOSSOM HILL RD	None	SAN JOSE	CA	95123	1103	43	06085	37.2509447	-121.8743507	Santa Clara County
101187	Fee-for-Service	1639471402	1639471402	1	1	WRIGHT, WENDY A LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43112 15TH STREET WEST	None	LANCATER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
101198	Fee-for-Service	1174538441	1174538441	1	1	WALGREEN CO	8/27/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16108 FOOTHILL BLVD	None	FONTANA	CA	92335	3356	36	06071	34.10659147	-117.4529823	San Bernardino County
101214	Fee-for-Service	1124543186	1124543186	1	1	WEST, CRYSTAL LMFT	3/18/2022	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
101216	Fee-for-Service	1598312928	1598312928	1	1	WONDROUS LOVE HOSPICE CARE	4/28/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	LLC	1811 W KATELLA AVE	STE 109	ANAHEIM	CA	92804	6657	30	06059	33.80322346	-117.9464535	Orange County
101252	Fee-for-Service	1053545129	1053545129	1	1	WOEHRSTEIN, CHRISTOPHER M MD	5/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	113935	45	Nephrology (Renal-Kidney)	0	In state provider	None	323 N PRAIRIE AVE	SUITE 334	INGLEWOOD	CA	90301	4502	19	06037	33.966333	-118.3439975	Los Angeles County
101268	Fee-for-Service	1265543672	1265543672	1	1	WRIGHT MILLER JENNIFER J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4245 ROOSEVELT WAY NE	None	SEATTLE	WA	98105	6008	00	None	47.65883901	-122.3177928	King County
101275	Fee-for-Service	1093732935	1093732935	1	1	WARDZINSKA, JANE H MD	10/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38490	01	General Practice	0	In state provider	None	13847 E 14TH STREET	STE 110	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
101286	Fee-for-Service	1942847272	1942847272	1	1	WARREN, YASHICA CNP	11/16/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1313 W 8TH ST	STE 100	LOS ANGELES	CA	90017	4420	19	06037	34.05048998	-118.269586	Los Angeles County
101311	Fee-for-Service	1376694919	1376694919	1	1	WANG, JANE Y NP	10/17/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
101333	Fee-for-Service	1881672806	1881672806	1	1	WONG, MICHAEL J MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	10110	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	201 S ALVARADO ST	#618	LOS ANGELES	CA	90057	2386	19	06037	34.06417777	-118.2719543	Los Angeles County
101337	Fee-for-Service	1114991155	1114991155	1	1	WILLIAMS,CANDYCE D MD	9/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 W THOMAS RD	None	PHOENIX	AZ	85013	0000	00	None	33.480864	-112.0795155	Maricopa County
101344	Fee-for-Service	1649830704	1649830704	1	1	WINSTEAD, AMY L MD	2/9/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	183500	None	None	0	In state provider	None	191 S BUENA VISTA ST	SUITE 100	BURBANK	CA	91505	4562	19	06037	34.15872557	-118.3283863	Los Angeles County
101348	Fee-for-Service	1174937049	1174937049	1	1	WILLIAMS, AMY E LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
101356	Fee-for-Service	1316338767	1316338767	1	1	WEDEMEYER, MICHELLE A MD	6/4/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	139448	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
101382	Fee-for-Service	1255585303	1255585303	1	1	WILKES BARRE HOSPITAL	5/4/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COMPANY LLC	575 N RIVER ST	None	WILKES BARRE	PA	18764	0999	00	None	41.25805459	-75.86822941	Luzerne County
101393	Fee-for-Service	1861782112	1861782112	1	1	WEINREB, DAVID B MD	7/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	116907	30	Radiology	0	In state provider	None	411 30TH ST	SUITE 508	OAKLAND	CA	94609	3033	01	06001	37.81903474	-122.2649444	Alameda County
101412	Fee-for-Service	1093975500	1093975500	1	1	WALCOTT, BRIAN P MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136268	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
101431	Fee-for-Service	1548535370	1548535370	1	1	WELLHOUSE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	11354 MOUNTAIN VIEW AVE	SUITE D	LOMA LINDA	CA	92354	3855	36	06071	34.04682408	-117.2436982	San Bernardino County
101434	Fee-for-Service	1366969990	1366969990	1	1	WAKEFIELD, LEANNE	11/13/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
101455	Fee-for-Service	1285712018	1285712018	1	1	WORMUTH, SEAN MD	10/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65543	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
101461	Fee-for-Service	1326056888	1326056888	2	1	WANG, YONG MD	1/3/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	56523	41	Internal Medicine	0	In state provider	None	11245 LOWER AZUSA RD	None	EL MONTE	CA	91731	1553	19	06037	34.09163095	-118.0213554	Los Angeles County
101511	Fee-for-Service	1134559149	1134559149	1	1	WALGREEN CO.	9/19/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8298 LANDER AVE	None	HILMAR	CA	95324	8323	24	06047	37.40847255	-120.8500602	Merced County
101525	Fee-for-Service	1447468566	1447468566	1	1	WHEELER, NICOLE M MD	9/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120446	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
101538	Fee-for-Service	1952325698	1952325698	1	1	WEBB, DARRELL A DO	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7333	05	Anesthesiology	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
101545	Fee-for-Service	1427101229	1427101229	1	1	WHITTIER ONCOLOGY MEDICAL	3/1/2019	261QX0203X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CLINIC INC	12393 WASHINGTON BLVD	None	WHITTIER	CA	90606	2502	19	06037	33.96719187	-118.0496563	Los Angeles County
101546	Fee-for-Service	1356569404	1356569404	1	1	WOORI PHARMACY, INC	11/1/2001	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WOORI PHARMACY	266 S HARVARD BLVD	STE 120	LOS ANGELES	CA	90004	4374	19	06037	34.069221	-118.3041245	Los Angeles County
101566	Fee-for-Service	1093732935	1093732935	1	1	WARDZINSKA, JANE H MD	10/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38490	41	Internal Medicine	0	In state provider	None	13847 E 14TH STREET	STE 110	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
101589	Fee-for-Service	1932555760	1932555760	1	1	WILLIAMS, MATTHEW A MD	10/17/2019	207P00000X	NA	Other	026	PHYSICIANS	162032	None	None	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
101621	Fee-for-Service	1881672806	1881672806	1	1	WONG, MICHAEL J MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	10110	41	Internal Medicine	0	In state provider	None	201 S ALVARADO ST	#618	LOS ANGELES	CA	90057	2386	19	06037	34.06417777	-118.2719543	Los Angeles County
101697	Fee-for-Service	1447209226	1447209226	1	1	WEBER, ELLEN J MD	8/31/1986	207P00000X	NA	Other	026	PHYSICIANS	53491	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	# 1E	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
101700	Fee-for-Service	1285383950	1285383950	1	1	WHEATLAND UNION HIGH SCHOOL	7/1/2022	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	1010 WHEATLAND RD	None	WHEATLAND	CA	95692	9798	58	06115	39.00756737	-121.4313596	Yuba County
101716	Fee-for-Service	1548535370	1548535370	1	1	WELLHOUSE CARE INC	5/20/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	11354 MOUNTAIN VIEW AVE	SUITE D	LOMA LINDA	CA	92354	3855	36	06071	34.04682408	-117.2436982	San Bernardino County
101717	Fee-for-Service	1548368772	1548368772	1	1	WALSH, DEBORAH J LMFT	6/18/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5000 WINDPLAY DR	SUITE 2	EL DORADO HILLS	CA	95762	9319	09	06017	38.63978974	-121.0710527	El Dorado County
101722	Fee-for-Service	1265449078	1265449078	1	1	WAITS, KERRY S DO	7/12/2006	207R00000X	NA	Other	026	PHYSICIANS	8424	41	Internal Medicine	0	In state provider	None	2550 SISTER MARY COLOMBA	None	RED BLUFF	CA	96080	4327	52	06103	40.14847323	-122.2180997	Tehama County
101795	Fee-for-Service	1275538605	1275538605	1	1	WEBB, AMY E MD	2/10/2009	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64739	40	Pediatrics	0	In state provider	None	911 OAK PARK BLVD	STE 107	PISMO BEACH	CA	93449	3406	40	06079	35.13435006	-120.6051746	San Luis Obispo County
101808	Fee-for-Service	1942433628	1942433628	1	1	WILLIAM E JOHNSON M.D.	7/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	251 N ESTRELLA PKWY	None	GOODYEAR	AZ	85338	9334	00	None	33.449436	-112.3919055	Maricopa County
101823	Fee-for-Service	1750869665	1750869665	1	2	WHOLE HEALTH PHARMACY	1/6/2020	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1415 N BROADWAY	None	SANTA ANA	CA	92706	3904	30	06059	33.757335	-117.869631	Orange County
101900	Fee-for-Service	1477634087	1477634087	2	1	WILLIAMSON, PHYLLIS N PHD	3/14/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2609 CAPITOL AVE	STE 6	SACRAMENTO	CA	95816	5904	34	06067	38.571426	-121.4728425	Sacramento County
101919	Fee-for-Service	1861655508	1861655508	1	1	WANG, TAO MD	6/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130104	22	Pathology (M.D. only)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
101936	Fee-for-Service	1194952416	1194952416	1	1	WILSON, THOMAS J MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147670	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
101989	Fee-for-Service	1285383950	1285383950	1	1	WHEATLAND UNION HIGH SCHOOL	1/1/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	1010 WHEATLAND RD	None	WHEATLAND	CA	95692	9798	58	06115	39.00756737	-121.4313596	Yuba County
102016	Fee-for-Service	1922391747	1922391747	1	1	WILLIAM MASSIE	3/15/2012	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1268 E LATHAM AVE	None	HEMET	CA	92543	1268	33	06065	33.7494633	-116.9589814	Riverside County
102017	Fee-for-Service	1811509813	1811509813	1	1	WU, JEFFERY PT	10/23/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
102026	Fee-for-Service	1093882847	1093882847	1	1	WILLIAMS, VALERIA L NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10850 ARROW RTE	None	RANCHO CUCAMONGA	CA	91730	4833	36	06071	34.0991609	-117.5680267	San Bernardino County
102046	Fee-for-Service	1114275930	1114275930	1	1	WATKINS, BRIGITTE Y MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128724	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
102117	Fee-for-Service	1235491143	1235491143	1	1	WARD, DANIEL MD	12/20/2023	207ZP0105X	NA	Other	026	PHYSICIANS	186521	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
102134	Fee-for-Service	1720370109	1720370109	1	1	WU, WILLIAM W MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	116068	22	Pathology (M.D. only)	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
102138	Fee-for-Service	1699071365	1699071365	1	1	WIENER, SHARON R CNM	1/22/2018	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
102147	Fee-for-Service	1326640582	1326640582	1	1	WEST GATE HOSPICE, INC	3/16/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14531 HAMLIN ST.	SUITE 220	VAN NUYS	CA	91414	4124	19	06037	34.18870941	-118.449902	Los Angeles County
102152	Fee-for-Service	1568655983	1568655983	1	1	WALGREEN CO.	2/28/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2261 W ESPLANADE AVE	None	SAN JACINTO	CA	92582	4704	33	06065	33.77281146	-117.005976	Riverside County
102162	Fee-for-Service	1073677613	1073677613	1	1	WILMER, CHRISTINA S OD	10/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
102194	Fee-for-Service	1992199889	1992199889	1	1	WALLACE, MARILYN E LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3333 SKY PARK DR	STE 220	TORRANCE	CA	90505	5023	19	06037	33.81036565	-118.3466218	Los Angeles County
102246	Fee-for-Service	1669499901	1669499901	1	1	WAL-MART STORES INC	2/22/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM #10-2842	1290 E ONTARIO AVE	None	CORONA	CA	92881	3600	33	06065	33.84697297	-117.5405763	Riverside County
102287	Fee-for-Service	1689906414	1689906414	1	1	WILSON, ERIC P MD	2/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113458	25	Physical Medicine and Rehabilitation	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
102371	Fee-for-Service	1184949661	1184949661	1	1	WALKER, JUDIANNE M	5/16/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1320 EL CAPITAN DRIVE	SUITE 450	DANVILLE	CA	94526	0000	07	06013	37.78476866	-121.9658691	Contra Costa County
102404	Fee-for-Service	1225130792	1225130792	1	1	WELSH, MARCELLINE K MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64468	40	Pediatrics	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
102426	Fee-for-Service	1740796358	1740796358	1	1	WILLIS, CARLENE NP	10/1/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
102427	Fee-for-Service	1538124409	1538124409	1	1	WATERS, MORNING A CNM	4/27/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
102434	Fee-for-Service	1326640582	1326640582	1	1	WEST GATE HOSPICE, INC	3/16/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14531 HAMLIN ST.	SUITE 220	VAN NUYS	CA	91414	4124	19	06037	34.18870941	-118.449902	Los Angeles County
102458	Fee-for-Service	1215300389	1215300389	1	1	WORDEN, DANIELLE M LCSW	6/18/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39350 CIVIC CENTER DR	None	FREMONT	CA	94538	2343	01	06001	37.55399458	-121.9756047	Alameda County
102481	Fee-for-Service	1164802161	1164802161	1	2	WILLHOITE, JOHN H MD	6/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145708	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
102490	Fee-for-Service	1265894067	1265894067	1	1	WEI, ANDREW MD	1/7/2025	261QU0200X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
102492	Fee-for-Service	1982781811	1982781811	1	1	WONG, ANTHONY P MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79100	40	Pediatrics	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
102532	Fee-for-Service	1396857942	1396857942	1	1	WELLS, ELIZABETH P MD	11/30/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	70698	08	Family Practice	0	In state provider	None	2230 LYNN RD	None	THOUSAND OAKS	CA	91360	1901	56	06111	34.20894685	-118.885185	Ventura County
102547	Fee-for-Service	1780614685	1780614685	1	1	WASHINGTON TOWNSHIP HLTHCRE	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	2000 MOWRY AVE	None	FREMONT	CA	94538	1746	01	06001	37.55769729	-121.9808861	Alameda County
102568	Fee-for-Service	1760620488	1760620488	1	1	WILSON, WILLARD F CP	1/11/1995	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1524 21ST ST	#B	BAKERSFIELD	CA	93301	4002	15	06029	35.3781555	-119.0195505	Kern County
102602	Fee-for-Service	1093156754	1093156754	1	1	WAL-MART STORES INC	12/24/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1830 SHAW AVE	None	CLOVIS	CA	93611	4000	10	06019	36.80848108	-119.6807722	Fresno County
102634	Fee-for-Service	1669038121	1669038121	1	1	WUU, PATRICIA DO	10/23/2023	207QH0002X	NA	Adult Primary Care	026	PHYSICIANS	21384	None	None	0	In state provider	None	1020 29TH ST	#550	SACRAMENTO	CA	95816	5126	34	06067	38.572803	-121.4685	Sacramento County
102645	Fee-for-Service	1003954421	1003954421	1	1	WHITE, ERIC A MD	3/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95894	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0112	19	06037	34.06169385	-118.2044698	Los Angeles County
102687	Fee-for-Service	1962744573	1962744573	1	1	WOO, JASON S	1/1/2020	207P00000X	NA	Other	026	PHYSICIANS	166878	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
102699	Fee-for-Service	1285770669	1285770669	1	1	WINDSOR VALLEJO CARE CTR	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2200 TUOLUMNE ST	None	VALLEJO	CA	94589	2523	48	06095	38.13006948	-122.2399634	Solano County
102749	Fee-for-Service	1073612982	1073612982	1	1	WESTSIDE PRIMARY CARE	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78716	08	Family Practice	0	In state provider	INC	2428 SANTA MONICA BLVD	STE 402	SANTA MONICA	CA	90404	2045	19	06037	34.0317559	-118.4762013	Los Angeles County
102752	Fee-for-Service	1861415499	1861415499	1	1	WEINGARTEN, GERALD M MD	1/1/1993	174400000X	NA	Other	026	PHYSICIANS	31540	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	16133 VENTURA BLVD	STE 400	ENCINO	CA	91436	2429	19	06037	34.15656164	-118.4849569	Los Angeles County
102757	Fee-for-Service	1154389385	1154389385	1	1	WU, EMILY Y MD	11/18/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	104651	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
102780	Fee-for-Service	1043312655	1043312655	1	1	WEINSTOCK, HENRY MD	11/1/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51131	08	Family Practice	0	In state provider	None	500 E CALAVERAS BLVD	STE 100	MILPITAS	CA	95035	7708	43	06085	37.43274015	-121.8967534	Santa Clara County
102804	Fee-for-Service	1811903461	1811903461	1	1	WALGREEN CO	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1344 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3807	38	06075	37.79820871	-122.408678	San Francisco County
102835	Fee-for-Service	1780614685	1780614685	1	1	WASHINGTON TOWNSHIP HLTHCRE	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	2000 MOWRY AVE	None	FREMONT	CA	94538	1746	01	06001	37.55769729	-121.9808861	Alameda County
102852	Fee-for-Service	1720036742	1720036742	1	1	WALLS, DAVID W DO	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	4041	08	Family Practice	0	In state provider	None	130 BRENTWOOD DR	None	CHESTER	CA	96020	0000	32	06063	40.30535806	-121.2340359	Plumas County
102861	Fee-for-Service	1316358435	1316358435	1	1	WALGREEN CO	10/14/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1911 LINCOLN BLVD	None	SANTA MONICA	CA	90405	1314	19	06037	34.01192219	-118.482444	Los Angeles County
102879	Fee-for-Service	1124513296	1124513296	1	1	WOOD, BENJAMIN W	7/24/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	91509	-	NOT APPLICABLE	0	In state provider	None	2560 PULGAS AVENUE	None	EAST PALO ALTO	CA	94303	1323	41	06081	37.47530197	-122.1318685	San Mateo County
102901	Fee-for-Service	1235498676	1235498676	1	1	WANG, JOHN H MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124689	41	Internal Medicine	0	In state provider	None	11370 ANDERSON	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
102908	Fee-for-Service	1144539099	1144539099	1	1	WANG, LINLIN MD	6/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127786	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
102948	Fee-for-Service	1508020728	1508020728	1	1	WARNER, JULIET L PHD	8/15/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4700 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
102960	Fee-for-Service	1710620687	1710620687	1	1	WELLRX INC	5/16/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 N SAN FERNANDO BLVD	None	BURBANK	CA	91502	1207	19	06037	34.18138193	-118.3093516	Los Angeles County
102973	Fee-for-Service	1831361450	1831361450	1	1	WALGREEN CO	12/21/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	42107 BIG BEAR BLVD	None	BIG BEAR LAKE	CA	92315	1518	36	06071	34.24520306	-116.8833343	San Bernardino County
103005	Fee-for-Service	1275966798	1275966798	1	1	WAL-MART STORES, INC	6/8/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W VENTURA BLVD	None	CAMARILLO	CA	93010	8359	56	06111	34.21668238	-119.0749846	Ventura County
103015	Fee-for-Service	1629082136	1629082136	1	1	WILHITE, CHARLES E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52675	20	Orthopedic Surgery	0	In state provider	INC	111 RALEY BLVD	STE 160	CHICO	CA	95928	8351	04	06007	39.71601447	-121.790817	Butte County
103040	Fee-for-Service	1861415499	1861415499	1	1	WEINGARTEN, GERALD M MD	1/1/1993	174400000X	NA	Other	026	PHYSICIANS	31540	41	Internal Medicine	0	In state provider	None	16133 VENTURA BLVD	STE 400	ENCINO	CA	91436	2429	19	06037	34.15656164	-118.4849569	Los Angeles County
103150	Fee-for-Service	1023095320	1023095320	1	1	WORK, JEFFREY W MD	3/31/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	47314	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2070 CENTURY PARK E	None	LOS ANGELES	CA	90067	1907	19	06037	34.05887194	-118.4122914	Los Angeles County
103255	Fee-for-Service	1760525810	1760525810	1	1	WELTI, ROBERT S MD	12/4/1986	174400000X	NA	Other	026	PHYSICIANS	39793	05	Anesthesiology	0	In state provider	None	4525 QUAIL LAKES DR	None	STOCKTON	CA	95207	5257	39	06077	37.98806683	-121.3402906	San Joaquin County
103343	Fee-for-Service	1770517732	1770517732	1	1	WANDERMAN, DAVID E MD	5/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90833	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94145	0001	38	06075	37.7634502	-122.4579779	San Francisco County
103378	Fee-for-Service	1609604164	1609604164	1	1	WONG, WILLIAM MD	10/22/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
103385	Fee-for-Service	1962491670	1962491670	1	1	WARREN, DERON T DO	11/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	10922	66	Emergency Medicine (Urgent Care)	0	In state provider	None	240 SPRUCE ST	None	GRIDLEY	CA	95948	2216	04	06007	39.36701046	-121.6895355	Butte County
103440	Fee-for-Service	1871605386	1871605386	1	1	WIRTH, GARRETT A MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81620	24	Plastic Surgery	0	In state provider	None	101 THE CITY DR S	BLDG 55	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
103447	Fee-for-Service	1063835528	1063835528	1	1	WEISS, ELINA CRNA	6/19/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
103454	Fee-for-Service	1063516409	1063516409	1	1	WANG, OLIVER DPM	5/5/2022	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	9017 RESEDA	SUITE 100	NORTHRIDGE	CA	91324	3922	19	06037	34.234155	-118.5360975	Los Angeles County
103476	Fee-for-Service	1437164704	1437164704	1	1	WALGREEN CO	6/14/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	611 SAN RAMON VALLEY BLV	None	DANVILLE	CA	94526	4013	07	06013	37.8122276	-121.9956234	Contra Costa County
103495	Fee-for-Service	1659394138	1659394138	1	1	WINSTON, KAREN A	8/15/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	46505	None	None	0	In state provider	None	2195 S CLUB CENTER DRIVE	SUITE A	SAN BERNARDINO	CA	92408	0000	36	06071	34.06055692	-117.2814193	San Bernardino County
103501	Fee-for-Service	1871173203	1871173203	1	1	WEINTRAUB, MARC J PHD	4/22/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
103506	Fee-for-Service	1285781922	1285781922	1	1	WAKE, EUGENE L OD	12/21/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
103547	Fee-for-Service	1902571037	1902571037	1	1	WILLIAMS, KIRSTEN E NP	10/18/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
103551	Fee-for-Service	1336680495	1336680495	1	1	WELLSPRING PSYCHOLOGICAL SER	6/14/2024	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	VICES, INC.	9829 BLUE LARKSPUR LN	SUITE 2	MONTEREY	CA	93940	6535	27	06053	36.57109892	-121.8021077	Monterey County
103557	Fee-for-Service	1861461352	1861461352	1	1	WOLFF, GREGG C MD	1/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	52658	41	Internal Medicine	0	In state provider	None	1000 GREENLEY ROAD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
103581	Fee-for-Service	1659336378	1659336378	1	1	WHITTEMORE, ANTHONY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
103640	Fee-for-Service	1336359892	1336359892	1	1	WATANABE,DANA T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL STREET	None	HONOLULU	HI	96813	0000	00	None	21.30800017	-157.8550765	Honolulu County
103644	Fee-for-Service	1083762512	1083762512	1	1	WORRELL, BURTON E JR OD	8/23/1968	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ADVANCE VISION CENTER OF	545 MERIDIAN AVE	STE G	SAN JOSE	CA	95126	3451	43	06085	37.31851957	-121.9138052	Santa Clara County
103660	Fee-for-Service	1417243163	1417243163	1	1	WERT, BRYAN P MD	12/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2540 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15904111	-115.1767658	Clark County
103663	Fee-for-Service	1457371585	1457371585	1	1	WONG, MITCHELL D MD	4/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111358	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA DR	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
103665	Fee-for-Service	1033349998	1033349998	1	1	WATSON, AMY G MD	8/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104098	08	Family Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
103685	Fee-for-Service	1053408435	1053408435	1	1	WONG, ING L MD	12/9/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	24840	41	Internal Medicine	0	In state provider	ALAMITOS RENAL MED GRP	3801 KATELLA AVE	STE 225	LOS ALAMITOS	CA	90720	3364	30	06059	33.80318951	-118.066068	Orange County
103701	Fee-for-Service	1588681902	1588681902	1	1	WAL-MART STORES, INC	2/17/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101899	2663 CANYON SPRINGS PKWY	None	RIVERSIDE	CA	92507	0911	33	06065	33.94112283	-117.2831422	Riverside County
103724	Fee-for-Service	1942420799	1942420799	1	1	WAL-MART STORES, INC	10/23/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-5425	1861 S SAN JACINTO AVE	None	SAN JACINTO	CA	92583	5605	33	06065	33.76695754	-116.9587348	Riverside County
103758	Fee-for-Service	1992123384	1992123384	1	1	WILLSON, CAMILLA M DPM	8/14/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
103762	Fee-for-Service	1992166938	1992166938	1	1	WARM SPRINGS ROAD CVS LLC	2/19/2025	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	3645 LAS VEGAS BLVD S	None	LAS VEGAS	NV	89109	4321	00	None	36.112761	-115.166664	Clark County
103793	Fee-for-Service	1285098384	1285098384	1	1	WALTER, JOHN MD	7/3/2020	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
103812	Fee-for-Service	1598084030	1598084030	1	1	WEISS, GUY A MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125480	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
103838	Fee-for-Service	1336680495	1336680495	1	1	WELLSPRING PSYCHOLOGICAL SER	6/14/2024	103TC1900X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	VICES, INC.	9829 BLUE LARKSPUR LN	SUITE 2	MONTEREY	CA	93940	6535	27	06053	36.57109892	-121.8021077	Monterey County
103854	Fee-for-Service	1346557014	1346557014	1	3	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	47	Miscellaneous	0	In state provider	FOUNDATION	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
103921	Fee-for-Service	1881177806	1881177806	1	1	WALLACE, MATTHEW E NP	12/19/2018	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
103952	Fee-for-Service	1659514701	1659514701	1	1	WHEATLEY, MATTHEW D MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130592	78	Neoplastic Diseases/Oncology	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
103972	Fee-for-Service	1053408435	1053408435	1	1	WONG, ING L MD	12/9/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	24840	45	Nephrology (Renal-Kidney)	0	In state provider	ALAMITOS RENAL MED GRP	3801 KATELLA AVE	STE 225	LOS ALAMITOS	CA	90720	3364	30	06059	33.80318951	-118.066068	Orange County
103988	Fee-for-Service	1073171930	1073171930	1	1	WILKERSON, MOLLY L MD	9/9/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179608	None	None	0	In state provider	None	1560 E. CHEVY CHASE DR.	SUITE 355	GLENDALE	CA	91206	4159	19	06037	34.15290734	-118.2302295	Los Angeles County
104031	Fee-for-Service	1912179722	1912179722	1	1	WHITTLE, AMY E MD	2/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103002	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	RM 6F	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
104082	Fee-for-Service	1396033510	1396033510	1	1	WOODMAN, ASA A LMFT	3/12/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	206 SACRAMENTO ST	204	NEVADA CITY	CA	95959	2633	29	06057	39.26103141	-121.0166729	Nevada County
104101	Fee-for-Service	1598084030	1598084030	1	1	WEISS, GUY A MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125480	10	Gastroenterology (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
104120	Fee-for-Service	1629274287	1629274287	1	1	WAGNER, JONATHAN G MD	12/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107380	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3751 KATELLA AVENUE	None	LOS ALAMITOS	CA	90720	3113	30	06059	33.80318353	-118.0666665	Orange County
104126	Fee-for-Service	1336680495	1336680495	1	1	WELLSPRING PSYCHOLOGICAL SER	6/14/2024	103TC1900X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	VICES, INC.	9829 BLUE LARKSPUR LN	SUITE 2	MONTEREY	CA	93940	6535	27	06053	36.57109892	-121.8021077	Monterey County
104150	Fee-for-Service	1346557014	1346557014	1	20	WASHINGTON TOWNSHIP MEDICAL	10/20/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FOUNDATION	39210 STATE ST	209	FREMONT	CA	94538	1456	01	06001	37.54911562	-121.9827983	Alameda County
104203	Fee-for-Service	1265479919	1265479919	1	1	WAPNER, ROGER PHD	3/11/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	565 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38903016	-122.0819046	Santa Clara County
104233	Fee-for-Service	1427168301	1427168301	1	1	WOODALL, GARY N MD	6/30/1994	207R00000X	NA	Other	026	PHYSICIANS	54031	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
104240	Fee-for-Service	1659514701	1659514701	1	1	WHEATLEY, MATTHEW D MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130592	30	Radiology	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
104281	Fee-for-Service	1013934413	1013934413	1	1	WAL-MART STORES EAST, LP	8/21/2020	3336S0011X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	9600 PARKSOUTH CT STE 12	SUITE 120	ORLANDO	FL	32837	6424	00	None	28.42787261	-81.41412638	Orange County
104308	Fee-for-Service	1770751992	1770751992	1	1	WINZELBERG JODY	4/1/1985	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
104319	Fee-for-Service	1538448345	1538448345	1	1	WON, CONNIE J PHD	7/23/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
104323	Fee-for-Service	1255622817	1255622817	1	1	WINDSOR CARE CENTER OF	5/1/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	PETALUMA LLC	523 HAYES LANE	None	PETALUMA	CA	94952	4011	49	06097	38.22182256	-122.6473346	Sonoma County
104326	Fee-for-Service	1730256686	1730256686	1	1	WEISGRAU, ROBERT A MD	4/23/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42727	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
104333	Fee-for-Service	1821286758	1821286758	2	1	WOOD, GRANT I CO	4/27/2012	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 S ELLSWORTH AVE	SUITE 203	SAN MATEO	CA	94404	3939	41	06081	37.56665635	-122.3247743	San Mateo County
104365	Fee-for-Service	1184116469	1184116469	1	1	WELL CARE HOME HEALTH CARE	2/19/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	13746 VICTORY BLVD	UNIT 313	VAN NUYS	CA	91401	6735	19	06037	34.18664551	-118.432764	Los Angeles County
104384	Fee-for-Service	1336189794	1336189794	1	1	WANG, ANITA H	10/31/1990	207P00000X	NA	Other	026	PHYSICIANS	41961	None	None	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
104389	Fee-for-Service	1972008688	1972008688	1	1	WU, JESSICA MD	12/3/2021	208600000X	NA	General Surgery	026	PHYSICIANS	165754	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
104391	Fee-for-Service	1689739526	1689739526	1	1	WESTBROOK, KIMBERLY A	2/8/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
104393	Fee-for-Service	1649970765	1649970765	1	1	WHITE, SUSAN	3/16/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	12296 HABITAT WAY	None	RANCHO CORDOVA	CA	95742	7704	34	06067	38.557845	-121.2151815	Sacramento County
104419	Fee-for-Service	1861707770	1861707770	1	1	WEST COAST CRITICAL CARE	11/23/2010	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1910 OUTLET CENTER DRIVE	None	OXNARD	CA	93036	0677	56	06111	34.2202663	-119.1484221	Ventura County
104527	Fee-for-Service	1447226980	1447226980	2	1	WILLIAM A WASWICK MD	9/10/2019	208600000X	NA	General Surgery	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	None	3243 E MURDOCK	STE 404	WICHITA	KS	67208	3007	00	None	37.6974125	-97.2972675	Sedgwick County
104532	Fee-for-Service	1164059564	1164059564	1	1	WARREN, JONATHAN S MD	7/15/2024	207P00000X	NA	Other	026	PHYSICIANS	180610	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
104533	Fee-for-Service	1851728141	1851728141	1	1	WANNARES, JEFFREY	8/22/2020	208600000X	NA	General Surgery	026	PHYSICIANS	162789	None	None	0	In state provider	None	5555 GROSSMONT CENTER	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
104573	Fee-for-Service	1144541376	1144541376	1	1	WALKER, KOLBY R DO	6/1/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	15429	36	Psychiatry	0	In state provider	None	17772 BEACH BLVD	None	HUNTINGTON BEACH	CA	92647	6819	30	06059	33.703677	-117.9865035	Orange County
104683	Fee-for-Service	1649970765	1649970765	1	1	WHITE, SUSAN	3/16/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	12296 HABITAT WAY	None	RANCHO CORDOVA	CA	95742	7704	34	06067	38.557845	-121.2151815	Sacramento County
104686	Fee-for-Service	1508131194	1508131194	1	1	WANG, JOSH DO	1/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12728	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
104793	Fee-for-Service	1285801027	1285801027	1	1	WENDT, KATHERINE L OD	7/13/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	225 LAUREL AVE	None	PACIFIC GROVE	CA	93950	3651	27	06053	36.61721911	-121.90931	Monterey County
104800	Fee-for-Service	1134152804	1134152804	1	1	WEST BAY ANESTHESIA MEDICAL	1/4/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	GROUP INC	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48093988	-122.2531826	San Mateo County
104806	Fee-for-Service	1487719845	1487719845	1	1	WOO, SUZANNE N MD	11/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	67576	41	Internal Medicine	0	In state provider	None	1000 FRANKLIN PKWY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
104820	Fee-for-Service	1881748143	1881748143	1	1	WALGREEN CO	2/8/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6316 IRVINE BLVD	None	IRVINE	CA	92620	2102	30	06059	33.69920001	-117.7393832	Orange County
104823	Fee-for-Service	1902836638	1902836638	1	1	WANDER, HARRY J MD	8/20/1971	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	6629	40	Pediatrics	0	In state provider	MARYSVILLE MED CTR	800 3RD ST	None	MARYSVILLE	CA	95901	5831	58	06115	39.13757487	-121.5949642	Yuba County
104824	Fee-for-Service	1306215850	1306215850	1	1	WESTERN PHYSICAL THERAPY INC	8/2/2021	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	THERAPY	1255 EAST STREET	100	REDDING	CA	96001	0815	45	06089	40.58763719	-122.3893695	Shasta County
104843	Fee-for-Service	1588007736	1588007736	1	1	WORKMAN, PRITHA M MD	6/14/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	133510	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
104864	Fee-for-Service	1962503805	1962503805	1	1	WEINSTEIN, STEVEN E DO	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	7567	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
104887	Fee-for-Service	1871719716	1871719716	1	1	WILLIAMS, VAN C	10/22/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1988 PARK MARINA DR	None	REDDING	CA	96001	0912	45	06089	40.58439914	-122.3745941	Shasta County
104900	Fee-for-Service	1588612154	1588612154	1	1	WASSERMAN, STEPHEN I MD	2/8/2015	207K00000X	NA	Other	026	PHYSICIANS	23431	03	Allergy	0	In state provider	None	225 DICKINSON ST	# H207	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
104902	Fee-for-Service	1306067897	1306067897	1	1	WALKER, MICHELLE LMFT	6/18/2019	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	801 E CHAPEL ST	STE 1	SANTA MARIA	CA	93454	4607	42	06083	34.9542915	-120.424455	Santa Barbara County
104938	Fee-for-Service	1396413043	1396413043	1	1	WEBB, CAROLYNN J PT	9/20/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1335 COFFEE RD	STE 200	MODESTO	CA	95355	3188	50	06099	37.66291854	-120.9756994	Stanislaus County
104987	Fee-for-Service	1770917478	1770917478	1	1	WEST BAY URGENT CARE	10/7/2013	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ASSOCIATES	4000 CIVIC CENTER	SUITE 206	SAN RAFAEL	CA	94903	5233	21	06041	38.0041783	-122.538861	Marin County
104996	Fee-for-Service	1972020972	1972020972	1	1	WITTING, CELESTE S MD	4/1/2024	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
105070	Fee-for-Service	1558708115	1558708115	1	1	WEST, EMILY K MD	8/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134891	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
105072	Fee-for-Service	1053499616	1053499616	1	1	WILKES, WILLIAM P MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69341	36	Psychiatry	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
105086	Fee-for-Service	1679523518	1679523518	1	1	WILLGING, STEFAN A MD	8/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81537	41	Internal Medicine	0	In state provider	None	4060 4TH AVE	STE 505	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
105111	Fee-for-Service	1306215850	1306215850	1	1	WESTERN PHYSICAL THERAPY INC	7/21/2021	225100000X	NA	Physical Therapist	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	THERAPY	1255 EAST STREET	100	REDDING	CA	96001	0815	45	06089	40.58763719	-122.3893695	Shasta County
105156	Fee-for-Service	1528486024	1528486024	1	1	WIRAWAN, SHARON MD	8/1/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	139576	40	Pediatrics	0	In state provider	None	12746 W JEFFERSON BLVD	FL 2-4	LOS ANGELES	CA	90094	2885	19	06037	33.97751255	-118.417598	Los Angeles County
105236	Fee-for-Service	1639688138	1639688138	1	1	WILLIAMS, CLEANDREA MD	8/31/2023	207ZP0105X	NA	Other	026	PHYSICIANS	160169	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
105250	Fee-for-Service	1053514901	1053514901	1	1	WAXMAN, LAUREN J MD	1/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110766	36	Psychiatry	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5427	19	06037	34.21980849	-118.4301135	Los Angeles County
105263	Fee-for-Service	1881773653	1881773653	1	1	WHITMORE, JASON C MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68539	41	Internal Medicine	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
105320	Fee-for-Service	1851757009	1851757009	1	1	WONG, CONNIE M OT	5/7/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
105375	Fee-for-Service	1134219686	1134219686	1	1	WILLIAMS, JACQUELINE A	8/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84069	None	None	0	In state provider	None	249 E HIGHLAND AVE	None	SAN BERNARDINO	CA	92404	3707	36	06071	34.13591253	-117.280809	San Bernardino County
105387	Fee-for-Service	1033176284	1033176284	1	1	WITTE, AMY	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13123 E 16TH AVE	None	AURORA	CO	80045	0000	00	None	39.742164	-104.8350375	Adams County
105399	Fee-for-Service	1306215850	1306215850	1	1	WESTERN PHYSICAL THERAPY INC	11/30/2015	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	THERAPY	1255 EAST STREET	100	REDDING	CA	96001	0815	45	06089	40.58763719	-122.3893695	Shasta County
105411	Fee-for-Service	1811058431	1811058431	1	1	WALLACE, JOANNA L PHD	6/29/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
105414	Fee-for-Service	1801384599	1801384599	1	1	WALKER, DEVIN C MD	7/27/2020	1835P1300X	NA	Other	026	PHYSICIANS	17649	36	Psychiatry	0	In state provider	None	399 E HIGHLAND AVE	STE 401	SAN BERNARDINO	CA	92402	3862	36	06071	34.1358627	-117.2757898	San Bernardino County
105495	Fee-for-Service	1023412129	1023412129	1	1	WILSHIRE-ROBERTSON DIALYSIS	4/25/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	8420 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3201	19	06037	34.06472266	-118.3745094	Los Angeles County
105511	Fee-for-Service	1023270485	1023270485	1	1	WASHBURN, CHRISTIAN R PHD	9/3/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
105582	Fee-for-Service	1699137679	1699137679	1	1	WOODWARD, ELEANOR MD	11/2/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	150551	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
105591	Fee-for-Service	1104861459	1104861459	1	1	WRIGHT, C MICHAEL MD	3/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	58919	41	Internal Medicine	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
105653	Fee-for-Service	1922158054	1922158054	1	1	WONG-PEARSON, MAY K OD	2/26/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
105683	Fee-for-Service	1487900429	1487900429	1	1	WALGREEN CO	10/16/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7195 BROADWAY	None	LEMON GROVE	CA	91945	1408	37	06073	32.74244718	-117.0431998	San Diego County
105689	Fee-for-Service	1801087036	1801087036	1	1	WONG, KAREN Y OD	2/10/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1015 S NOGALES STREET	SUITE 109	ROWLAND HEIGHTS	CA	91748	1309	19	06037	33.99637543	-117.8884823	Los Angeles County
105699	Fee-for-Service	1720136799	1720136799	1	1	WILDER, MICHAEL L MD	1/1/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	25317	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
105705	Fee-for-Service	1386030906	1386030906	1	1	WILLIAMS, MIA F MD	7/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149645	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
105746	Fee-for-Service	1891976379	1891976379	1	1	WATSON, LAWRENCE C OD A PROF	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORPORATION	73211 FRED WARING DR	STE 102	PALM DESERT	CA	92260	2871	33	06065	33.72862966	-116.3870098	Riverside County
105755	Fee-for-Service	1982965414	1982965414	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	21132 BEACH BLVD	None	HUNTINGTON BEACH	CA	92648	5408	30	06059	33.65554227	-117.9881891	Orange County
105756	Fee-for-Service	1104900190	1104900190	1	1	WARREN, SANFORD E MD	10/3/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	36873	41	Internal Medicine	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
105803	Fee-for-Service	1437576634	1437576634	1	1	WONG, JOCELYN Y MD	5/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137878	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
105815	Fee-for-Service	1306459615	1306459615	1	1	WALGREEN CO	7/13/2022	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	23335 SOBOBA RD	None	SAN JACINTO	CA	92583	0000	33	06065	33.78252219	-116.9187403	Riverside County
105816	Fee-for-Service	1811056419	1811056419	1	1	WALTON, LAUREN M MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80871	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
105849	Fee-for-Service	1144391905	1144391905	1	1	WRIGHT, GWENDOLYN M MD	9/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	55695	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
105878	Fee-for-Service	1104861459	1104861459	1	1	WRIGHT, C MICHAEL MD	3/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	58919	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
105957	Fee-for-Service	1770749525	1770749525	1	1	WAYNE H. MARTIN, M.D., INC.	1/25/2022	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1111 S GRAND AVE	SUITE A	DIAMOND BAR	CA	91765	2230	19	06037	34.00172352	-117.813184	Los Angeles County
106086	Fee-for-Service	1598843641	1598843641	1	1	WU, RYAN MD	10/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81955	08	Family Practice	0	In state provider	None	3000 LAS POSITAS RD	None	LIVERMORE	CA	94551	9627	01	06001	37.69960369	-121.7628917	Alameda County
106107	Fee-for-Service	1194414722	1194414722	1	1	WALBRINK, HALEY	6/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
106139	Fee-for-Service	1457824476	1457824476	1	1	WILLIAMS, HAJAR A RCP	11/14/2020	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
106247	Fee-for-Service	1770749525	1770749525	1	1	WAYNE H. MARTIN, M.D., INC.	1/25/2022	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 S GRAND AVE	SUITE A	DIAMOND BAR	CA	91765	2230	19	06037	34.00172352	-117.813184	Los Angeles County
106271	Fee-for-Service	1194791640	1194791640	1	1	WATTENBURG, ERIC J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78764	08	Family Practice	0	In state provider	None	1045 BUCKS LAKE RD	None	QUINCY	CA	95971	9507	32	06063	39.93916024	-120.9619096	Plumas County
106301	Fee-for-Service	1700099611	1700099611	1	1	WICK, BRYAN M MD	11/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95308	36	Psychiatry	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
106323	Fee-for-Service	1144596974	1144596974	1	1	WALLEN, JARED J MD	4/2/2023	208800000X	NA	Other	026	PHYSICIANS	183802	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
106464	Fee-for-Service	1588899363	1588899363	1	1	WILLIAMS, CHRISTOPHER K MD	10/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54588	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
106492	Fee-for-Service	1275780009	1275780009	1	1	WILLIAM LEE GORDON	7/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 E AJO WAY	None	TUCSON	AZ	85713	6204	00	None	32.175801	-110.9306925	Pima County
106527	Fee-for-Service	1972994622	1972994622	1	1	WAL-MART STORES INC	7/1/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	350 WALTERS RD	None	SUISUN CITY	CA	94585	3043	48	06095	38.242584	-121.9908015	Solano County
106533	Fee-for-Service	1972535318	1972535318	2	1	WELLSTAR SPALDING REGIONAL	1/31/2017	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	601 S 8TH STREET	None	GRIFFIN	GA	30224	4213	00	None	33.238944	-84.26571552	Spalding County
106564	Fee-for-Service	1285988949	1285988949	1	1	WANNING, ESTHER LMFT	9/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	318 WESTLAKE CTR	SUITE 204	DALY CITY	CA	94015	1436	41	06081	37.70104849	-122.4832932	San Mateo County
106585	Fee-for-Service	1073579827	1073579827	1	1	WOLFE, JOHN D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	VALLEY AMESTHSIOLOGY	2901 N CENTRAL AVE,	SUITE 500	PHOENIX	AZ	85012	0000	00	None	33.480666	-112.0729905	Maricopa County
106618	Fee-for-Service	1033564943	1033564943	1	1	WU, MUZO MD	10/3/2019	208M00000X	NA	Other	026	PHYSICIANS	158768	41	Internal Medicine	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
106619	Fee-for-Service	1063783066	1063783066	1	1	WILLIAMS, CAROL L CNP	11/7/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1720 S BASCOM AVE	None	CAMPBELL	CA	95008	0608	43	06085	37.292472	-121.9315815	Santa Clara County
106631	Fee-for-Service	1710105341	1710105341	1	1	WELLS, JANA R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	47899	40	Pediatrics	0	In state provider	None	12444 WASHINGTON BLVD	None	WHITTIER	CA	90602	1005	19	06037	33.96757592	-118.046351	Los Angeles County
106643	Fee-for-Service	1457341851	1457341851	2	2	WESTPAC LABS, INC.	3/1/2011	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	3701 S. HIGUERA STREET	SUITE 102	SAN LUIS OBISPO	CA	93401	7462	40	06079	35.2507845	-120.6712168	San Luis Obispo County
106650	Fee-for-Service	1356787170	1356787170	1	1	WAL-MART STORES INC	7/19/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	501 SERENO DR	None	VALLEJO	CA	94589	2415	48	06095	38.12760656	-122.2544618	Solano County
106653	Fee-for-Service	1285660696	1285660696	1	1	WAKUZAWA, WYNN T. MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	THE EMERGENCY GRP INC	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
106656	Fee-for-Service	1770110397	1770110397	1	1	WALTERS, KELLY M MD	6/13/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	184845	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
106705	Fee-for-Service	1457396897	1457396897	1	1	WANDISAN-ROSETE, F MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72169	41	Internal Medicine	0	In state provider	None	4600 S TRACY BLVD	STE 107	TRACY	CA	95377	8105	39	06077	37.698111	-121.4345315	San Joaquin County
106706	Fee-for-Service	1821149923	1821149923	1	1	WIGGEN, RHETT J CRNA	7/24/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	43563 HWY 299 E	None	FALL RIVER MILLS	CA	96028	9787	45	06089	41.02401196	-121.4246219	Shasta County
106754	Fee-for-Service	1588899363	1588899363	1	1	WILLIAMS, CHRISTOPHER K MD	10/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54588	41	Internal Medicine	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
106762	Fee-for-Service	1639494701	1639494701	1	1	WADE, ELIZABETH A	8/28/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	980 ROOSEVELT	None	IRVINE	CA	92620	3670	30	06059	33.69380208	-117.7653165	Orange County
106781	Fee-for-Service	1932502150	1932502150	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2710 E WILLOW STREET	None	SIGNAL HILL	CA	90755	2217	19	06037	33.80432955	-118.1594295	Los Angeles County
106803	Fee-for-Service	1003833351	1003833351	1	1	WAL-MART STORES, INC	4/13/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PAHRMACY 102568	8333 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	3607	19	06037	34.222617	-118.4487785	Los Angeles County
106820	Fee-for-Service	1972535318	1972535318	2	1	WELLSTAR SPALDING REGIONAL	1/31/2017	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	601 S 8TH STREET	None	GRIFFIN	GA	30224	4213	00	None	33.238944	-84.26571552	Spalding County
106827	Fee-for-Service	1790078129	1790078129	1	1	WANG, AARON S MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136483	18	Ophthalmology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
106856	Fee-for-Service	1235152620	1235152620	1	1	WILEN, BARRY L MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55781	30	Radiology	0	In state provider	None	1250 S SUNSET AVE	STE 101	WEST COVINA	CA	91790	3900	19	06037	34.0610671	-117.9463685	Los Angeles County
106940	Fee-for-Service	1285365478	1285365478	1	1	WANG, XINYI PHD	12/4/2024	101Y00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
106982	Fee-for-Service	1528720661	1528720661	1	1	WEISSMAN, CORY R MD	11/10/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	174625	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
106986	Fee-for-Service	1497772727	1497772727	1	1	WAL-MART STORES, INC	10/11/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102032	2001 N ROSE AVE	None	OXNARD	CA	93036	2681	56	06111	34.220106	-119.1608865	Ventura County
107023	Fee-for-Service	1710992094	1710992094	1	1	WALGREEN CO.	9/6/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2703 ORO DAM BLVD E	None	OROVILLE	CA	95966	5116	04	06007	39.50709449	-121.5453316	Butte County
107034	Fee-for-Service	1326053604	1326053604	1	1	WALGREEN CO	10/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4610 SONOMA HWY	None	SANTA ROSA	CA	95409	4137	49	06097	38.45941178	-122.6728844	Sonoma County
107040	Fee-for-Service	1588899363	1588899363	1	1	WILLIAMS, CHRISTOPHER K MD	10/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54588	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
107115	Fee-for-Service	1659532505	1659532505	1	1	WICKMAN, AMY MD	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116979	20	Orthopedic Surgery	0	In state provider	None	511 BATH ST	None	SANTA BARBARA	CA	93101	3403	42	06083	34.41386476	-119.6993335	Santa Barbara County
107119	Fee-for-Service	1457997983	1457997983	1	1	WRIGHT, ISAAC LCSW	9/15/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
107144	Fee-for-Service	1346557014	1346557014	1	25	WASHINGTON TOWNSHIP MEDICAL	10/18/2023	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	6236 THORNTON AVE	None	NEWARK	CA	94560	3732	01	06001	37.53514287	-122.0319492	Alameda County
107165	Fee-for-Service	1194913962	1194913962	1	1	WEBER, ROGER B CPO	12/20/2013	222Z00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	980 S ARROYO PKWY	#100	PASADENA	CA	91105	3924	19	06037	34.12906711	-118.1471676	Los Angeles County
107172	Fee-for-Service	1770598062	1770598062	1	1	WALGREEN CO.	9/28/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1826 W ORANGETHORPE AVE	None	FULLERTON	CA	92833	4406	30	06059	33.85917352	-117.96057	Orange County
107180	Fee-for-Service	1447582861	1447582861	1	1	WOLTERSTORFF, CAMERON S MD	11/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132351	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
107250	Fee-for-Service	1124237094	1124237094	1	1	WOODLAND RESIDENTIAL SVS	1/16/2003	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1215 EVERGREEN WAY	None	WOODLAND	CA	95695	4353	57	06113	38.666115	-121.7965735	Yolo County
107261	Fee-for-Service	1871533299	1871533299	1	1	WILLIAMS, GEORGE F MD	1/1/1979	208600000X	NA	General Surgery	026	PHYSICIANS	21676	02	General Surgery	0	In state provider	None	39 CONGRESS ST	STE 302	PASADENA	CA	91105	3022	19	06037	34.13407645	-118.151226	Los Angeles County
107313	Fee-for-Service	1417480898	1417480898	1	1	WESTCARE CALIFORNIA INC	11/30/2017	261QR0405X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1715 DAVID E COOKWAY	None	CLOVIS	CA	93611	0593	10	06019	36.83427141	-119.6840586	Fresno County
107314	Fee-for-Service	1871678755	1871678755	1	1	WONG, RICHARD MD	7/31/1992	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	49501	01	General Practice	0	In state provider	None	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	19	06037	33.929829	-118.157607	Los Angeles County
107324	Fee-for-Service	1861949331	1861949331	1	1	WADELL DIALYSIS LLC	8/1/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	44605 AVENIDA DE MISSION	SUITE 100	TEMECULA	CA	92592	3098	33	06065	33.47672591	-117.111462	Riverside County
107344	Fee-for-Service	1861592602	1861592602	3	1	WHITTIER MEDICAL HOMECARE SU	11/28/2018	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	PPLY, INC	12633 WHITTIER BLVD,	None	WHITTIER	CA	90602	2927	19	06037	33.96780522	-118.0403013	Los Angeles County
107368	Fee-for-Service	1255747010	1255747010	1	1	WILBER, CARA LMFT	8/18/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	11512 B AVE	None	AUBURN	CA	95603	2605	31	06061	38.93969517	-121.1046397	Placer County
107369	Fee-for-Service	1750952677	1750952677	1	1	WALTERIA DIALYSIS LLC	7/1/2021	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	8275 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	2308	34	06067	38.456964	-121.417047	Sacramento County
107373	Fee-for-Service	1780285544	1780285544	1	1	WONG, KAREN PT	3/25/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	STE 306	SAN DIEGO	CA	92108	4404	37	06073	32.77677653	-117.1592911	San Diego County
107384	Fee-for-Service	1437440567	1437440567	1	1	WRIGHT-DASSE, TAMIE CRNA	6/23/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
107428	Fee-for-Service	1134248925	1134248925	1	1	WAITIKI, LINCOLN LMFT	5/20/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	179	1101 STANDIFORD AVE	SUITE B2	MODESTO	CA	95350	0981	50	06099	37.68934851	-121.009653	Stanislaus County
107432	Fee-for-Service	1346557014	1346557014	1	10	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	FOUNDATION	2500 MOWRY AVE	STE 222	FREMONT	CA	94538	1605	01	06001	37.555011	-121.9801005	Alameda County
107483	Fee-for-Service	1255677142	1255677142	1	1	WONG, ERIKA K MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	121983	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
107494	Fee-for-Service	1497395255	1497395255	1	1	WEISZ, JESSICA R LPCC	1/24/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
107522	Fee-for-Service	1790785467	1790785467	2	1	WILGARDE, DAVID S MD	5/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74463	41	Internal Medicine	0	In state provider	None	1150 N INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
107527	Fee-for-Service	1922560762	1922560762	1	1	WANG, HUBERT MD	11/5/2022	207R00000X	NA	Other	026	PHYSICIANS	181127	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
107530	Fee-for-Service	1457417644	1457417644	1	1	WYATT, LISA A LCSW	2/10/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	51873	-	NOT APPLICABLE	0	In state provider	None	325 CALIFORNIA STREET	None	SALINAS	CA	93901	3505	27	06053	36.67346657	-121.6500594	Monterey County
107532	Fee-for-Service	1528479342	1528479342	1	1	WAHJUDI, INGRID N MD	9/11/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	145785	07	Dermatology	0	In state provider	None	2081 BRONZE STAR DR	None	WOODLAND	CA	95776	5423	57	06113	38.67049812	-121.7238394	Yolo County
107602	Fee-for-Service	1265447270	1265447270	1	1	WALGREEN CO	8/20/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2222 COLORADO BLVD	None	LOS ANGELES	CA	90041	1143	19	06037	34.13922329	-118.2149338	Los Angeles County
107605	Fee-for-Service	1134626914	1134626914	1	1	WALDROP, GREER E MD	9/11/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	189345	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
107637	Fee-for-Service	1033422274	1033422274	1	1	WILLIAMS, TOKUNBO L MD	9/13/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	129162	36	Psychiatry	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
107665	Fee-for-Service	1689689770	1689689770	1	1	WALGREEN CO	9/5/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1781 COLUSA HWY	None	YUBA CITY	CA	95993	9096	51	06101	39.14166118	-121.6480966	Sutter County
107666	Fee-for-Service	1104047596	1104047596	1	1	WALLACE MED GROUP INC	5/12/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	8920 WILSHIRE BLVD	STE 327	BEVERLY HILLS	CA	90211	2007	19	06037	34.06703599	-118.3863456	Los Angeles County
107678	Fee-for-Service	1013414812	1013414812	1	1	WONG, HAYDEN MD	9/23/2021	207P00000X	NA	Other	026	PHYSICIANS	174012	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
107694	Fee-for-Service	1588712483	1588712483	1	1	WONG, JOHNNY K OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1635 DIVISADERO STREET	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
107706	Fee-for-Service	1962436428	1962436428	1	1	WONG, KIN DO	5/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	7258	41	Internal Medicine	0	In state provider	None	709 N HILL STREET	#8	LOS ANGELES	CA	90012	2352	19	06037	34.06103994	-118.2404034	Los Angeles County
107717	Fee-for-Service	1013113679	1013113679	1	1	WEINGROW, DANIEL M MD	5/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10747	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	RM 15-17	LOS ANGELES	CA	90045	5655	19	06037	34.06633051	-118.4452686	Los Angeles County
107720	Fee-for-Service	1346557014	1346557014	1	10	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	FOUNDATION	2500 MOWRY AVE	STE 222	FREMONT	CA	94538	1605	01	06001	37.555011	-121.9801005	Alameda County
107729	Fee-for-Service	1215370267	1215370267	1	1	WESAW, LINDA LMFT	12/1/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
107737	Fee-for-Service	1235393299	1235393299	1	1	WATTS, BRETT	9/8/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	349 E BULLARD AVE	STE 102	FRESNO	CA	93710	5298	10	06019	36.82285854	-119.7825885	Fresno County
107743	Fee-for-Service	1730190471	1730190471	1	1	WREDEN, MAXINE MD	7/1/2001	207R00000X	NA	Other	026	PHYSICIANS	57677	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300230	SACRAMENTO	CA	95816	5238	34	06067	38.570076	-121.4657145	Sacramento County
107756	Fee-for-Service	1013524198	1013524198	1	1	WILEY, AYANA RCP	10/15/2020	2279P1004X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
107772	Fee-for-Service	1174159115	1174159115	1	1	WANG, ANGELIA	9/12/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	178441	15	Obstetrics (D.O. only)	0	In state provider	None	8170 LAGUNA BLVD	STE 304	ELK GROVE	CA	95758	7903	34	06067	38.421054	-121.405365	Sacramento County
107796	Fee-for-Service	1205859089	1205859089	1	1	WANG, CHENG MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	63715	41	Internal Medicine	0	In state provider	None	355 TERRACINA BLVD	None	REDLANDS	CA	92373	4819	36	06071	34.03693536	-117.204131	San Bernardino County
107809	Fee-for-Service	1083755912	1083755912	1	1	WALLDER, DOROTHY M	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
107811	Fee-for-Service	1790785467	1790785467	2	1	WILGARDE, DAVID S MD	5/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74463	25	Physical Medicine and Rehabilitation	0	In state provider	None	1150 N INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
107864	Fee-for-Service	1205947611	1205947611	1	1	WENDT, DANIEL E DPM	10/31/1988	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
107882	Fee-for-Service	1619219847	1619219847	1	1	WAHEED, MARK DO	12/30/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	13993	13	Neurology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
107895	Fee-for-Service	1538116967	1538116967	2	1	WENDEL, JOHN D MD	8/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	56158	30	Radiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
107903	Fee-for-Service	1053482000	1053482000	1	1	WESTON, LYNN A MD	4/1/1995	208C00000X	NA	General Surgery	026	PHYSICIANS	79376	02	General Surgery	0	In state provider	None	1510 SAN PABLO ST	STE 514	LOS ANGELES	CA	90033	5324	19	06037	34.06287152	-118.2029433	Los Angeles County
107948	Fee-for-Service	1477600435	1477600435	1	1	WICHMANN, JILL B LCSW	8/3/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19 WILLIAMSBURG LN	None	CHICO	CA	95926	2225	04	06007	39.7525191	-121.8551479	Butte County
107954	Fee-for-Service	1104047596	1104047596	1	1	WALLACE MED GROUP INC	5/12/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	24	Plastic Surgery	0	In state provider	None	8920 WILSHIRE BLVD	STE 327	BEVERLY HILLS	CA	90211	2007	19	06037	34.06703599	-118.3863456	Los Angeles County
107973	Fee-for-Service	1588753610	1588753610	1	1	WALTERS, MARK C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	85406	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
108006	Fee-for-Service	1215954540	1215954540	1	1	WAL-MART PHARMACY 102048	10/4/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 CHADBOURNE RD	None	SUISUN CITY	CA	94534	9636	48	06095	38.238498	-122.081094	Solano County
108013	Fee-for-Service	1760409080	1760409080	1	3	WAL-MART PHARMACY 102002	10/7/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7900 ARROYO CIR	None	GILROY	CA	95020	7314	43	06085	37.0185064	-121.5599329	Santa Clara County
108030	Fee-for-Service	1730190471	1730190471	1	1	WREDEN, MAXINE MD	7/1/2001	207R00000X	NA	Other	026	PHYSICIANS	57677	41	Internal Medicine	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300230	SACRAMENTO	CA	95816	5238	34	06067	38.570076	-121.4657145	Sacramento County
108034	Fee-for-Service	1982933180	1982933180	1	2	WEST COAST UROLOGY	9/18/2023	208800000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2486 N PONDEROSA DR	STE D-202	CAMARILLO	CA	93010	2470	56	06111	34.24266768	-119.0228157	Ventura County
108046	Fee-for-Service	1154143444	1154143444	1	1	WRIGHT, SALLY DOULA	4/18/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
108081	Fee-for-Service	1053503722	1053503722	1	1	WOELFFER, NANCY C	6/20/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
108098	Fee-for-Service	1225696008	1225696008	1	2	WEL-MOR PSYCHOLOGY GROUP, IN	3/1/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	C	25401 CABOT RD	SUITE 212	LAGUNA HILLS	CA	92653	5514	30	06059	33.59334249	-117.6748702	Orange County
108101	Fee-for-Service	1619954740	1619954740	1	1	WHITE, BARBARA M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	311 S CLARK ST	None	CARROLL	IA	51401	3038	00	None	42.0562041	-94.86784625	Carroll County
108161	Fee-for-Service	1609255660	1609255660	1	1	WARNER, AMBER N	8/4/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9980 MILL ST	None	LOWER LAKE	CA	95457	9980	17	06033	38.91049007	-122.6060668	Lake County
108172	Fee-for-Service	1639249741	1639249741	1	1	WEISS, DANIEL MD	11/21/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	100 PINE ST	STE 1250	SAN FRANCISCO	CA	94111	5235	38	06075	37.79237874	-122.3989278	San Francisco County
108240	Fee-for-Service	1992288716	1992288716	1	1	WALSH, MARY B CNP	9/10/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	100A SAN PABLO TOWNE CTR	None	SAN PABLO	CA	94806	0000	07	06013	37.95446487	-122.3326626	Contra Costa County
108248	Fee-for-Service	1710129325	1710129325	1	1	WINGE, GOLDIE R MD	10/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116148	None	None	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
108271	Fee-for-Service	1093834491	1093834491	1	1	WALSH, CATHERINE A MD	10/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116474	24	Plastic Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
108274	Fee-for-Service	1871794768	1871794768	1	1	WHITESMAN, JACQUELINE T CRNA	12/21/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
108345	Fee-for-Service	1760409007	1760409007	1	1	WAL-MART STORES, INC	1/9/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101704	1501 HELEN POWER DR	None	VACAVILLE	CA	95687	0000	48	06095	38.36271186	-121.9582706	Solano County
108348	Fee-for-Service	1508844093	1508844093	1	1	WALL, WILLIAM J III MD	7/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	54648	30	Radiology	0	In state provider	None	300 PASTEUR DR	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
108438	Fee-for-Service	1124523923	1124523923	1	1	WU, MENGYA MD	8/9/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	166036	None	None	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
108454	Fee-for-Service	1750395083	1750395083	1	1	WALGREEN CO	1/16/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 PARADISE RD	None	MODESTO	CA	95351	3104	50	06099	37.62692973	-121.0131742	Stanislaus County
108477	Fee-for-Service	1770673618	1770673618	1	1	WEISS, STEVEN JAY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
108511	Fee-for-Service	1356570519	1356570519	1	1	WU, WEI-I MD	11/15/2010	207R00000X	NA	Other	026	PHYSICIANS	108211	41	Internal Medicine	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06287152	-118.2029433	Los Angeles County
108552	Fee-for-Service	1144245838	1144245838	1	1	WILLIAMS, RAY E MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32137	41	Internal Medicine	0	In state provider	None	323 N PRAIRIE AVE	STE 222	INGLEWOOD	CA	90301	4504	19	06037	33.966333	-118.3439975	Los Angeles County
108559	Fee-for-Service	1093834491	1093834491	1	1	WALSH, CATHERINE A MD	10/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116474	46	Hand Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
108593	Fee-for-Service	1386724748	1386724748	1	1	WERNER, LEONARD MD	1/1/1982	207R00000X	NA	Other	026	PHYSICIANS	40218	01	General Practice	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
108594	Fee-for-Service	1144237405	1144237405	1	1	WILLIAMS, SCOTT T MD	6/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76241	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
108604	Fee-for-Service	1295929651	1295929651	1	1	WOOD, CRISTINA LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
108614	Fee-for-Service	1952747438	1952747438	1	1	WINNIE K PANG MD INC	10/17/2018	207RR0500X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	500 N GARFIELD AVE	#102	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
108648	Fee-for-Service	1467692046	1467692046	1	1	WALGREEN CO	6/11/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W PORTAL AVE	None	SAN FRANCISCO	CA	94127	1423	38	06075	37.73876619	-122.4681748	San Francisco County
108667	Fee-for-Service	1003013715	1003013715	1	1	WANG, ROBERTA Y MD	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89339	25	Physical Medicine and Rehabilitation	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
108784	Fee-for-Service	1295302891	1295302891	1	1	WHITTINGTON, LANDON MD	1/3/2025	207Q00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	185671	-	NOT APPLICABLE	0	In state provider	None	2413 2ND STREET	None	EUREKA	CA	95501	0811	12	06023	40.80634452	-124.1456445	Humboldt County
108801	Fee-for-Service	1902043649	1902043649	1	1	WARNER, M DHYANNE MD	7/3/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	49947	36	Psychiatry	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
108811	Fee-for-Service	1316271745	1316271745	1	1	WOO, CANDACE M NP	4/21/2017	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
108856	Fee-for-Service	1346255635	1346255635	1	1	WALGREEN CO	1/14/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #06718	2730 SHAFFER RD	None	ATWATER	CA	95301	2225	24	06047	37.36230716	-120.5957396	Merced County
108878	Fee-for-Service	1255862587	1255862587	1	1	WEST, LESLIE C MD	10/18/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	157439	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
108892	Fee-for-Service	1104257849	1104257849	1	1	WOLFSOHN, STEFANY D MD INC	4/22/2016	193400000X	NA	Other	026	PHYSICIANS	89556	05	Anesthesiology	0	In state provider	None	1600 N ROSE AVE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
108936	Fee-for-Service	1891513636	1891513636	1	1	WALTON, JAMES P NP	10/28/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
109073	Fee-for-Service	1003880865	1003880865	1	1	WYLAM, MARK E MD	10/25/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
109083	Fee-for-Service	1619947322	1619947322	1	1	WRIGHT, DOUGLAS R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2901 N CENTRAL AVE,	STE 500	PHOENIX	AZ	85012	0000	00	None	33.480666	-112.0729905	Maricopa County
109086	Fee-for-Service	1649208638	1649208638	1	2	WALLACE KECSKES, DIANE MD	11/19/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	74951	-	NOT APPLICABLE	0	In state provider	None	7120 N MARKS AVE	SUITE 110	FRESNO	CA	93711	0268	10	06019	36.83911219	-119.8473805	Fresno County
109173	Fee-for-Service	1801831037	1801831037	2	1	WESTPRIME SYSTEMS INC	5/26/2015	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	5751 CHINO AVE	None	CHINO	CA	91710	5226	36	06071	34.01183125	-117.6791939	San Bernardino County
109193	Fee-for-Service	1215469382	1215469382	1	1	WISWELL, WALTER T MD	11/14/2020	207P00000X	NA	Other	026	PHYSICIANS	169474	None	None	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
109213	Fee-for-Service	1760969174	1760969174	1	1	WARD, CARLYE N NP	8/1/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1374 E ALLUVIAL AVE	None	FRESNO	CA	93720	2608	10	06019	36.84475352	-119.758806	Fresno County
109250	Fee-for-Service	1184357170	1184357170	1	1	WASHINGTON, TIFFANY L CD	7/28/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	07	06013	0	0	None
109325	Fee-for-Service	1285782128	1285782128	1	1	WOOD-SCOTT, HEATHER S NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7035 CONVOY CT	None	SAN DIEGO	CA	92111	1016	37	06073	32.8346295	-117.165015	San Diego County
109346	Fee-for-Service	1871968107	1871968107	1	1	WYATT, TAMIKA S LMFT	12/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
109352	Fee-for-Service	1417911009	1417911009	1	1	WILLIAMS, KENNETH V DO	8/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	10021	08	Family Practice	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
109361	Fee-for-Service	1003880865	1003880865	1	1	WYLAM, MARK E MD	10/25/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
109368	Fee-for-Service	1982783627	1982783627	1	1	WILLIAMS, AARON C MD	12/4/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76508	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
109380	Fee-for-Service	1821125550	1821125550	1	1	WESTERN CONSULTING &	10/2/2003	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	ANCILLARY SERVICES INC	240 S MAGNOLIA AVE	None	EL CAJON	CA	92020	4524	37	06073	32.79342371	-116.9623758	San Diego County
109393	Fee-for-Service	1316964737	1316964737	1	1	WAL-MART STORES, INC	10/26/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102291	75 N BROADWAY	None	CHULA VISTA	CA	91910	1417	37	06073	32.65042862	-117.0943509	San Diego County
109423	Fee-for-Service	1356819015	1356819015	1	1	WEEKS, KAREN LMFT	11/26/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10470 FOOTHILL BLVD	SUITE 116	RANCHO CUCAMONGA	CA	91730	3754	36	06071	34.10659649	-117.576603	San Bernardino County
109492	Fee-for-Service	1497811095	1497811095	1	1	WANG, YAN H AC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	YAN HUA WANG ACUPUNCTURE	320 13TH ST	STE 107	OAKLAND	CA	94612	3910	01	06001	37.80245652	-122.2685402	Alameda County
109527	Fee-for-Service	1922176718	1922176718	1	1	WATERMAN, ALYSON L MD	9/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131281	02	General Surgery	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
109585	Fee-for-Service	1932545662	1932545662	1	1	WANG, JENNIE M P DO	12/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	15067	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
109604	Fee-for-Service	1093875197	1093875197	1	1	WOLFF, BRETT H MD	11/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	77493	41	Internal Medicine	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
109638	Fee-for-Service	1760654495	1760654495	1	1	WONG, HANNAH H MD	8/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106387	22	Pathology (M.D. only)	0	In state provider	None	3301 C ST	STE 200E	SACRAMENTO	CA	95816	3363	34	06067	38.579877	-121.456143	Sacramento County
109653	Fee-for-Service	1023456118	1023456118	1	1	WOLFE, MICHAEL W MD	7/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148049	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
109672	Fee-for-Service	1871080804	1871080804	1	1	WILSON, JOSEPH MD	7/11/2024	2080P0203X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
109690	Fee-for-Service	1073667978	1073667978	1	1	WOODS, SONYA R	8/8/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4000 LONG BEACH BOULEVAR	SUITE #206	LONG BEACH	CA	90807	2910	19	06037	33.830928	-118.189321	Los Angeles County
109693	Fee-for-Service	1356086748	1356086748	1	1	WISE, SHAUNA NP	9/29/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43360 MISSION BLVD	SUITE 100	FREMONT	CA	94539	5829	01	06001	37.53249631	-121.9198141	Alameda County
109700	Fee-for-Service	1912434796	1912434796	1	1	WANG, CINDY X MD	4/13/2022	207ZP0101X	NA	Other	026	PHYSICIANS	171394	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
109717	Fee-for-Service	1659705374	1659705374	1	1	WAL-MART STORES INC	12/2/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 W BASELINE RD	None	RIALTO	CA	92376	3347	36	06071	34.1214301	-117.3748452	San Bernardino County
109732	Fee-for-Service	1649545708	1649545708	1	1	WHITE, KASANDRA R MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118572	None	None	0	In state provider	None	3779 PIEDMONT AVENUE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
109789	Fee-for-Service	1154402352	1154402352	1	2	WOODHOUSE, SHERYL E LMFT	5/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23121 VERDUGO DR	SUITE 200	LAGUNA HILLS	CA	92653	1339	30	06059	33.62655523	-117.7292097	Orange County
109813	Fee-for-Service	1922176718	1922176718	1	1	WATERMAN, ALYSON L MD	9/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131281	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
109825	Fee-for-Service	1326091695	1326091695	1	1	WALSTON, AMY K MD	8/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	75249	36	Psychiatry	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
109851	Fee-for-Service	1427111228	1427111228	1	1	WOLTERSTORFF, LAURA L LMFT	6/4/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
109887	Fee-for-Service	1275969081	1275969081	1	1	WHITEHEAD, STACY K NP	2/22/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	251 TURNPIKE	None	FOLSOM	CA	95630	0000	34	06067	38.654946	-121.170537	Sacramento County
109922	Fee-for-Service	1659792471	1659792471	1	1	WATT, LINDSEY PT	9/25/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
109948	Fee-for-Service	1720582646	1720582646	1	1	WHITE, CLAIRE E MD	9/20/2022	207R00000X	NA	Other	026	PHYSICIANS	166043	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
109995	Fee-for-Service	1821426735	1821426735	1	1	WEIL, LAURA R CNM	5/30/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
110040	Fee-for-Service	1407962491	1407962491	1	1	WAISMAN, NORBERTO S MD	1/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	35479	66	Emergency Medicine (Urgent Care)	0	In state provider	None	480 4TH AVE	STE 500	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
110058	Fee-for-Service	1245640143	1245640143	1	1	WANG, DAVID MD	10/19/2017	207R00000X	NA	Other	026	PHYSICIANS	140913	41	Internal Medicine	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
110066	Fee-for-Service	1851318273	1851318273	1	1	WAL-MART STORES, INC	1/25/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101914	4210 HIGHLAND AVE	None	HIGHLAND	CA	92346	2742	36	06071	34.137684	-117.1947915	San Bernardino County
110160	Fee-for-Service	1326024191	1326024191	1	1	WADE LARSEN MD	8/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2121 N 1700 W	None	LAYTON	UT	84041	8803	00	None	41.090832	-111.9973165	Davis County
110171	Fee-for-Service	1619041316	1619041316	1	1	WHANG, SUK C MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	87386	10	Gastroenterology (M.D. only)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
110201	Fee-for-Service	1508949868	1508949868	1	1	WEINBERG, SARAH A LCSW	9/2/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	380 W MACARTHUR BLVD	None	OAKLAND	CA	94609	2819	01	06001	37.82519027	-122.2609525	Alameda County
110212	Fee-for-Service	1073926283	1073926283	1	1	WESSNER, MARGARET I LCSW	8/18/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
110271	Fee-for-Service	1265511059	1265511059	1	1	WONG, DAVID C MD	10/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69146	18	Ophthalmology	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
110273	Fee-for-Service	1720284417	1720284417	1	1	WILSON, STACY E MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106686	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
110292	Fee-for-Service	1407962491	1407962491	1	1	WAISMAN, NORBERTO S MD	1/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	35479	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	480 4TH AVE	STE 500	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
110296	Fee-for-Service	1649212549	1649212549	1	1	WIGTON, ROGER B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5216 DAWES AVE	None	ALEXANDRIA	VA	22311	1404	00	None	38.83997458	-77.1193102	Alexandria city
110308	Fee-for-Service	1154559433	1154559433	1	1	WRIGHT, RYAN J MD	5/8/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	116607	-	NOT APPLICABLE	0	In state provider	None	24432 MUIRLANDS BLVD	STE 221	LAKE FOREST	CA	92630	3951	30	06059	33.62755212	-117.7028876	Orange County
110332	Fee-for-Service	1285925255	1285925255	1	1	WHITE, MORGAN E MD	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131282	40	Pediatrics	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
110459	Fee-for-Service	1619041316	1619041316	1	1	WHANG, SUK C MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	87386	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
110473	Fee-for-Service	1790948354	1790948354	1	1	WHITING, BRADLEY L MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	110074	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
110500	Fee-for-Service	1538495973	1538495973	1	1	WOOTEN, DARCY A MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114007	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
110541	Fee-for-Service	1154336436	1154336436	1	1	WALGREEN CO	2/4/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	44840 MONTEREY AVE	None	PALM DESERT	CA	92260	3325	33	06065	33.722667	-116.391222	Riverside County
110573	Fee-for-Service	1528322393	1528322393	1	1	WOODELL, TYLER B MD	6/25/2018	207RN0300X	NA	Nephrology	026	PHYSICIANS	127833	45	Nephrology (Renal-Kidney)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
110575	Fee-for-Service	1073933545	1073933545	1	1	WANG, YAO MD	2/18/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	161002	18	Ophthalmology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
110580	Fee-for-Service	1407962491	1407962491	1	1	WAISMAN, NORBERTO S MD	1/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	35479	41	Internal Medicine	0	In state provider	None	480 4TH AVE	STE 500	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
110633	Fee-for-Service	1083894216	1083894216	1	1	WU SHRESTHA, JENN J LCSW	9/10/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
110653	Fee-for-Service	1992869986	1992869986	1	1	WADE, BECKY J. M.D.	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69748	41	Internal Medicine	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
110688	Fee-for-Service	1295025666	1295025666	1	1	WAHEED, UZMA MD	5/28/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172610	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
110713	Fee-for-Service	1487999140	1487999140	1	1	WHITE, JESSICA M NP	2/8/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92193	2410	37	06073	32.7537975	-117.1658298	San Diego County
110727	Fee-for-Service	1073074670	1073074670	1	1	WITCHEY, LAUREN MD	9/1/2023	363LX0001X	NA	Nurse Practitioner	026	PHYSICIANS	181883	None	None	0	In state provider	None	3828 SCHAUFELE AVENUE	SUITE 200	LONG BEACH	CA	90808	1793	19	06037	33.8283	-118.1479725	Los Angeles County
110759	Fee-for-Service	1881781375	1881781375	1	1	WEILER, AMANDA P MD	5/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90432	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 W SUNSET BLVD	MS 113	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
110765	Fee-for-Service	1144416090	1144416090	1	1	WOOD, MONICA L LMFT	5/29/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	130 E LELAND RD	C	PITTSBURG	CA	94565	4983	07	06013	38.01186589	-121.8902232	Contra Costa County
110766	Fee-for-Service	1316237175	1316237175	1	1	WU, BIAN MD	6/13/2021	2086S0129X	NA	General Surgery	026	PHYSICIANS	123527	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
110853	Fee-for-Service	1356363550	1356363550	1	1	WAGNER, ROBERT J JR MD	11/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	20612	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
110887	Fee-for-Service	1275889511	1275889511	1	1	WANG, SARAH Q DO	6/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15297	01	General Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
110898	Fee-for-Service	1700953601	1700953601	1	1	WASSERMAN, BRUCE A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25332	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
110948	Fee-for-Service	1114063294	1114063294	1	1	WEDEEN, GLENN P MD AMC	5/6/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	15248 11TH ST	None	VICTORVILLE	CA	92395	3704	36	06071	34.52825401	-117.2925587	San Bernardino County
110997	Fee-for-Service	1174717045	1174717045	1	1	WALGREEN CO	2/22/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	331 N PACIFIC COAST HWY	None	EL SEGUNDO	CA	90245	4444	19	06037	33.92058735	-118.39638	Los Angeles County
111011	Fee-for-Service	1679637706	1679637706	1	1	WANG, CHIHHUNG J MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65537	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
111028	Fee-for-Service	1144672825	1144672825	1	1	WILLIAM SPEARS APRN	1/11/2023	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11321 INTERSTATE 30	STE 10	LITTLE ROCK	AR	72209	7040	00	None	34.656894	-92.4020865	Pulaski County
111035	Fee-for-Service	1649400953	1649400953	1	1	WALGREEN CO	10/8/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2245 S EUCLID AVE	None	ONTARIO	CA	91762	6519	36	06071	34.032942	-117.6499755	San Bernardino County
111046	Fee-for-Service	1881781375	1881781375	1	1	WEILER, AMANDA P MD	5/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90432	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	MS 113	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
111069	Fee-for-Service	1881019156	1881019156	1	1	WAL-MART STORES, INC	5/14/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12234 PALMDALE RD	None	VICTORVILLE	CA	92392	9418	36	06071	34.509285	-117.396792	San Bernardino County
111074	Fee-for-Service	1912431065	1912431065	1	1	WU, CHRISTINA Y MD	8/11/2020	207R00000X	NA	Other	026	PHYSICIANS	159282	41	Internal Medicine	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
111083	Fee-for-Service	1821657131	1821657131	1	1	WHEELER, MADELYN MD	8/19/2024	2080P0203X	NA	Other	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
111098	Fee-for-Service	1154336162	1154336162	1	1	WALGREEN CO	10/28/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2851 S ROSE AVE	None	OXNARD	CA	93033	3953	56	06111	34.17389279	-119.1601891	Ventura County
111116	Fee-for-Service	1972801645	1972801645	1	1	WINKLERPRINS, MINKE	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	49417	41	Internal Medicine	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
111126	Fee-for-Service	1023567963	1023567963	1	1	WHITE, PAUL M LMFT	10/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
111136	Fee-for-Service	1841295722	1841295722	1	1	WILDE, MICHAEL C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1201 S EUCLID AVE	STE 510	SIOUX FALLS	SD	57105	0404	00	None	43.536301	-96.74241503	Minnehaha County
111138	Fee-for-Service	1992736086	1992736086	1	1	WINTERS HEATHCARE FNDTN	3/1/2006	261QC1500X	NA	Other	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	172 EAST GRANT AVE	None	WINTERS	CA	95694	1780	57	06113	38.5264496	-121.9668052	Yolo County
111156	Fee-for-Service	1003310228	1003310228	1	1	WOODCOCK, ALEXANDRA MD	5/15/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	183325	09	Gynecology (D.O. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
111171	Fee-for-Service	1336862192	1336862192	1	1	WOOD, BROOKE PT	9/30/2022	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18700 BEACH BLVD	SUITE 120 SUITE 110	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
111186	Fee-for-Service	1700953601	1700953601	1	1	WASSERMAN, BRUCE A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25332	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
111265	Fee-for-Service	1316208804	1316208804	1	1	WOODS, ONG-DEE LIU NP	9/20/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
111289	Fee-for-Service	1861462285	1861462285	1	1	WALKER, JOHN L PT	3/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29650 BRADLEY RD	None	MENIFEE	CA	92586	6521	33	06065	33.6899672	-117.1885767	Riverside County
111299	Fee-for-Service	1891959730	1891959730	1	1	WOOLERY, JONATHAN D MD	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104833	41	Internal Medicine	0	In state provider	None	47111 MONROE STREET	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
111334	Fee-for-Service	1285298760	1285298760	1	1	WILLIAMS, GERARD K MD	7/8/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
111346	Fee-for-Service	1659052157	1659052157	1	1	WOMACK, HAYLEY	11/14/2024	390200000X	NA	Other	026	PHYSICIANS	23215	08	Family Practice	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
111347	Fee-for-Service	1114211091	1114211091	1	1	WHITE, KELLY MD	11/22/2019	207RC0200X	NA	Other	026	PHYSICIANS	156556	41	Internal Medicine	0	In state provider	None	215 WEST JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
111401	Fee-for-Service	1649665092	1649665092	1	1	WOOLWINE, SPENCER J MD	9/1/2022	207XS0114X	NA	Orthopedic Surgery	026	PHYSICIANS	146545	None	None	0	In state provider	None	604 N MAGNOLIA AVE	100	CLOVIS	CA	93611	9204	10	06019	36.83939464	-119.6661479	Fresno County
111403	Fee-for-Service	1780158030	1780158030	1	1	WATERS-ROMAN, DEBRA K PSYD	1/10/2025	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
111425	Fee-for-Service	1902184823	1902184823	1	1	WHEELER, REBEKAH G CNM	4/2/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D	SAN FRANCISCO	CA	94110	9518	38	06075	37.75548534	-122.4065362	San Francisco County
111426	Fee-for-Service	1992736086	1992736086	1	1	WINTERS HEATHCARE FNDTN	7/1/2024	No Taxonomy Provided	NA	None	110	FQHC/RHC APM PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	172 EAST GRANT AVE	None	WINTERS	CA	95694	1780	57	06113	38.5264496	-121.9668052	Yolo County
111458	Fee-for-Service	1518155720	1518155720	1	1	WHEELER, RYAN M	2/16/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 TRAVELODGE DR	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
111464	Fee-for-Service	1275074866	1275074866	1	1	WILSON, ADRINA LMFT	11/19/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2009 PALO VERDE AVE	SUITE A	LONG BEACH	CA	90815	3322	19	06037	33.792597	-118.1080155	Los Angeles County
111649	Fee-for-Service	1295941433	1295941433	1	2	WALGREEN CO	9/14/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2310 TELEGRAPH AVE	None	BERKELEY	CA	94704	1613	01	06001	37.86849167	-122.2591827	Alameda County
111661	Fee-for-Service	1992962245	1992962245	1	1	WAGNER, GABRIEL A MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108967	77	Infectious Disease	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
111674	Fee-for-Service	1285722819	1285722819	1	1	WAGNER, ANDREW S MD	7/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	50907	08	Family Practice	0	In state provider	None	819 LONGWOOD LANE	None	SEBASTOPOL	CA	95472	2734	49	06097	38.40853406	-122.8448607	Sonoma County
111712	Fee-for-Service	1992736086	1992736086	1	1	WINTERS HEATHCARE FNDTN	5/1/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	172 EAST GRANT AVE	None	WINTERS	CA	95694	1780	57	06113	38.5264496	-121.9668052	Yolo County
111719	Fee-for-Service	1225390347	1225390347	1	1	WEBER, JONATHAN F MD	9/6/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	136832	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
111740	Fee-for-Service	1891998910	1891998910	1	1	WRIGHT, LARA M MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62841	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
111748	Fee-for-Service	1396265245	1396265245	1	1	WINTER, GEORGE D CNP	6/14/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2550 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	52	06103	40.14847323	-122.2180997	Tehama County
111755	Fee-for-Service	1295959591	1295959591	1	1	WASHINGTON UNIFIED SD	6/8/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	930 WESTACRE RD	None	WEST SACRAMENTO	CA	95691	3224	57	06113	38.57772188	-121.5306566	Yolo County
111756	Fee-for-Service	1194862532	1194862532	1	2	WILLIAMSON, JULIE L DO	12/23/2021	207L00000X	NA	Other	026	PHYSICIANS	18815	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
111765	Fee-for-Service	1225043508	1225043508	1	1	WALGREEN CO	1/18/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7800 OLD REDWOOD HWY	None	COTATI	CA	94931	5106	49	06097	38.33061586	-122.7099939	Sonoma County
111767	Fee-for-Service	1235439381	1235439381	1	1	WITCHER, CURTIS L MD	2/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114116	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
111812	Fee-for-Service	1285123620	1285123620	1	1	WHOLE CHILD THERAPY. INC.	2/25/2020	261QD1600X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 S INDIAN HILL BLVD S	None	CLAREMONT	CA	91711	5461	19	06037	34.084494	-117.7191945	Los Angeles County
111946	Fee-for-Service	1669487955	1669487955	1	1	WALGREEN CO	5/6/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #05863	2525 HARRIS ST	None	EUREKA	CA	95503	4805	12	06023	40.780953	-124.139643	Humboldt County
111960	Fee-for-Service	1992812671	1992812671	1	1	WACKER, MARGARET R MD	7/30/1991	207T00000X	NA	General Surgery	026	PHYSICIANS	50981	13	Neurology (M.D. only)	0	In state provider	None	780 E GILBERT ST	None	SAN BERNARDINO	CA	92415	1003	36	06071	34.1268333	-117.2705634	San Bernardino County
111961	Fee-for-Service	1437397122	1437397122	1	1	WONG, ADAM MD INC	2/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95311	05	Anesthesiology	0	In state provider	None	9080 COLIMA ROAD	None	WHITTIER	CA	90605	1898	19	06037	33.95062799	-118.0051627	Los Angeles County
112003	Fee-for-Service	1992736086	1992736086	1	1	WINTERS HEATHCARE FNDTN	11/28/2005	261QC1500X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	172 EAST GRANT AVE	None	WINTERS	CA	95694	1780	57	06113	38.5264496	-121.9668052	Yolo County
112017	Fee-for-Service	1013909621	1013909621	1	1	WERTZ, ANDREW W MD	6/21/2000	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	34429	40	Pediatrics	0	In state provider	None	1020 29TH STREET	STE 120	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
112065	Fee-for-Service	1508024217	1508024217	1	1	WRIGHT, LUKE A MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107013	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
112095	Fee-for-Service	1437786498	1437786498	1	1	WANG, DENISE MD	9/15/2023	207R00000X	NA	Other	026	PHYSICIANS	187075	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
112102	Fee-for-Service	1548641939	1548641939	1	1	WONG, TONY L MD INC	1/16/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	51262	41	Internal Medicine	0	In state provider	None	1800 SULLIVAN AVE	ROOM 104	DALY CITY	CA	94015	2227	41	06081	37.68077723	-122.4728941	San Mateo County
112105	Fee-for-Service	1285123620	1285123620	1	1	WHOLE CHILD THERAPY. INC.	5/25/2022	261QD1600X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 S INDIAN HILL BLVD S	None	CLAREMONT	CA	91711	5461	19	06037	34.084494	-117.7191945	Los Angeles County
112115	Fee-for-Service	1912044421	1912044421	1	1	WANG, HENRY J CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	368 7TH AVE	APT 4	SAN FRANCISCO	CA	94118	2381	38	06075	37.78165895	-122.4653791	San Francisco County
112126	Fee-for-Service	1427174622	1427174622	1	1	WU, CONNIE Y OD	1/27/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	322 E THOUSAND OAKS BLVD	100	THOUSAND OAKS	CA	91360	5804	56	06111	34.17896875	-118.8712017	Ventura County
112170	Fee-for-Service	1265524920	1265524920	1	1	WANG, KASPER MD	10/1/1998	2086S0120X	NA	General Surgery	026	PHYSICIANS	54991	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
112173	Fee-for-Service	1023079803	1023079803	1	1	WALLACE, JOHN T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37773	41	Internal Medicine	0	In state provider	None	510 CYPRESS ST	None	FORT BRAGG	CA	95437	5411	23	06045	39.43260152	-123.798942	Mendocino County
112190	Fee-for-Service	1912007121	1912007121	1	1	WEBSTER, MICHAEL MD	8/13/1996	207L00000X	NA	Other	026	PHYSICIANS	43773	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6969 BROCKTON AVE	STE B	RIVERSIDE	CA	92506	3813	33	06065	33.94701	-117.396786	Riverside County
112203	Fee-for-Service	1285921635	1285921635	1	1	WALGREEN CO	9/26/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	160 DIAMOND DR	None	LAKE ELSINORE	CA	92530	4499	33	06065	33.658974	-117.3003035	Riverside County
112244	Fee-for-Service	1639157167	1639157167	1	1	WANKMULLER, ROBERT T	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	74319	30	Radiology	0	In state provider	None	945 SHASTA ST	None	YUBA CITY	CA	95991	4114	51	06101	39.14392271	-121.6160328	Sutter County
112257	Fee-for-Service	1619087988	1619087988	1	1	WAVECREST MEDICINE INC	11/18/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1850 SULLIVAN AVE	STE 320	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
112274	Fee-for-Service	1245438365	1245438365	1	1	WONG, DENNIS OD	10/10/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2771 S DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	3513	19	06037	33.97449155	-117.8375299	Los Angeles County
112293	Fee-for-Service	1295707115	1295707115	1	1	WU, KAREN L MD	8/5/2008	207L00000X	NA	Other	026	PHYSICIANS	81107	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
112312	Fee-for-Service	1689603193	1689603193	1	1	WONG, ARTHUR H MD	3/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82757	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
112329	Fee-for-Service	1548329139	1548329139	1	1	WANG, QUINCY C MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	64131	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
112387	Fee-for-Service	1811592298	1811592298	1	1	WEINBERGER, MICHAL S CNP	2/15/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
112419	Fee-for-Service	1780636076	1780636076	1	1	WHITE, MATTHEW F MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	71459	05	Anesthesiology	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
112443	Fee-for-Service	1992971840	1992971840	1	1	WILLIAMS, NADINE L MD	1/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145293	20	Orthopedic Surgery	0	In state provider	None	25455 BARTON RD	101B 102B 104B 106B108B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
112461	Fee-for-Service	1023079803	1023079803	1	1	WALLACE, JOHN T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37773	66	Emergency Medicine (Urgent Care)	0	In state provider	None	510 CYPRESS ST	None	FORT BRAGG	CA	95437	5411	23	06045	39.43260152	-123.798942	Mendocino County
112482	Fee-for-Service	1912007121	1912007121	1	1	WEBSTER, MICHAEL MD	8/13/1996	207L00000X	NA	Other	026	PHYSICIANS	43773	05	Anesthesiology	0	In state provider	None	6969 BROCKTON AVE	STE B	RIVERSIDE	CA	92506	3813	33	06065	33.94701	-117.396786	Riverside County
112489	Fee-for-Service	1396713426	1396713426	1	1	WEIMER, AMY K MD	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74204	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
112522	Fee-for-Service	1780210658	1780210658	1	1	WALLACE, JORDAN S MD	8/14/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	188568	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
112556	Fee-for-Service	1104831494	1104831494	1	1	WALGREEN CO #04136	7/14/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1919 FRUITRIDGE RD	None	SACRAMENTO	CA	95822	3114	34	06067	38.525283	-121.4959365	Sacramento County
112570	Fee-for-Service	1407888308	1407888308	1	1	WALLS, MELISSA PT	3/6/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3760 CONVOY STREET	100	SAN DIEGO	CA	92111	3743	37	06073	32.81197521	-117.1531278	San Diego County
112596	Fee-for-Service	1497217913	1497217913	1	1	WEBER, ROBERT J MD	1/9/2024	207R00000X	NA	Other	026	PHYSICIANS	177781	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
112602	Fee-for-Service	1063620649	1063620649	1	1	WANG, YING MD	10/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144632	66	Emergency Medicine (Urgent Care)	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
112616	Fee-for-Service	1023415882	1023415882	1	1	WAYZTOWN INC	6/29/2018	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1326 E CALIFORNIA AVE	None	BAKERSFIELD	CA	93307	1302	15	06029	35.3685965	-118.984428	Kern County
112643	Fee-for-Service	1891847430	1891847430	1	1	WONG, SHARON L OD	10/16/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM DRIVE	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
112687	Fee-for-Service	1144249202	1144249202	1	1	WHINERY, FREDERIC P MD	5/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	23088	41	Internal Medicine	0	In state provider	None	2100 WEBSTER ST	STE 423	SAN FRANCISCO	CA	94115	2380	38	06075	37.7904826	-122.4324477	San Francisco County
112750	Fee-for-Service	1023079803	1023079803	1	1	WALLACE, JOHN T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37773	01	General Practice	0	In state provider	None	510 CYPRESS ST	None	FORT BRAGG	CA	95437	5411	23	06045	39.43260152	-123.798942	Mendocino County
112779	Fee-for-Service	1639398878	1639398878	1	1	WANG, JENNY C DO	9/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9971	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
112781	Fee-for-Service	1417561788	1417561788	1	1	WILLIAMS, SHIRLDAWN LCSW	11/28/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
112912	Fee-for-Service	1972544468	1972544468	1	1	WONG, ALEXIS D MD	6/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90936	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
112924	Fee-for-Service	1962895532	1962895532	1	1	WINGS SPEECH AND LANGUAGE CE	6/5/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	NTER INC	1500 S HAVEN AVE	SUITE 190	ONTARIO	CA	91761	2969	36	06071	34.046307	-117.576387	San Bernardino County
112932	Fee-for-Service	1356964720	1356964720	1	1	WU, ANNA OD	9/19/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	388 9TH STREET	SUITE 157	OAKLAND	CA	94607	4290	01	06001	37.80019425	-122.2715222	Alameda County
112935	Fee-for-Service	1689062903	1689062903	1	1	WERNOW, BRIANA J	5/12/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
112953	Fee-for-Service	1003225707	1003225707	1	1	WAHIDI, SALMA PSYD	2/19/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	21545 CNTRE POINTE PRKWY	None	SANTA CLARITA	CA	91350	2947	19	06037	34.413021	-118.514534	Los Angeles County
113005	Fee-for-Service	1982757944	1982757944	1	1	WEAVER, KERRIE A LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3333 SKY PARK DR	STE 220	TORRANCE	CA	90505	5023	19	06037	33.81036565	-118.3466218	Los Angeles County
113020	Fee-for-Service	1649364837	1649364837	1	1	WANG, ALBERT Y MD	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	56862	41	Internal Medicine	0	In state provider	None	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
113070	Fee-for-Service	1093976045	1093976045	1	1	WIEKING, DANIEL C MD	8/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	2	Out of state provider	None	537 SW UNION AVE	None	GRANTS PASS	OR	97527	5543	00	None	42.42237366	-123.3423317	Josephine County
113107	Fee-for-Service	1548346067	1548346067	1	1	WON, LAWRENCE A MD	10/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76969	25	Physical Medicine and Rehabilitation	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
113188	Fee-for-Service	1619923331	1619923331	1	1	WERDEN, SCOTT A MD	3/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	84749	30	Radiology	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
113201	Fee-for-Service	1740242189	1740242189	1	1	WANG, TING W MD	12/7/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	39974	40	Pediatrics	0	In state provider	None	345 9TH ST	STE 204	OAKLAND	CA	94607	4206	01	06001	37.79975865	-122.2705956	Alameda County
113318	Fee-for-Service	1679575765	1679575765	1	1	WHITNEY, CHARLES E MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	33880	08	Family Practice	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
113330	Fee-for-Service	1417211707	1417211707	1	1	WASCHAK, NICOLE C MD	10/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139531	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
113341	Fee-for-Service	1700891090	1700891090	1	1	WALGREENS CO	1/4/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #06124	9750 WOODMAN AVE	None	ARLETA	CA	91331	6422	19	06037	34.24797121	-118.448713	Los Angeles County
113362	Fee-for-Service	1205435989	1205435989	1	1	WELLNESS CHECK LLC	5/19/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	ATORIES	18173 PIONEER BLVD	STE K	ARTESIA	CA	90701	3988	19	06037	33.8659421	-118.082335	Los Angeles County
113364	Fee-for-Service	1942662176	1942662176	1	1	WOLFSON, JEREMY MD	6/19/2020	207L00000X	NA	Other	026	PHYSICIANS	151757	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
113395	Fee-for-Service	1154500122	1154500122	1	1	WEILAND, FREDERICK L MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	39050	42	Nuclear Medicine	0	In state provider	None	ONE MEDICAL PLAZA	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
113478	Fee-for-Service	1508663071	1508663071	1	1	WOVEN LACTATION LLC	3/8/2025	174N00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
113533	Fee-for-Service	1821002619	1821002619	1	1	WOLFF, DONALD R MD	1/30/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	78984	18	Ophthalmology	0	In state provider	None	345 5TH ST	#20	HOLLISTER	CA	95023	3844	35	06069	36.85144793	-121.4029697	San Benito County
113549	Fee-for-Service	1013171651	1013171651	1	1	WONG, DEANNA L	7/29/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
113550	Fee-for-Service	1275624090	1275624090	1	1	WALDROP, FRANK C MD	4/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81690	18	Ophthalmology	0	In state provider	None	7075 N SHARON AVE	None	FRESNO	CA	93720	3329	10	06019	36.83882737	-119.7590708	Fresno County
113568	Fee-for-Service	1427142363	1427142363	1	1	WANG, EMILY J MD	10/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89393	40	Pediatrics	0	In state provider	None	6699 ALVARADO RD	STE 2204	SAN DIEGO	CA	92120	5253	37	06073	32.77665383	-117.0540279	San Diego County
113592	Fee-for-Service	1356710487	1356710487	1	1	WON, JASON N	9/11/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	STE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
113593	Fee-for-Service	1942227368	1942227368	1	1	WAL-MART STORES, INC	1/25/1993	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1366 S RIVERSIDE AVE	None	RIALTO	CA	92376	7608	36	06071	34.076583	-117.373455	San Bernardino County
113606	Fee-for-Service	1679575765	1679575765	1	1	WHITNEY, CHARLES E MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	33880	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
113625	Fee-for-Service	1720267396	1720267396	1	1	WATSON, LESLYN A CNP	2/27/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
113645	Fee-for-Service	1548210081	1548210081	1	1	WILLIAMS, HOWARD V MD	8/16/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	51223	41	Internal Medicine	0	In state provider	None	4060 4TH AVE	STE 505	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
113657	Fee-for-Service	1679671705	1679671705	1	1	WOODS, ROCHELLE J MD	5/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	92420	36	Psychiatry	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
113662	Fee-for-Service	1699853309	1699853309	1	1	WORKMAN, STEVEN J MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	54814	34	Urology and Urological Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
113671	Fee-for-Service	1467505008	1467505008	1	1	WONG, NATALIE	5/11/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
113676	Fee-for-Service	1003906942	1003906942	1	1	WHITE DRUG COMPANY OF JAMEST	10/26/2022	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	706 38TH ST NW	UNIT A	FARGO	ND	58102	2953	00	None	46.884186	-96.842043	Cass County
113742	Fee-for-Service	1710062484	1710062484	1	1	WEINER, IRA R MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36356	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1330 CUTTING BLVD	None	RICHMOND	CA	94804	2555	07	06013	37.92518651	-122.3564715	Contra Costa County
113762	Fee-for-Service	1982028049	1982028049	1	1	WEST, CIERRA N LMFT	9/19/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	302 W 5TH ST	STE 308	SAN PEDRO	CA	90731	2750	19	06037	33.73971572	-118.284045	Los Angeles County
113767	Fee-for-Service	1174918049	1174918049	1	1	WONG, VALERIE S MD	7/6/2020	207R00000X	NA	Other	026	PHYSICIANS	None	38	Geriatrics	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
113787	Fee-for-Service	1982864211	1982864211	1	1	WOOLERY, REBEKAH LCSW	10/13/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
113797	Fee-for-Service	1043639008	1043639008	1	1	WU, LYNNE C MD	11/26/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	142092	40	Pediatrics	0	In state provider	None	2652 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3041	43	06085	37.35228637	-121.9754073	Santa Clara County
113805	Fee-for-Service	1265459499	1265459499	1	1	WAL-MART STORES, INC	2/20/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHAR 10-3494	732 CENTER DR	None	SAN MARCOS	CA	92069	3535	37	06073	33.13603083	-117.1243168	San Diego County
113860	Fee-for-Service	1467489674	1467489674	1	1	WONG, PHILLIP C MD	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94979	None	None	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
113885	Fee-for-Service	1114954385	1114954385	1	1	WU, LISA MD	12/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87391	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
113894	Fee-for-Service	1679575765	1679575765	1	1	WHITNEY, CHARLES E MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	33880	01	General Practice	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
113924	Fee-for-Service	1750835773	1750835773	1	1	WALGREEN CO	1/24/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16477	3009 BROADWAY	None	OAKLAND	CA	94611	5712	01	06001	37.81907291	-122.2621457	Alameda County
113936	Fee-for-Service	1821404344	1821404344	1	1	WILLIAMS, DANIELLE C MD	11/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140388	None	None	0	In state provider	None	9925 INTERNATIONAL BLVD	STE 5	OAKLAND	CA	94603	2558	01	06001	37.74332565	-122.1698542	Alameda County
113962	Fee-for-Service	1902967938	1902967938	1	1	WILSON, CRAIG R CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
113981	Fee-for-Service	1518266923	1518266923	1	1	WALKER, THERESA M LCSW	5/12/2011	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	15525 POMERADO RD	SUITE E-4	POWAY	CA	92064	2427	37	06073	32.99479918	-117.0579468	San Diego County
114031	Fee-for-Service	1265537005	1265537005	1	1	WISEMAN,ESMAGH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	119-05 80TH ROAD	None	KEW GARDENS	NY	11415	0000	00	None	40.712526	-73.8324135	Queens County
114036	Fee-for-Service	1336616481	1336616481	1	1	WELLS AND HILE OD AN OPTOMET	1/23/2020	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8105 MORRO RD	SUITE A	ATASCADERO	CA	93422	3911	40	06079	35.47338669	-120.6685149	San Luis Obispo County
114053	Fee-for-Service	1700216835	1700216835	1	1	WHITE, CHARLES L	1/2/2019	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	552 PASEO DOROTEA	STE 4	PALM SPRINGS	CA	92264	1437	33	06065	33.81460283	-116.5017722	Riverside County
114056	Fee-for-Service	1174918049	1174918049	1	1	WONG, VALERIE S MD	7/6/2020	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
114060	Fee-for-Service	1669732426	1669732426	1	1	WILSONA ELEMENTARY SCHOOL	5/22/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	18050 E AVENUE O	None	PALMDALE	CA	93591	3800	19	06037	34.615854	-117.808479	Los Angeles County
114090	Fee-for-Service	1932115508	1932115508	1	1	WALGREEN CO.	2/27/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2050 IRVING ST	None	SAN FRANCISCO	CA	94122	1716	38	06075	37.76346003	-122.4800787	San Francisco County
114110	Fee-for-Service	1013020288	1013020288	1	1	WENSTRUP, SUSIE M MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	55289	08	Family Practice	0	In state provider	None	401 PARADISE RD	STE E	MODESTO	CA	95351	3104	50	06099	37.62692973	-121.0131742	Stanislaus County
114147	Fee-for-Service	1336482140	1336482140	1	1	WARREN CARLL DO	4/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
114160	Fee-for-Service	1659535656	1659535656	1	1	WYSOCZANSKI, MARIUSZ W MD	2/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55986	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	754 MEDICAL CENTER COURT	SUITE 204	CHULA VISTA	CA	91911	6656	37	06073	32.61778462	-117.0228924	San Diego County
114175	Fee-for-Service	1497354716	1497354716	1	1	WENTWORTH, APRIL R LMFT	8/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
114217	Fee-for-Service	1700544566	1700544566	1	1	WALKER, SHANIQUE E LCSW	5/29/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
114264	Fee-for-Service	1376029512	1376029512	1	1	WILSON, NATALIE E CPO	8/28/2018	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	855 N LARK ELLEN AVE	SUITE A	WEST COVINA	CA	91791	1099	19	06037	34.087707	-117.9166385	Los Angeles County
114401	Fee-for-Service	1518128081	1518128081	1	1	WYMORE, LUCAS R MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124543	20	Orthopedic Surgery	0	In state provider	None	6719 ALVARADO ROAD	SUITE 200	SAN DIEGO	CA	92120	5256	37	06073	32.77684978	-117.055137	San Diego County
114428	Fee-for-Service	1871576470	1871576470	1	1	WILENSKY, JON S MD	12/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93345	24	Plastic Surgery	0	In state provider	None	4510 EXECUTIVE	STE 105	SAN DIEGO	CA	92121	3022	37	06073	32.87570943	-117.2100834	San Diego County
114450	Fee-for-Service	1487652046	1487652046	1	1	WERBER, FRED A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37080	07	Dermatology	0	In state provider	None	2967 LOMA VISTA RD	None	VENTURA	CA	93003	2915	56	06111	34.27555639	-119.2565838	Ventura County
114468	Fee-for-Service	1427424464	1427424464	1	1	WRAY, LINDSAY L PSYD	6/17/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5005 CANYON CREST DR	None	RIVERSIDE	CA	92507	7721	33	06065	33.95957554	-117.3311659	Riverside County
114492	Fee-for-Service	1740893510	1740893510	1	1	WEIDNER, ELISE A	5/19/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
114581	Fee-for-Service	1720253388	1720253388	1	2	WESCARE HOME HEALTH	2/9/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PROVIDERS INC	16921 PARTHENIA STREET	SUITE 304	NORTHRIDGE	CA	91343	4559	19	06037	34.22853846	-118.501092	Los Angeles County
114607	Fee-for-Service	1427065481	1427065481	1	1	WALGREEN CO	8/19/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8975 N CHESTNUT AVE	None	FRESNO	CA	93720	5366	10	06019	36.86609164	-119.7388753	Fresno County
114636	Fee-for-Service	1295781979	1295781979	1	1	WONG, PATRICIA W MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67231	None	None	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
114666	Fee-for-Service	1619269925	1619269925	1	1	WONG, HON L DO	10/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12526	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
114702	Fee-for-Service	1366778326	1366778326	1	1	WAYNE, ELIZABETH M NP	6/19/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
114709	Fee-for-Service	1780221945	1780221945	1	1	WOOD, BRITTNEY D CNM	11/14/2021	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
114726	Fee-for-Service	1831350958	1831350958	1	1	WOGU, CAMELIA C MD	5/6/2014	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	102408	08	Family Practice	0	In state provider	None	444 BRUCE ST	None	YREKA	CA	96097	3450	47	06093	41.71863548	-122.6458755	Siskiyou County
114744	Fee-for-Service	1639847494	1639847494	1	1	WELLS, SARAH A NP	12/8/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
114771	Fee-for-Service	1942694922	1942694922	1	1	WILSON, NICHOLAS MD	6/17/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	167109	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
114775	Fee-for-Service	1740956564	1740956564	1	1	WONG, CYNTHIA	9/23/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	500 W GLENOAKS BLVD	None	GLENDALE	CA	91202	2813	19	06037	34.15937082	-118.2644042	Los Angeles County
114900	Fee-for-Service	1598879553	1598879553	1	1	WIENS, AARON M OD	1/22/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
114906	Fee-for-Service	1396883104	1396883104	1	1	WOMENS HEALTHCARE ASSOC	8/7/1978	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	OF SANTA MONICA AMC	1245 16TH ST	STE 300	SANTA MONICA	CA	90404	1239	19	06037	34.02726451	-118.4857138	Los Angeles County
114950	Fee-for-Service	1174829261	1174829261	1	1	WYLER, BENJAMIN A MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115590	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH STREET	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
114958	Fee-for-Service	1821314535	1821314535	1	1	WANG, WENJIA MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140072	30	Radiology	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
114968	Fee-for-Service	1205030707	1205030707	1	1	WU, BOB J MD	8/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101512	02	General Surgery	0	In state provider	None	1510 SAN PABLO STREET	STE 514	LOS ANGELES	CA	90033	5324	19	06037	34.06287152	-118.2029433	Los Angeles County
114986	Fee-for-Service	1376586594	1376586594	1	1	WILLIAMSON,JAMIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2821 E PRES GEORGE BUSH	TURNPIKE STE	DALLAS	TX	75284	3680	00	None	32.88853417	-96.5571941	Dallas
114997	Fee-for-Service	1669466041	1669466041	1	1	WYNNE DUNCAN, GRACIA L MD	10/1/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
115014	Fee-for-Service	1760497044	1760497044	1	1	WALGREEN CO.	9/20/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#3815	111 S MAIN ST	None	ORANGE	CA	92868	2842	30	06059	33.787512	-117.867272	Orange County
115018	Fee-for-Service	1043486897	1043486897	1	1	WITKOWSKI, AGNIESZKA E MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109830	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
115096	Fee-for-Service	1275809584	1275809584	1	1	WALSH, MARIETTA DO	4/7/2025	207T00000X	NA	General Surgery	026	PHYSICIANS	23971	14	Neurological Surgery	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
115105	Fee-for-Service	1922079177	1922079177	1	1	WALKER, KIMBERLY R OD	4/18/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND STREET	SUITE 2	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
115111	Fee-for-Service	1063704195	1063704195	1	1	WESSELMAN, CHRISTOPHER J MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136821	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
115136	Fee-for-Service	1033564687	1033564687	1	1	WEBB, MATTHEW L MD	6/18/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	172301	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
115138	Fee-for-Service	1750984332	1750984332	1	1	WELL CARE HOSPICE	6/21/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	& PALLIATIVE CARE INC	14545 FRIAR STREET	SUITE 263	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
115150	Fee-for-Service	1285620666	1285620666	1	1	WARSHAL, WILLIAM S MD	12/31/1988	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41468	08	Family Practice	0	In state provider	None	12980 TEN OAK WAY	None	SARATOGA	CA	95070	4421	43	06085	37.28151679	-122.0190463	Santa Clara County
115161	Fee-for-Service	1881709749	1881709749	1	1	WALKER, JENNIFER A	11/29/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9280 WEST STOCKTON BLVD	SUITE 116	SACRAMENTO	CA	95758	8073	34	06067	38.420235	-121.394961	Sacramento
115171	Fee-for-Service	1740218601	1740218601	1	1	WARWICK, GEORGE M DO II	6/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	9001	05	Anesthesiology	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
115196	Fee-for-Service	1285223818	1285223818	1	1	WADHWANI, PRIYANKA PT	2/9/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2815 MAIN ST.,	SUITE 205	CORONA	CA	92882	0000	33	06065	33.84741266	-117.570694	Riverside County
115271	Fee-for-Service	1649290503	1649290503	1	1	WHEELER, ERVIN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	20992	01	General Practice	0	In state provider	None	8690 CENTER DR	None	LA MESA	CA	91942	3057	37	06073	32.78074466	-117.0112355	San Diego County
115314	Fee-for-Service	1265454656	1265454656	1	1	WAPNER, DANIEL E MD	6/21/2000	207L00000X	NA	Other	026	PHYSICIANS	51430	05	Anesthesiology	0	In state provider	None	4107 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83763464	-118.3572101	Los Angeles County
115336	Fee-for-Service	1902002231	1902002231	1	1	WONG, DANIEL MD	7/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120861	67	Endocrinology	0	In state provider	None	1020 29TH ST	STE 270	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
115354	Fee-for-Service	1255920518	1255920518	1	1	WELLSPECT INC	1/17/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1297 FLYNN RD	STE 230	CAMARILLO	CA	93012	8041	56	06111	34.22902154	-119.0172731	Ventura County
115375	Fee-for-Service	1811190770	1811190770	1	1	WANG, JULIA MD	4/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89751	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
115407	Fee-for-Service	1174954689	1174954689	1	1	WESTERN HEALTH RESOURCES	2/1/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5500 MING AVENUE	SUITE 128	BAKERSFIELD	CA	93309	4619	15	06029	35.33787572	-119.0620525	Kern County
115416	Fee-for-Service	1578183471	1578183471	1	1	WILLIAM, MIRA MOURAD PT	6/23/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	30141 ANTELOPE RD.	STE A	MENIFEE	CA	92584	7001	33	06065	33.68176015	-117.1680307	Riverside County
115423	Fee-for-Service	1487645180	1487645180	1	1	WHITTIER VISION CENTER	2/11/1996	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY	11311 LA MIRADA BLVD	STE B	WHITTIER	CA	90604	2126	19	06037	33.928245	-118.0119195	Los Angeles County
115426	Fee-for-Service	1750984332	1750984332	1	1	WELL CARE HOSPICE	6/21/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	& PALLIATIVE CARE INC	14545 FRIAR STREET	SUITE 263	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
115437	Fee-for-Service	1285620666	1285620666	1	1	WARSHAL, WILLIAM S MD	12/31/1988	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41468	38	Geriatrics	0	In state provider	None	12980 TEN OAK WAY	None	SARATOGA	CA	95070	4421	43	06085	37.28151679	-122.0190463	Santa Clara County
115455	Fee-for-Service	1003848441	1003848441	1	1	WEISS, MARTIN M MD	8/28/2018	207R00000X	NA	Other	026	PHYSICIANS	34370	41	Internal Medicine	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
115468	Fee-for-Service	1801999602	1801999602	1	1	WARREN, HILLIS L MD	2/28/1985	174400000X	NA	Other	026	PHYSICIANS	30438	18	Ophthalmology	0	In state provider	None	77 SCRIPPS DR	STE 205	SACRAMENTO	CA	95825	6209	34	06067	38.57238	-121.410756	Sacramento County
115470	Fee-for-Service	1952370694	1952370694	1	1	WILLS, CHARLOTTE P MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67034	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
115498	Fee-for-Service	1386645117	1386645117	1	1	WANG, YING-FUH A MD	6/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77698	08	Family Practice	0	In state provider	None	1770 N ORANGE GROVE AVE	STE 101	POMONA	CA	91767	3027	19	06037	34.07637624	-117.7492622	Los Angeles County
115504	Fee-for-Service	1699707893	1699707893	1	1	WONG, JEFFREY MD	11/30/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	47819	30	Radiology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
115510	Fee-for-Service	1194746958	1194746958	1	1	WUST-SMITH, MARLENE MD	2/8/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	159436	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
115513	Fee-for-Service	1235156647	1235156647	1	1	WAL-MART STORES, INC	11/18/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102150	710 DENNERY RD	None	SAN DIEGO	CA	92154	8400	37	06073	32.581476	-117.035532	San Diego County
115534	Fee-for-Service	1841205127	1841205127	1	1	WALGREEN CO	6/30/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	111 W WASHINGTON AVE	None	ESCONDIDO	CA	92025	2629	37	06073	33.1266858	-117.0846994	San Diego County
115568	Fee-for-Service	1184697658	1184697658	1	1	WELLS, RYAN D MD	9/2/2017	207N00000X	NA	Dermatology	026	PHYSICIANS	73951	07	Dermatology	0	In state provider	None	2438 N PONDEROSA DR	C105	CAMARILLO	CA	93010	2369	56	06111	34.24219545	-119.0227012	Ventura County
115592	Fee-for-Service	1033397336	1033397336	1	1	WESTERN HEALTH RESOURCES	1/1/2008	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	440 GREENFIELD AVE	SUITE C	HANFORD	CA	93230	3568	16	06031	36.32904	-119.6582155	Kings County
115598	Fee-for-Service	1265741003	1265741003	1	1	WILLIAMS, VICKIE LMFT	12/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1545 WEBSTER	A	FAIRFIELD	CA	94533	4989	48	06095	38.25753941	-122.0475412	Solano County
115636	Fee-for-Service	1235287202	1235287202	1	1	WONG, MAY S MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	61626	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
115670	Fee-for-Service	1548465040	1548465040	1	1	WINTERMAN, MARK S LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
115699	Fee-for-Service	1609982925	1609982925	1	1	WELTER, KRISTIN L MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63197	41	Internal Medicine	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
115729	Fee-for-Service	1386683423	1386683423	1	1	WILLIS, ROGER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	IMPACT MEDICAL SERVICES	2827 BABCOCK RD	None	SAN ANTONIO	TX	78229	0000	00	None	29.51266568	-98.59158714	Bexar County
115799	Fee-for-Service	1972842193	1972842193	1	1	WANG, YUQI K MD	6/3/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	167259	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
115874	Fee-for-Service	1225597040	1225597040	1	1	WOLFISH, ERICA B MD	4/19/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176329	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
115905	Fee-for-Service	1992853816	1992853816	1	1	WEILER, DANIELLE D MD	12/5/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	74203	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
115908	Fee-for-Service	1639466097	1639466097	1	1	WOOD, CORRINA H MD	10/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122646	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
115926	Fee-for-Service	1366698375	1366698375	1	1	WRIGHT, PAMELA M NP	6/23/2011	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
115942	Fee-for-Service	1922059716	1922059716	1	1	WRIGHT, CHARLES	8/31/1989	207L00000X	NA	Other	026	PHYSICIANS	68011	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
115993	Fee-for-Service	1881165645	1881165645	1	1	WENDY K. Y. NG, MD	12/30/2019	208200000X	NA	General Surgery	026	PHYSICIANS	None	24	Plastic Surgery	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
116013	Fee-for-Service	1295772804	1295772804	1	1	WISHEK HOSPITAL-CLINIC ASSOC	6/4/2024	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1007 4TH AVE S	None	WISHEK	ND	58495	0647	00	None	46.25512648	-99.5517045	McIntosh County
116017	Fee-for-Service	1922041573	1922041573	1	1	WOHLRAB, JULIETTE L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5216 DAWES AVE	None	ALEXANDRIA	VA	22311	1404	00	None	38.83997458	-77.1193102	Alexandria city
116035	Fee-for-Service	1871530824	1871530824	1	1	WALSH ,GUERIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1055 N CURTIS RD	None	BOISE	ID	83706	0000	00	None	43.61455048	-116.256231	Ada County
116036	Fee-for-Service	1922243633	1922243633	1	1	WANG, JEFFREY	1/28/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT STREET	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
116059	Fee-for-Service	1881798460	1881798460	1	1	WING, DEBORAH ANN MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48495	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
116067	Fee-for-Service	1326225814	1326225814	1	1	WEST, STEPHANIE M PT	8/12/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
116069	Fee-for-Service	1891779369	1891779369	1	1	WALLACH, STACEY J MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68624	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	701 E 28TH ST	STE 212	LONG BEACH	CA	90806	2774	19	06037	33.80803441	-118.1847137	Los Angeles County
116082	Fee-for-Service	1710922687	1710922687	1	1	WASSERSTROM, JEFFREY MD	1/31/1987	207W00000X	NA	Ophthalmology	026	PHYSICIANS	54813	18	Ophthalmology	0	In state provider	None	5565 GROSSMONT CENTER DR	STE 551	LA MESA	CA	91942	3078	37	06073	32.77978322	-117.0094766	San Diego County
116104	Fee-for-Service	1629284872	1629284872	1	1	WATANABE, THOMAS M MD	7/19/2019	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89119	5168	00	None	36.163269	-115.1654465	Clark County
116113	Fee-for-Service	1003034737	1003034737	1	1	WHITING BARRON AND WHITI	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A PROF CORP	1 COUNTRY CLUB PLZ	None	ORINDA	CA	94563	2308	07	06013	37.88568592	-122.1926401	Contra Costa County
116136	Fee-for-Service	1982123139	1982123139	1	1	WEBER, MORGAN E PT	6/25/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5533 W HILLSDALE AVE	SUITE 'A'	VISALIA	CA	93291	5138	54	06107	36.329238	-119.35251	Tulare County
116162	Fee-for-Service	1144551060	1144551060	1	1	WOODS, BRENNA M LMFT	12/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
116182	Fee-for-Service	1295790319	1295790319	1	1	WILLIAMS, BYRON K MD	10/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	76616	77	Infectious Disease	0	In state provider	None	801 S CHEVY CHASE DR	STE 105	GLENDALE	CA	91205	4432	19	06037	34.136757	-118.2396195	Los Angeles County
116222	Fee-for-Service	1639542046	1639542046	1	1	WILDER, MEGAN NP	3/13/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
116231	Fee-for-Service	1457646119	1457646119	1	1	WRIGHT, ANDREW P MD	7/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149170	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
116289	Fee-for-Service	1407160914	1407160914	1	1	WHITGOB, EMILY E MD	6/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127289	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
116301	Fee-for-Service	1295772804	1295772804	1	1	WISHEK HOSPITAL-CLINIC ASSOC	6/4/2024	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1007 4TH AVE S	None	WISHEK	ND	58495	0647	00	None	46.25512648	-99.5517045	McIntosh County
116310	Fee-for-Service	1699985556	1699985556	1	1	WOODLEY, STEPHEN A	6/26/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1550 THE ALAMEDA STE 130	None	SAN JOSE	CA	95126	2322	43	06085	37.33513357	-121.9160189	Santa Clara County
116328	Fee-for-Service	1922496439	1922496439	1	1	WILLIAMS, ASHLEY N LMFT	11/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1740 PLUM LN	STE B	REDLANDS	CA	92374	0109	36	06071	34.06899169	-117.2145582	San Bernardino County
116333	Fee-for-Service	1144428392	1144428392	1	1	WHEELER, MATTHEW T MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	98583	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	MC 500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
116354	Fee-for-Service	1013036045	1013036045	1	1	WALGREEN CO	7/20/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #09884	40663 CALIFORNIA OAKS RD	None	MURRIETA	CA	92562	5729	33	06065	33.57229056	-117.2037807	Riverside County
116369	Fee-for-Service	1710922687	1710922687	1	1	WASSERSTROM, JEFFREY MD	1/31/1987	207W00000X	NA	Ophthalmology	026	PHYSICIANS	54813	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	5565 GROSSMONT CENTER DR	STE 551	LA MESA	CA	91942	3078	37	06073	32.77978322	-117.0094766	San Diego County
116383	Fee-for-Service	1912905787	1912905787	1	2	WANG, DAVID W MD	5/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37520	40	Pediatrics	0	In state provider	None	210 N GARFIELD AVE	STE 300	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
116421	Fee-for-Service	1760569701	1760569701	2	1	WRIGHT, PALMER P. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3999 ENGLEWOOD AVE.	SUITE #201	YAKIMA	WA	98902	0000	00	None	46.60714156	-120.5612461	Yakima County
116442	Fee-for-Service	1093735136	1093735136	1	1	WOOD, DAWN E MD	12/31/1995	207R00000X	NA	Other	026	PHYSICIANS	40846	41	Internal Medicine	0	In state provider	None	23704 MALIBU RD	None	MALIBU	CA	90265	4603	19	06037	34.03370004	-118.691184	Los Angeles County
116455	Fee-for-Service	1083725030	1083725030	1	1	WILKINSON, BRENDA LMFT	8/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4909 MURPHY CANYON RD	300	SAN DIEGO	CA	92123	4349	37	06073	32.8287682	-117.1197549	San Diego County
116456	Fee-for-Service	1770663247	1770663247	1	1	WOLFSEN, ADA R MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	23375	41	Internal Medicine	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
116499	Fee-for-Service	1467724716	1467724716	1	1	WALGREEN CO	7/5/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#15294	8490 SANTA MONICA BLVD	STE 1	WEST HOLLYWOOD	CA	90069	4261	19	06037	34.08950508	-118.3760465	Los Angeles County
116519	Fee-for-Service	1710065727	1710065727	1	1	WAGGONER, LARRY E OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	P O BOX 291, MT MESA	12134 MOUNTAIN MESA RD	None	LAKE ISABELLA	CA	93240	9690	15	06029	35.64119978	-118.4090716	Kern County
116525	Fee-for-Service	1801286125	1801286125	1	1	WANG, CRYSTAL H MD	6/28/2023	2080P0207X	NA	Hematology	026	PHYSICIANS	170091	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
116548	Fee-for-Service	1568542363	1568542363	2	1	WISE, DOUGLAS J DO	2/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	5399	08	Family Practice	0	In state provider	None	40285 WINCHESTER RD	STE 103	TEMECULA	CA	92591	5547	33	06065	33.53330454	-117.1488732	Riverside County
116558	Fee-for-Service	1841723335	1841723335	1	1	WHITE, LEE W MD	7/10/2023	208800000X	NA	Other	026	PHYSICIANS	156994	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
116562	Fee-for-Service	1376558650	1376558650	1	1	WALGREEN CO	2/20/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #05844	215 N 2ND ST	None	EL CAJON	CA	92021	7243	37	06073	32.796792	-116.935631	San Diego County
116590	Fee-for-Service	1962580746	1962580746	1	1	WILLIAMS, DELYSE R MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	66073	18	Ophthalmology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
116607	Fee-for-Service	1588055230	1588055230	1	1	WEI, ANDREW	4/24/2024	207L00000X	NA	Other	026	PHYSICIANS	165729	05	Anesthesiology	0	In state provider	None	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	4809	19	06037	34.158213	-118.328112	Los Angeles County
116616	Fee-for-Service	1174562490	1174562490	1	1	WONG, STEVE YING-HSIOW	6/20/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75214	05	Anesthesiology	0	In state provider	None	27401 LOS ALTOS	STE 180	MISSION VIEJO	CA	92691	8580	30	06059	33.56489118	-117.665546	Orange County
116619	Fee-for-Service	1144428392	1144428392	1	1	WHEELER, MATTHEW T MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	98583	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
116667	Fee-for-Service	1184703217	1184703217	1	1	WILKES, ROBERT M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	15217	01	General Practice	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
116733	Fee-for-Service	1275720856	1275720856	1	1	WATERMAN, JASON J MD	10/23/2009	207R00000X	NA	Other	026	PHYSICIANS	108207	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
116839	Fee-for-Service	1700804077	1700804077	1	1	WAGNER, DAVID MD	12/1/2003	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	55652	40	Pediatrics	0	In state provider	None	91 GREGORY LN	STE 15	PLEASANT HILL	CA	94523	4927	07	06013	37.94801808	-122.062028	Contra Costa County
116865	Fee-for-Service	1770842940	1770842940	1	1	WAL-MART STORES, INC	12/28/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10355 TRINITY PKWY	None	STOCKTON	CA	95219	7243	39	06077	38.05026767	-121.3750074	San Joaquin County
116882	Fee-for-Service	1851688790	1851688790	1	1	WELCH, KELLY B CRNA	8/2/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
116914	Fee-for-Service	1528590510	1528590510	1	1	WATHEN, JOSHUA N MD	9/16/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	158777	None	None	0	In state provider	None	655 EUCLID AVE	STE 205	NATIONAL CITY	CA	91950	2967	37	06073	32.68353398	-117.082625	San Diego County
116927	Fee-for-Service	1023696937	1023696937	1	1	WILKERSON, HANNAH MD	8/15/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	9411	38	06075	37.78610439	-122.421569	San Francisco County
116997	Fee-for-Service	1851956833	1851956833	1	1	WALSH, ALEX B DO	8/1/2023	207P00000X	NA	Other	026	PHYSICIANS	21136	None	None	0	In state provider	None	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48093988	-122.2531826	San Mateo County
117001	Fee-for-Service	1134144983	1134144983	1	1	WILLIAMS, JONAS A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	28569	41	Internal Medicine	0	In state provider	None	2070 CLINTON AVE	None	ALAMEDA	CA	94501	4320	01	06001	37.76333626	-122.253868	Alameda County
117049	Fee-for-Service	1437789229	1437789229	1	1	WESTERN HEALTH RESOURCES	8/1/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	20100 CEDAR RD NORTH	None	SONORA	CA	95370	5925	55	06109	37.98700879	-120.3663189	Tuolumne County
117082	Fee-for-Service	1295959096	1295959096	1	1	WRIGHT, DUPERLY LMFT	12/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4125 BLACKFORD AVE	STE 245	SAN JOSE	CA	95117	1705	43	06085	37.31436259	-121.9754443	Santa Clara County
117135	Fee-for-Service	1679872006	1679872006	1	1	WEST, ANNA M MD	7/2/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	188578	30	Radiology	0	In state provider	None	6412 LAUREL AVE	None	MOUNTAIN MESA	CA	93240	9529	15	06029	35.63564004	-118.407037	Kern County
117139	Fee-for-Service	1912387929	1912387929	1	1	WEST GLENN MANOR INC	8/16/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7242 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4253	30	06059	33.75911254	-118.0024155	Orange County
117217	Fee-for-Service	1255457404	1255457404	1	1	WHITNEY, CHRISTOPHER J OD	12/16/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4650 PALM AVE	None	SAN DIEGO	CA	92154	8404	37	06073	32.5839467	-117.0337851	San Diego County
117220	Fee-for-Service	1215901897	1215901897	1	1	WASCHER, ROBERT A MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	47782	78	Neoplastic Diseases/Oncology	0	In state provider	None	1328 22ND ST	FL 3	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
117287	Fee-for-Service	1134144983	1134144983	1	1	WILLIAMS, JONAS A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	28569	05	Anesthesiology	0	In state provider	None	2070 CLINTON AVE	None	ALAMEDA	CA	94501	4320	01	06001	37.76333626	-122.253868	Alameda County
117355	Fee-for-Service	1326174152	1326174152	1	1	WANG, LENA Y MD	8/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93082	None	None	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
117361	Fee-for-Service	1285356337	1285356337	1	1	WOMBAT MENTAL HEALTH SERVICE	12/7/2022	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	S A LCSW PROFESSIONAL CO	9431 HAVEN AVE	STE 100	RANCHO CUCAMONGA	CA	91730	5879	36	06071	34.082244	-117.5756135	San Bernardino County
117372	Fee-for-Service	1639639008	1639639008	1	1	WRIGHT, MIA MD	8/17/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178135	None	None	0	In state provider	None	3201 DATA DRIVE	None	RANCHO CORDOVA	CA	95670	7374	34	06067	38.58561	-121.2838875	Sacramento County
117512	Fee-for-Service	1790869782	1790869782	1	1	WALTERS, SAMUEL J MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	68055	01	General Practice	0	In state provider	None	1515 SCOTT ST	RM 1	SAN FRANCISCO	CA	94115	3511	38	06075	37.78406999	-122.4379366	San Francisco County
117519	Fee-for-Service	1871758508	1871758508	1	1	WATERS, GABRIELA R NP	6/9/2009	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
117530	Fee-for-Service	1366860561	1366860561	1	1	WELCH, AMBER M LMFT	1/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
117564	Fee-for-Service	1073685202	1073685202	1	1	WILLS, CARLA L LCSW	5/25/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
117572	Fee-for-Service	1659717197	1659717197	1	1	WARD, BRITTANY E NP	10/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
117584	Fee-for-Service	1952457467	1952457467	1	1	WYCKOFF, MARY NP	2/9/2012	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
117595	Fee-for-Service	1952830168	1952830168	1	1	WILLIAMS, JAQUETA A CNP	12/6/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	491 E ALESSANDRO BLVD	None	RIVERSIDE	CA	92508	6071	33	06065	33.91628714	-117.3230954	Riverside County
117603	Fee-for-Service	1346557014	1346557014	1	23	WASHINGTON TOWNSHIP MEDICAL	10/29/2021	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	FOUNDATION	2299 MOWRY AVE	2C	FREMONT	CA	94538	1621	01	06001	37.55671415	-121.9817758	Alameda County
117645	Fee-for-Service	1467504001	1467504001	1	1	WOO, MICHAEL OD	11/26/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
117650	Fee-for-Service	1285356337	1285356337	1	1	WOMBAT MENTAL HEALTH SERVICE	1/31/2024	103TC1900X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	S A LCSW PROFESSIONAL CO	9431 HAVEN AVE	STE 100	RANCHO CUCAMONGA	CA	91730	5879	36	06071	34.082244	-117.5756135	San Bernardino County
117666	Fee-for-Service	1336336304	1336336304	1	1	WONG, ANDREW B OD	1/2/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1026 W WEST COVINA PKWY	STE B	WEST COVINA	CA	91790	8212	19	06037	34.06855822	-117.9319371	Los Angeles County
117697	Fee-for-Service	1679805311	1679805311	1	1	WHITLEY, LISA D CNM	5/27/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
117721	Fee-for-Service	1770974529	1770974529	1	1	WONG, ALYSIA F LMFT	8/3/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3551 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
117723	Fee-for-Service	1588241863	1588241863	1	1	WALLACE, NICOLAI MD	6/9/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
117738	Fee-for-Service	1083718217	1083718217	1	1	WILLIS, PAUL S MD	5/9/1987	2084N0400X	NA	Neurology	026	PHYSICIANS	32285	13	Neurology (M.D. only)	0	In state provider	None	2320 BATH ST	STE 305	SANTA BARBARA	CA	93105	4385	42	06083	34.43082689	-119.7223032	Santa Barbara County
117776	Fee-for-Service	1962580647	1962580647	1	1	WALL, CRAIG J OD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7179	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
117791	Fee-for-Service	1275553307	1275553307	1	1	WONG, STEVEN G MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79910	68	Hematology	0	In state provider	None	200 MED PLAZA STE 120	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
117799	Fee-for-Service	1477600435	1477600435	1	2	WICHMANN, JILL LCSW	3/8/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	159 BRENTWOOD DR	None	GRASS VALLEY	CA	95945	5703	29	06057	39.23230278	-121.0486552	Nevada County
117824	Fee-for-Service	1336517291	1336517291	1	1	WANG, MARGERY A PHD	8/8/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
117849	Fee-for-Service	1750714879	1750714879	1	1	WANG, ANGELINE L MD	9/20/2017	207W00000X	NA	Ophthalmology	026	PHYSICIANS	149302	18	Ophthalmology	0	In state provider	None	101 THE CITY DR S	None	LOS ANGELES	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
117858	Fee-for-Service	1861419285	1861419285	1	1	WAL-MART STORES, INC	10/14/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101882	3400 FLORAL AVE	None	SELMA	CA	93662	9036	10	06019	36.57635934	-119.634474	Fresno County
117870	Fee-for-Service	1508102336	1508102336	1	1	WANG, PIN WEN OT	12/14/2022	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
117889	Fee-for-Service	1346557014	1346557014	1	23	WASHINGTON TOWNSHIP MEDICAL	10/29/2021	106H00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FOUNDATION	2299 MOWRY AVE	2C	FREMONT	CA	94538	1621	01	06001	37.55671415	-121.9817758	Alameda County
117942	Fee-for-Service	1992792402	1992792402	1	1	WONG, ALEXANDER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	16659 SOUTHWEST FWY	STE 581	SUGAR LAND	TX	77479	2669	00	None	29.588265	-95.630949	Fort Bend County
118035	Fee-for-Service	1073697843	1073697843	2	1	WATSON, LAWRENCE C OD	7/7/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	73211 FRED WARING DR	STE 102	PALM DESERT	CA	92260	2871	33	06065	33.72862966	-116.3870098	Riverside County
118042	Fee-for-Service	1104029552	1104029552	1	1	WELTON, SHAWNA V PSYD	3/27/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	39650 LIBERTY ST	STE 310	FREMONT	CA	94358	2227	01	06001	37.54662058	-121.9736002	Alameda County
118138	Fee-for-Service	1750300315	1750300315	1	1	WINTON, FRANK A MD	1/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	70068	01	General Practice	0	In state provider	None	1035 SOUTH MAIN ST	None	FALLBROOK	CA	92028	3338	37	06073	33.373188	-117.2515065	San Diego County
118170	Fee-for-Service	1215026331	1215026331	1	1	WINKELMANN, JACQUELIN MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72934	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
118234	Fee-for-Service	1144352592	1144352592	1	1	WEISS, WENDY S PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7485 RUSH RIVER DR	STE 710	SACRAMENTO	CA	95831	5260	34	06067	38.485557	-121.5342225	Sacramento County
118239	Fee-for-Service	1114352960	1114352960	1	1	WILD-MCKINNEY, MARGARET N LM	1/31/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	317 W F ST	None	ONTARIO	CA	91762	3205	36	06071	34.06932	-117.6542865	San Bernardino County
118310	Fee-for-Service	1124104427	1124104427	1	2	WESTWOOD MEDICAL GROUP	8/22/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	505 S VIRGIL AVE	STE 208	LOS ANGELES	CA	90020	1415	19	06037	34.064883	-118.287086	Los Angeles County
118314	Fee-for-Service	1306109434	1306109434	1	1	WOO, TAMMY Y MD	9/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127571	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	STE 4100	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
118330	Fee-for-Service	1477945970	1477945970	1	1	WRIGHT, SAMANTHA LPCC	3/11/2025	No Taxonomy Provided	NA	None	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
118362	Fee-for-Service	1235454315	1235454315	1	1	WALSH, J MARTIN	7/21/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
118407	Fee-for-Service	1952316234	1952316234	1	1	WALGREENS CO	1/9/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15 W HARDING WAY	None	STOCKTON	CA	95204	5716	39	06077	37.96722115	-121.295851	San Joaquin County
118447	Fee-for-Service	1467120527	1467120527	1	1	WELLSPRING HOME HEALTH CARE	1/4/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	17050 CHATSWORTH ST	UNIT 101A	GRANADA HILLS	CA	91344	5847	19	06037	34.26477251	-118.5039945	Los Angeles County
118450	Fee-for-Service	1174594360	1174594360	1	1	WILLIAM,TRELOAR,S DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2700 STEWART PARKWAY	None	ROSEBURG	OR	97470	0000	00	None	43.2399838	-123.3665048	Douglas County
118459	Fee-for-Service	1932181609	1932181609	1	1	WUN, THEODORE MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	56276	None	None	0	In state provider	None	2525 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
118472	Fee-for-Service	1194711580	1194711580	1	1	WOODS, NORMAN P MD	1/31/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	34166	38	Geriatrics	0	In state provider	None	1472 OAK CANYON DR	None	SAN JOSE	CA	95120	5711	43	06085	37.23173	-121.8972212	Santa Clara County
118506	Fee-for-Service	1033613377	1033613377	1	1	WATKINS, WILLIAM G MD	6/17/2022	207L00000X	NA	Other	026	PHYSICIANS	163321	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
118531	Fee-for-Service	1982707097	1982707097	1	1	WOOD, JOHN C MD	6/1/1999	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	85259	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
118536	Fee-for-Service	1104833532	1104833532	1	1	WANG, YI LAC	6/14/2022	163WG0000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	928 SAN PABLO AVENUE	None	ALBANY	CA	94706	2010	01	06001	37.88929513	-122.2986723	Alameda County
118593	Fee-for-Service	1346421930	1346421930	1	1	WISEMAN, JAMES EDWARD S MD	11/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101865	02	General Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
118636	Fee-for-Service	1982061180	1982061180	1	1	WIREMAN, GARRETT P DPM	5/2/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1255 LIBERTY STREET	None	REDDING	CA	96001	0814	45	06089	40.58769807	-122.3879041	Shasta County
118651	Fee-for-Service	1689783706	1689783706	1	1	WENDALL PAHLS MD	8/1/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
118674	Fee-for-Service	1902899354	1902899354	1	1	WILCKENS-GJATA, PAOLA A LCSW	10/11/2007	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2777 JEFFERSON ST	STE 203C	CARLSBAD	CA	92008	1743	37	06073	33.16370246	-117.3476018	San Diego County
118690	Fee-for-Service	1487603759	1487603759	1	1	WILLIAMS, MARY L MD	11/30/1993	207N00000X	NA	Dermatology	026	PHYSICIANS	24961	07	Dermatology	0	In state provider	None	400 PARNASSUS AVE	STE 316	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
118720	Fee-for-Service	1295787257	1295787257	1	1	WINDLE, JOHN R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
118743	Fee-for-Service	1205138963	1205138963	1	1	WILLIAMS, INGRID M	7/27/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	276 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
118764	Fee-for-Service	1437781416	1437781416	1	1	WALTHERS, ANDREA MARIE DEFEL	11/8/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	ICE NP	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1563	34	06067	38.546091	-121.447305	Sacramento County
118791	Fee-for-Service	1205005584	1205005584	1	1	WANG, GEORGE J DO	9/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9862	08	Family Practice	0	In state provider	None	2600 REDONDO AVENUE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
118810	Fee-for-Service	1447251392	1447251392	1	1	WELSH,TAMARA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 WENDELL AVE	STE 103	LEWISTOWN	MT	59457	2267	00	None	47.058021	-109.4434515	Fergus County
118834	Fee-for-Service	1063590560	1063590560	1	1	WU, MIN H MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89677	08	Family Practice	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
118842	Fee-for-Service	1689675365	1689675365	1	1	WANGYAL, TENZING MD	7/30/1991	207R00000X	NA	Other	026	PHYSICIANS	49789	41	Internal Medicine	0	In state provider	None	600 CITY PARKWAY WEST	None	ORANGE	CA	92868	2900	30	06059	33.78299646	-117.89694	Orange County
118856	Fee-for-Service	1821651357	1821651357	1	1	WILDER, SCOTT D DO	9/9/2022	207P00000X	NA	Other	026	PHYSICIANS	19617	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
118984	Fee-for-Service	1922451905	1922451905	1	1	WEST COVINA MEDICAL CENTER	8/23/2016	3336I0012X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	725 S ORANGE AVE	None	WEST COVINA	CA	91790	2614	19	06037	34.07079634	-117.9445034	Los Angeles County
119031	Fee-for-Service	1699186247	1699186247	2	1	WESTERN PHYSICAL THERAPY, IN	11/29/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1528 PLUMAS CT	STE 200	YUBA CITY	CA	95991	2973	51	06101	39.15297032	-121.6186294	Sutter County
119055	Fee-for-Service	1730129271	1730129271	1	1	WANG, CHUNG N MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	31187	05	Anesthesiology	0	In state provider	None	3116 WEST MARCH LANE	SUITE 200	STOCKTON	CA	95219	2370	39	06077	37.98398283	-121.350684	San Joaquin County
119057	Fee-for-Service	1932228764	1932228764	1	1	WINKLE, RICHARD MD INC	1/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	EASTGATE MEDICAL GROUP	11741 VALLEY VIEW ST	None	CYPRESS	CA	90630	5500	30	06059	33.79210447	-118.0287769	Orange County
119064	Fee-for-Service	1073936712	1073936712	1	1	WICKERSHAM, CAROLYN NP	2/6/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	818193	-	NOT APPLICABLE	0	In state provider	None	11600 ELDRIDGE AVENUE	None	LAKE VIEW TERRACE	CA	91342	6506	19	06037	34.28038404	-118.3838708	Los Angeles County
119073	Fee-for-Service	1255859914	1255859914	1	1	WITHERS, CHARLETTE J CNM	1/14/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
119079	Fee-for-Service	1205128881	1205128881	1	1	WOOTEN, MICHELLE V MD	3/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114114	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
119122	Fee-for-Service	1730136011	1730136011	1	1	WEAKLEY, RONALD G MD INC	11/30/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	36554	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1401 SPANOS CT	STE 124	MODESTO	CA	95355	2814	50	06099	37.66975543	-120.9724048	Stanislaus County
119176	Fee-for-Service	1780909333	1780909333	1	1	WARRINGTON, STEVEN J MD	7/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131858	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
119233	Fee-for-Service	1386626208	1386626208	1	1	WISNER, DAVID H MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	48742	02	General Surgery	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
119252	Fee-for-Service	1497731178	1497731178	1	1	WAYNE, BARRY A MD	4/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53647	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
119273	Fee-for-Service	1568625275	1568625275	1	1	WICKLEY, AARON B MD	6/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132302	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
119300	Fee-for-Service	1639762032	1639762032	1	1	WCL MARRIAGE AND FAMILY THER	1/9/2025	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	APY, INC.	595 E COLORADO BLVD	SUITE 403	PASADENA	CA	91101	2039	19	06037	34.14588202	-118.1380722	Los Angeles County
119311	Fee-for-Service	1649238593	1649238593	1	1	WILCOX, DUNCAN T MD	3/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
119381	Fee-for-Service	1891877106	1891877106	1	1	WINTON, CAROL J.	4/30/1991	207W00000X	NA	Ophthalmology	026	PHYSICIANS	76078	18	Ophthalmology	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
119390	Fee-for-Service	1205994159	1205994159	1	1	WANG, YIN-ZU MD	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38145	40	Pediatrics	0	In state provider	None	7837 GARVEY AVE	None	ROSEMEAD	CA	91770	3013	19	06037	34.06265748	-118.098162	Los Angeles County
119404	Fee-for-Service	1255877262	1255877262	1	1	WACHHOLDER, JAYLEE LCSW	8/16/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
119418	Fee-for-Service	1235434895	1235434895	1	1	WANJAU, LYDIAH K LMFT	8/7/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	514 N CALIFORNIA AVE	None	BEAUMONT	CA	92223	2113	33	06065	33.92824357	-116.9812965	Riverside County
119424	Fee-for-Service	1245271253	1245271253	1	1	WILLIAMSON, LENITA R MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	76941	20	Orthopedic Surgery	0	In state provider	None	2116 E ORANGEBURG AVE	# A	MODESTO	CA	95355	3370	50	06099	37.66354152	-120.958056	Stanislaus County
119445	Fee-for-Service	1285993667	1285993667	1	1	WHELAN, VINCENT P MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131029	40	Pediatrics	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
119469	Fee-for-Service	1912472176	1912472176	1	1	WORRELL, BENJAMIN J	10/30/2021	344600000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	101 E ALMA ST	201	MOUNT SHASTA	CA	96067	2290	47	06093	41.31530709	-122.3145125	Siskiyou County
119508	Fee-for-Service	1710063235	1710063235	1	1	WU, FLORA C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38533	40	Pediatrics	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
119510	Fee-for-Service	1215954631	1215954631	1	1	WAL-MART STORES, INC	12/18/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101881	7901 WATT AVE	None	ANTELOPE	CA	95843	2000	34	06067	38.712825	-121.3937685	Sacramento County
119518	Fee-for-Service	1477795151	1477795151	1	1	WINGFIELDRITTER, SUSAN MFT	10/5/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	34658	-	NOT APPLICABLE	0	In state provider	None	1385 N JOHNSON AVE	SUITE 102 103	EL CAJON	CA	92020	1660	37	06073	32.813847	-116.970981	San Diego County
119522	Fee-for-Service	1386626208	1386626208	1	1	WISNER, DAVID H MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	48742	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
119546	Fee-for-Service	1740742568	1740742568	1	1	WEISER, NATASHA E MD	6/21/2022	207ZP0101X	NA	Other	026	PHYSICIANS	176713	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
119560	Fee-for-Service	1396892162	1396892162	1	1	WEIDNER, JAMES B MD	1/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	60943	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	25 N 14TH ST	STE 635	SAN JOSE	CA	95112	6213	43	06085	37.34293357	-121.8775187	Santa Clara County
119578	Fee-for-Service	1780094391	1780094391	1	1	WOODWARD, TIMOTHY A MD	1/14/2020	207L00000X	NA	Other	026	PHYSICIANS	164917	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
119627	Fee-for-Service	1659716603	1659716603	1	1	WHITNEY, CHRISTINA LMFT	12/28/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18260 WILDRIDGE RD	None	COTTONWOOD	CA	96022	0027	52	06103	40.32453485	-122.3640053	Tehama County
119635	Fee-for-Service	1245490721	1245490721	2	1	WILSON, KATHY MD	7/21/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	119319	None	None	0	In state provider	None	972 GOODRICH BLVD	None	COMMERCE	CA	90022	4114	19	06037	34.01786727	-118.1546159	Los Angeles County
119668	Fee-for-Service	1821050766	1821050766	1	1	WILLIAMS, JENNIFER MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55656	08	Family Practice	0	In state provider	None	2448 GUERNEVILLE RD	STE 300	SANTA ROSA	CA	95403	7224	49	06097	38.452194	-122.766786	Sonoma County
119702	Fee-for-Service	1255585675	1255585675	1	1	WOMENS INSTITUTE FOR INFERTI	1/3/1987	193400000X	NA	Other	026	PHYSICIANS	41811	None	None	0	In state provider	LITY AND REPRODUCTIVE M	760 WASHBURN AVE	STE 9	CORONA	CA	92882	3303	33	06065	33.87374678	-117.5678721	Riverside County
119712	Fee-for-Service	1285673996	1285673996	1	1	WYNN, MICHAEL L MD	1/25/2018	208600000X	NA	General Surgery	026	PHYSICIANS	39800	02	General Surgery	0	In state provider	None	5601 NORRIS CANYON RD	SUITE 100	SAN RAMON	CA	94583	5407	07	06013	37.77772182	-121.9579459	Contra Costa County
119734	Fee-for-Service	1700886322	1700886322	1	1	WYCKOFF HEIGHTS MEDICAL CENT	11/22/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	374 STOCKHOLM STREET	3RD FLOOR	BROOKLYN	NY	11237	0000	00	None	40.70457	-73.9175805	Kings County
119749	Fee-for-Service	1538247358	1538247358	1	1	WINTER, JULIE A MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71460	01	General Practice	0	In state provider	None	3284 JEFFERSON ST	None	NAPA	CA	94558	3436	28	06055	38.32147532	-122.2994954	Napa County
119754	Fee-for-Service	1891889580	1891889580	1	1	WILSON, CHRISTINE	11/14/2006	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 MOORPARK RD	STE D	THOUSAND OAKS	CA	91360	4318	56	06111	34.182162	-118.878309	Ventura County
119813	Fee-for-Service	1548898620	1548898620	1	1	WONG, CELINA B MD	6/26/2023	390200000X	NA	Other	026	PHYSICIANS	183433	None	None	0	In state provider	None	600 N HIGHLAND SPRINGS A	None	BANNING	CA	92220	3046	33	06065	33.9316595	-116.9468639	Riverside County
119888	Fee-for-Service	1740234640	1740234640	1	1	WEIL, FRANKLIN B MD	11/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	23327	41	Internal Medicine	0	In state provider	None	2230 LYNN RD	STE 200	THOUSAND OAKS	CA	91360	1900	56	06111	34.20894685	-118.885185	Ventura County
119916	Fee-for-Service	1669082590	1669082590	1	1	WYLIE CENTER - A PSYCHOLOGIC	3/8/2021	103K00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	AL CORPORATION	4164 BROCKTON AVE	None	RIVERSIDE	CA	92501	3400	33	06065	33.98077024	-117.3813862	Riverside County
119924	Fee-for-Service	1871869743	1871869743	1	1	WEIANT, TIMOTHY A NP	6/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
119991	Fee-for-Service	1487834131	1487834131	1	1	WADHWANI, RITA R MD	1/11/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	97163	41	Internal Medicine	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	5409	01	06001	37.54866156	-121.9750739	Alameda County
120019	Fee-for-Service	1831979657	1831979657	1	1	WHOLE PERSON CARE MEDICAL GR	6/12/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	OUP INC.	1410 N GAREY AVE	None	POMONA	CA	91767	3810	19	06037	34.07202454	-117.7522105	Los Angeles County
120046	Fee-for-Service	1942757380	1942757380	1	1	WILLIAMS, KRYSTAL LMFT	6/24/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
120064	Fee-for-Service	1013922384	1013922384	1	1	WALGREEN CO	4/25/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3446 W BALL RD	None	ANAHEIM	CA	92804	3709	30	06059	33.81723147	-118.009845	Orange County
120099	Fee-for-Service	1154559110	1154559110	1	1	WOLAK, REBEKAH L MD	1/13/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	180920	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
120101	Fee-for-Service	1063496396	1063496396	2	1	WESTERN SIERRA MEDICAL	12/4/2013	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	29	06057	39.23512508	-121.0306878	Nevada County
120111	Fee-for-Service	1700561511	1700561511	1	1	WALSH, HEATHER	8/2/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
120128	Fee-for-Service	1730766460	1730766460	1	1	WORTH, CHARLES	8/16/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
120157	Fee-for-Service	1639640089	1639640089	1	1	WESTERN HEALTH RESOURCES	11/13/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1007 LIVE OAK BLVD	STE B3	YUBA CITY	CA	95991	3454	51	06101	39.14368281	-121.6207923	Sutter County
120164	Fee-for-Service	1568522928	1568522928	1	1	WCHS, INC	3/16/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	COLTON CLINICAL SERVICES	2775 E COOLEY DR	None	COLTON	CA	92324	6324	36	06071	34.06013641	-117.3042153	San Bernardino County
120203	Fee-for-Service	1669082590	1669082590	1	1	WYLIE CENTER - A PSYCHOLOGIC	3/8/2021	103K00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	AL CORPORATION	4164 BROCKTON AVE	None	RIVERSIDE	CA	92501	3400	33	06065	33.98077024	-117.3813862	Riverside County
120244	Fee-for-Service	1659712776	1659712776	1	1	WEIL, SAHAR NP	3/27/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
120277	Fee-for-Service	1225105455	1225105455	1	1	WONG, MICHAEL T MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67888	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
120282	Fee-for-Service	1437786001	1437786001	1	1	WANG, JOHN DO	2/10/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	23654	40	Pediatrics	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6919	38	06075	37.78610439	-122.421569	San Francisco County
120290	Fee-for-Service	1639229057	1639229057	2	1	WIGGINS HOMES LP	9/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	675 NORTH JAYE STREET	None	PORTERVILLE	CA	93257	2163	54	06107	36.07805415	-119.0263824	Tulare County
120390	Fee-for-Service	1669023453	1669023453	1	1	WEILL, ERIC D PT	8/11/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
120391	Fee-for-Service	1063496396	1063496396	2	1	WESTERN SIERRA MEDICAL	6/2/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	29	06057	39.23512508	-121.0306878	Nevada County
120406	Fee-for-Service	1578191516	1578191516	1	1	WHITAKER, ALJANEE MD	1/2/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180078	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
120436	Fee-for-Service	1396789905	1396789905	1	1	WHITNEY, WINSTON MD	9/30/1990	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	49478	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
120441	Fee-for-Service	1013078617	1013078617	1	1	WHITE, MATTHEW	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
120454	Fee-for-Service	1568522928	1568522928	1	1	WCHS, INC	5/1/1985	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	COLTON CLINICAL SERVICES	2775 E COOLEY DR	None	COLTON	CA	92324	6324	36	06071	34.06013641	-117.3042153	San Bernardino County
120541	Fee-for-Service	1013942986	1013942986	1	1	WESLEY, GEORGE W MD	4/28/1999	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54949	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1140 W LA VETA AVE	STE 640	ORANGE	CA	92868	4228	30	06059	33.7802984	-117.8651669	Orange County
120566	Fee-for-Service	1225105455	1225105455	1	1	WONG, MICHAEL T MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67888	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
120601	Fee-for-Service	1427403021	1427403021	1	1	WOOD, MONA MD	8/7/2020	207ZP0102X	NA	Other	026	PHYSICIANS	150913	22	Pathology (M.D. only)	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
120615	Fee-for-Service	1407533193	1407533193	1	1	WACHARA, JANE MUGENDITSA	5/15/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	500 GOLDEN SPRINGS DR	E	DIAMOND BAR	CA	91765	1458	19	06037	34.03146832	-117.7967956	Los Angeles County
120641	Fee-for-Service	1619094687	1619094687	1	1	WILBUR, BRUCE	2/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77764	08	Family Practice	0	In state provider	None	2585 SAMARITAN DR	None	SAN JOSE	CA	95124	4107	43	06085	37.25083752	-121.9503884	Santa Clara County
120672	Fee-for-Service	1043399199	1043399199	1	1	WILCOX, ANDREA MD	8/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	71126	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
120681	Fee-for-Service	1063496396	1063496396	2	1	WESTERN SIERRA MEDICAL	6/2/2010	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	29	06057	39.23512508	-121.0306878	Nevada County
120765	Fee-for-Service	1053326330	1053326330	1	1	WALGREEN CO.	6/10/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	191 E 3RD AVE	None	SAN MATEO	CA	94401	4012	41	06081	37.56505473	-122.3231627	San Mateo County
120773	Fee-for-Service	1922383587	1922383587	1	1	WONG, ROSIE M OD	7/29/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	477 E COLORADO BLVD	None	PASADENA	CA	91101	2024	19	06037	34.14587948	-118.140561	Los Angeles County
120827	Fee-for-Service	1790017622	1790017622	1	1	WALGREEN CO	10/5/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2417 SYCAMORE DR	None	SIMI VALLEY	CA	93065	2301	56	06111	34.279884	-118.743926	Ventura County
120835	Fee-for-Service	1851576490	1851576490	1	1	WILLIAMSON, SHERI	1/10/2017	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2289 OAK AVE	None	SANGER	CA	93657	1930	10	06019	36.72089004	-119.5694696	Fresno County
120843	Fee-for-Service	1336362920	1336362920	1	1	WIN, KHAING S MD	7/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110342	22	Pathology (M.D. only)	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
120854	Fee-for-Service	1285780197	1285780197	1	1	WASSEF, RAAFAT N MD	12/1/2003	207P00000X	NA	Other	026	PHYSICIANS	35462	08	Family Practice	0	In state provider	None	1477 SAN MARINO AVE	STE 2	SAN MARINO	CA	91108	2054	19	06037	34.12226254	-118.1064859	Los Angeles County
120887	Fee-for-Service	1518173749	1518173749	1	1	WOOD, STEVEN A OD	6/16/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2111 FULKERTH RD	None	TURLOCK	CA	95380	9515	50	06099	37.50939	-120.8729835	Stanislaus County
120898	Fee-for-Service	1538381322	1538381322	1	1	WOLCOTT, DEANE L MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	28538	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
120901	Fee-for-Service	1407533193	1407533193	1	1	WACHARA, JANE MUGENDITSA	5/15/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	500 GOLDEN SPRINGS DR	E	DIAMOND BAR	CA	91765	1458	19	06037	34.03146832	-117.7967956	Los Angeles County
120906	Fee-for-Service	1891852794	1891852794	1	1	WIETZMAN, JACK LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1392	43	06085	37.23418124	-121.7818366	Santa Clara County
120935	Fee-for-Service	1225186141	1225186141	1	1	WEESE, DOUGLAS S MD	9/30/1993	207R00000X	NA	Other	026	PHYSICIANS	78472	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
120941	Fee-for-Service	1720006398	1720006398	1	1	WILLIAMS, ALISA L MD INC	6/30/1989	174400000X	NA	Other	026	PHYSICIANS	60944	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4060 4TH AVE	STE 640	SAN DIEGO	CA	92103	2118	37	06073	32.75053673	-117.1616539	San Diego County
120966	Fee-for-Service	1063496396	1063496396	2	1	WESTERN SIERRA MEDICAL	6/2/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	29	06057	39.23512508	-121.0306878	Nevada County
121016	Fee-for-Service	1396977211	1396977211	1	1	WANG, SUSAN Y MD	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	115390	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
121079	Fee-for-Service	1568640860	1568640860	1	1	WESTERN HEALTH RESOURCES	1/1/2008	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	440 GREENFIELD AVE	SUITE B	HANFORD	CA	93230	3568	16	06031	36.32904	-119.6582155	Kings County
121104	Fee-for-Service	1376723676	1376723676	1	1	WILSHIRE ONCOLOGY MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GRP INC	935 S SUNSET AVE	None	WEST COVINA	CA	91790	3408	19	06037	34.06431388	-117.9431184	Los Angeles County
121107	Fee-for-Service	1255609509	1255609509	1	1	WALLMARK, JENNIFER M	12/16/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
121122	Fee-for-Service	1851576490	1851576490	1	1	WILLIAMSON, SHERI	9/13/2006	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2289 OAK AVE	None	SANGER	CA	93657	1930	10	06019	36.72089004	-119.5694696	Fresno County
121143	Fee-for-Service	1285780197	1285780197	1	1	WASSEF, RAAFAT N MD	12/1/2003	207P00000X	NA	Other	026	PHYSICIANS	35462	02	General Surgery	0	In state provider	None	1477 SAN MARINO AVE	STE 2	SAN MARINO	CA	91108	2054	19	06037	34.12226254	-118.1064859	Los Angeles County
121178	Fee-for-Service	1174765093	1174765093	1	1	WOLF, SKY J DO	4/3/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	11115	08	Family Practice	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
121182	Fee-for-Service	1073607305	1073607305	1	1	WEYANT, MICHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
121222	Fee-for-Service	1174607626	1174607626	1	1	WINDSTONE BEHAVIORAL HEALTH	4/20/2015	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	151 KALMUS DR	K2	COSTA MESA	CA	92626	5988	30	06059	33.67282141	-117.8824994	Orange County
121259	Fee-for-Service	1861851503	1861851503	1	1	WOODS CREEK PSYCHOLOGICAL GR	8/1/2016	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	OUP, APC	103 S FOREST RD	None	SONORA	CA	95370	4895	55	06109	37.98049475	-120.3898999	Tuolumne County
121283	Fee-for-Service	1043233158	1043233158	1	1	WONG, GREGORY T MD	6/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	69611	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
121327	Fee-for-Service	1295903706	1295903706	1	1	WONG, KELVIN L T MD	8/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98242	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
121369	Fee-for-Service	1568640860	1568640860	1	1	WESTERN HEALTH RESOURCES	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	440 GREENFIELD AVE	SUITE B	HANFORD	CA	93230	3568	16	06031	36.32904	-119.6582155	Kings County
121393	Fee-for-Service	1376723676	1376723676	1	1	WILSHIRE ONCOLOGY MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GRP INC	935 S SUNSET AVE	None	WEST COVINA	CA	91790	3408	19	06037	34.06431388	-117.9431184	Los Angeles County
121426	Fee-for-Service	1538317201	1538317201	1	1	WATANABE, STEPHANIE	5/11/2009	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	101 S 1ST ST	STE 1800	BURBANK	CA	91502	1938	19	06037	34.17942444	-118.3096895	Los Angeles County
121465	Fee-for-Service	1023167301	1023167301	1	1	WONG, WARREN U MD	6/21/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54369	08	Family Practice	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
121477	Fee-for-Service	1104378850	1104378850	1	1	WILLIAMS, CRYSTAL S LMFT	1/17/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3393 14TH ST STE A	None	RIVERSIDE	CA	92501	3857	33	06065	33.97447738	-117.3746729	Riverside County
121510	Fee-for-Service	1134459365	1134459365	1	1	WEI, DANIEL D MD	9/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110549	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
121543	Fee-for-Service	1851755649	1851755649	1	1	WASIK, KRAIG K	8/1/2019	207P00000X	NA	Other	026	PHYSICIANS	17357	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	6533	09	06017	38.72453536	-120.7921649	El Dorado County
121554	Fee-for-Service	1861851503	1861851503	1	1	WOODS CREEK PSYCHOLOGICAL GR	8/1/2016	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	OUP, APC	103 S FOREST RD	None	SONORA	CA	95370	4895	55	06109	37.98049475	-120.3898999	Tuolumne County
121595	Fee-for-Service	1619944824	1619944824	1	1	WAVERLY SURGERY CENTER	2/1/2006	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	400 FOREST AVE	None	PALO ALTO	CA	94301	2608	43	06085	37.44572845	-122.1576613	Santa Clara County
121660	Fee-for-Service	1154787968	1154787968	1	1	WEINGART, KIMBERLY R PHD	6/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5893 COPLEY DR	None	SAN DIEGO	CA	92111	7906	37	06073	32.84332697	-117.1728709	San Diego County
121733	Fee-for-Service	1639360878	1639360878	1	1	WEILL, D MICHAEL DPM	1/1/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	425 N LARCHMONT BLVD	None	LOS ANGELES	CA	90004	3013	19	06037	34.07825093	-118.3236691	Los Angeles County
121764	Fee-for-Service	1609845734	1609845734	1	1	WALSH, KEVIN J. MD	4/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5121 COTTONWOOD ST	None	MURRAY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
121769	Fee-for-Service	1003113663	1003113663	1	1	WALNUT VALLEY UNIFIED	7/27/2010	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOL DISTRICT	880 S LEMON AVE	None	WALNUT	CA	91789	2931	19	06037	33.9999117	-117.8550964	Los Angeles County
121800	Fee-for-Service	1992187355	1992187355	1	1	WEAVER, TAYLOR	4/29/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
121832	Fee-for-Service	1396270880	1396270880	1	1	WALKER, JACQUAE M MD	10/30/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169673	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
121876	Fee-for-Service	1710510375	1710510375	1	1	WISDOM HOME HEALTH INC	4/30/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	21032 DEVONSHIRE ST	STE 212	CHATSWORTH	CA	91311	2368	19	06037	34.25722053	-118.591857	Los Angeles County
121931	Fee-for-Service	1093906836	1093906836	1	1	WONG, MICHAEL J MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	10110	41	Internal Medicine	0	In state provider	None	1127 WILSHIRE BLVD	STE 903	LOS ANGELES	CA	90017	3910	19	06037	34.05270508	-118.2641005	Los Angeles County
121960	Fee-for-Service	1750678017	1750678017	1	1	WANG, HONGTAO MD	2/11/2022	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	168782	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
121980	Fee-for-Service	1154562551	1154562551	1	1	WANG, SANDY DO	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11635	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
122006	Fee-for-Service	1033267067	1033267067	1	1	WILLIAMSON, DOUGLAS J MD	10/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	79642	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
122076	Fee-for-Service	1053744912	1053744912	1	1	WANG, MICHAEL Z MD	5/20/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	156280	07	Dermatology	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
122141	Fee-for-Service	1831104116	1831104116	1	1	WALGREEN CO	9/12/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17010 CHATSWORTH ST	None	GRANADA HILLS	CA	91344	5844	19	06037	34.26477352	-118.503045	Los Angeles County
122145	Fee-for-Service	1497929343	1497929343	1	1	WICKHAM, MICHAEL Q MD	4/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	54729	22	Pathology (M.D. only)	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
122178	Fee-for-Service	1346557014	1346557014	1	4	WASHINGTON TOWNSHIP MEDICAL	10/10/2011	208G00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	FOUNDATION	39141 CIVIC CENTER DR	STE 335	FREMONT	CA	94538	5831	01	06001	37.55436307	-121.9764708	Alameda County
122184	Fee-for-Service	1710515036	1710515036	1	1	WELL-PLAY FAMILY COUNSELING,	8/14/2023	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	EING CENTER	1611 SOUTH PACIFIC COAST	307	REDONDO BEACH	CA	90277	5606	19	06037	33.81973754	-118.3853919	Los Angeles County
122218	Fee-for-Service	1093906836	1093906836	1	1	WONG, MICHAEL J MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	10110	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1127 WILSHIRE BLVD	STE 903	LOS ANGELES	CA	90017	3910	19	06037	34.05270508	-118.2641005	Los Angeles County
122249	Fee-for-Service	1336155704	1336155704	1	1	WALGREEN CO	3/9/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	WALGREENS #09742	2491 W 24TH ST	None	YUMA	AZ	85364	6153	00	None	32.683212	-114.6497265	Yuma County
122255	Fee-for-Service	1578834834	1578834834	1	1	WU, LIHONG MD INC	6/23/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	79643	68	Hematology	0	In state provider	None	10941 BLOOMFIELD STREET	SUITE A	LOS ALAMITOS	CA	90720	6702	30	06059	33.804234	-118.0632055	Orange County
122297	Fee-for-Service	1386677102	1386677102	1	1	WILLIAMS, LEON D MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111391	01	General Practice	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
122298	Fee-for-Service	1538403217	1538403217	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2701 SAVIERS RD	None	OXNARD	CA	93033	4517	56	06111	34.174584	-119.1795705	Ventura County
122304	Fee-for-Service	1407911878	1407911878	1	1	WIGLE, CHARLES E JR LMFT	11/30/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	282 LANDIS AVENUE	None	CHULA VISTA	CA	91910	2627	37	06073	32.64168665	-117.0812298	San Diego County
122320	Fee-for-Service	1912135930	1912135930	1	1	WALGREEN CO	8/28/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	30592 SANTA MARGARITA PK	STE B	RANCHO SANTA MARG	CA	92688	5802	30	06059	33.64345316	-117.597728	Orange County
122328	Fee-for-Service	1730558479	1730558479	1	1	WE CARE HOSPICE INC	7/14/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2333 MOWRY AVE	STE 220	FREMONT	CA	94538	1626	01	06001	37.55614438	-121.9822469	Alameda County
122357	Fee-for-Service	1891773024	1891773024	1	1	WILLIAM THOMAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	445 N SILVERBELL RD	STE 200	TUCSON	AZ	85745	2686	00	None	32.227632	-111.0001545	Pima County
122362	Fee-for-Service	1902646284	1902646284	1	1	WRIGHT, BRIANNE	3/7/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
122367	Fee-for-Service	1598805483	1598805483	1	1	WU, JACK C MD	7/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55337	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7500 HOSPITAL DR	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
122376	Fee-for-Service	1578790655	1578790655	1	1	WANG, DEHUA MD	9/8/2021	207ZP0213X	NA	Other	026	PHYSICIANS	128088	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
122378	Fee-for-Service	1891755567	1891755567	1	1	WRIGHT, WILLIAM J MD	2/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	81886	30	Radiology	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
122392	Fee-for-Service	1700988011	1700988011	1	1	WING, THOMAS W OD	9/15/1980	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6320 MACK RD	None	SACRAMENTO	CA	95823	4646	34	06067	38.472768	-121.4289405	Sacramento County
122400	Fee-for-Service	1023023314	1023023314	1	1	WALGREEN CO	11/7/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3570 ATLANTIC AVE	None	LONG BEACH	CA	90807	4516	19	06037	33.821568	-118.185003	Los Angeles County
122410	Fee-for-Service	1225155773	1225155773	1	1	WALKER, VANESSA J DO	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	5 MEDICAL PLAZA	190	ROSEVILLE	CA	95661	2867	31	06061	38.76604411	-121.2466761	Placer County
122448	Fee-for-Service	1306473087	1306473087	1	1	WANG, CHENG-LUN MD	10/25/2023	390200000X	NA	Other	026	PHYSICIANS	179597	None	None	0	In state provider	None	3160 FOLSOM BLVD.	STE 1400	SACRAMENTO	CA	91816	5219	34	06067	38.568393	-121.4658585	Sacramento County
122477	Fee-for-Service	1285804740	1285804740	1	1	WATERFRONT FITNESS AND NUTRI	5/7/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27725 SANTA MARGARITA PK	STE 210	MISSION VIEJO	CA	92691	6710	30	06059	33.65386492	-117.6476716	Orange County
122490	Fee-for-Service	1619029964	1619029964	1	1	WONG, SHI YIN A MEDICAL	3/29/2011	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CORPORATION	407 W COLLEGE ST	None	LOS ANGELES	CA	90012	2313	19	06037	34.06413934	-118.237719	Los Angeles County
122498	Fee-for-Service	1306164645	1306164645	1	1	WALDMAN, LYNN LCSW	10/11/2010	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2423 CAMINO DEL RIO S	STE 103	SAN DIEGO	CA	92108	3734	37	06073	32.76759179	-117.1387533	San Diego County
122545	Fee-for-Service	1578834834	1578834834	1	1	WU, LIHONG MD INC	6/23/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	79643	41	Internal Medicine	0	In state provider	None	10941 BLOOMFIELD STREET	SUITE A	LOS ALAMITOS	CA	90720	6702	30	06059	33.804234	-118.0632055	Orange County
122615	Fee-for-Service	1730558479	1730558479	1	1	WE CARE HOSPICE INC	7/14/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2333 MOWRY AVE	STE 220	FREMONT	CA	94538	1626	01	06001	37.55614438	-121.9822469	Alameda County
122621	Fee-for-Service	1992710289	1992710289	1	1	WALGREEN CO	11/1/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	58133 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	5801	36	06071	34.12845391	-116.395626	San Bernardino County
122721	Fee-for-Service	1821217845	1821217845	1	1	WHITE, KEITH C MD	4/30/1990	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	57666	40	Pediatrics	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
122767	Fee-for-Service	1730632357	1730632357	1	1	WALGREEN CO	9/1/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16482	1902 MARENGO ST	STE 105	LOS ANGELES	CA	90033	1317	19	06037	34.05770831	-118.2099519	Los Angeles County
122785	Fee-for-Service	1033297130	1033297130	1	1	WRIGHT, FRANCIS MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	71643	None	None	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
122830	Fee-for-Service	1578834834	1578834834	1	1	WU, LIHONG MD INC	6/23/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	79643	78	Neoplastic Diseases/Oncology	0	In state provider	None	10941 BLOOMFIELD STREET	SUITE A	LOS ALAMITOS	CA	90720	6702	30	06059	33.804234	-118.0632055	Orange County
122832	Fee-for-Service	1003250002	1003250002	1	1	WELLINGTON, KRISTEN M MD	8/4/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	133430	05	Anesthesiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
122834	Fee-for-Service	1568595965	1568595965	1	1	WILLIAMS, RICHARD S LMFT	6/25/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2020 COFFEE RD	STE H6	MODESTO	CA	95355	2416	50	06099	37.672569	-120.9757125	Stanislaus County
122846	Fee-for-Service	1760534671	1760534671	1	1	WELLS, JANICE R LCSW	11/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	22399	-	NOT APPLICABLE	0	In state provider	None	10 N SAN PEDRO ROAD	SUITE 1015, 1018, 1019	SAN RAFAEL	CA	94903	4155	21	06041	37.99529182	-122.5300426	Marin County
122940	Fee-for-Service	1750491023	1750491023	1	1	WEINZIMER, ROBERT DC	8/12/2024	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	535 H ST	None	CHULA VISTA	CA	91910	4301	37	06073	32.63175527	-117.0867242	San Diego County
122977	Fee-for-Service	1750822904	1750822904	1	1	WADA, PAUL MD	9/9/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	157786	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
123027	Fee-for-Service	1891744470	1891744470	1	1	WADDINGTON, THOMAS W MD	6/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81367	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
123033	Fee-for-Service	1790956779	1790956779	1	1	WILLIAMS, DANIEL A DO	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10678	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
123041	Fee-for-Service	1295049674	1295049674	1	1	WOOD, KEITH M MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137208	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
123055	Fee-for-Service	1568554939	1568554939	1	1	WALLING, ANNE M MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91084	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	STE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
123064	Fee-for-Service	1952317513	1952317513	1	1	WALGREEN CO	11/9/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2101 E HATCH RD	None	MODESTO	CA	95351	4814	50	06099	37.60926706	-120.9564749	Stanislaus County
123076	Fee-for-Service	1245426964	1245426964	2	1	WESTERN MEDICAL PHARMACY INC	11/2/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2426 W. 8TH STREET	SUITE 102	LOS ANGELES	CA	90057	3840	19	06037	34.05650917	-118.2815796	Los Angeles County
123142	Fee-for-Service	1205269727	1205269727	1	1	WAL-MART STORES, INC	7/17/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11822 GILBERT ST	None	GARDEN GROVE	CA	92841	2720	30	06059	33.790752	-117.964377	Orange County
123200	Fee-for-Service	1588807556	1588807556	1	1	WELLS, SYKI D MD	12/12/2018	208M00000X	NA	Other	026	PHYSICIANS	151511	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
123207	Fee-for-Service	1669545174	1669545174	1	1	WESTPHAL, KENNETH MD	2/1/2001	207ZP0102X	NA	Other	026	PHYSICIANS	59273	22	Pathology (M.D. only)	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
123229	Fee-for-Service	1720259872	1720259872	1	1	WARD, MICHAEL	4/14/2007	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	13203 HADLEY ST	STE 209	WHITTIER	CA	90601	4538	19	06037	33.98273153	-118.0347615	Los Angeles County
123246	Fee-for-Service	1942338892	1942338892	1	1	WITTENBERG, CARLA J NP	6/19/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
123263	Fee-for-Service	1366654238	1366654238	1	1	WOODLAND NEPHROLOGY	1/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	MEDICAL GROUP	520 COTTONWOOD ST	STE 2	WOODLAND	CA	95695	3603	57	06113	38.675016	-121.7933365	Yolo County
123310	Fee-for-Service	1831413400	1831413400	1	1	WEAH, MALON LORPU	1/15/2025	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1064 14TH ST	None	OAKLAND	CA	94607	2701	01	06001	37.80924387	-122.2843564	Alameda County
123315	Fee-for-Service	1427346154	1427346154	1	1	WHITE, XUANHA N DO MD	7/5/2018	207RC0200X	NA	Other	026	PHYSICIANS	16066	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
123317	Fee-for-Service	1891744470	1891744470	1	1	WADDINGTON, THOMAS W MD	6/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81367	41	Internal Medicine	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
123350	Fee-for-Service	1073946943	1073946943	1	1	WAVE IMAGING LLC	2/27/2015	106H00000X	NA	Mental Health Outpatient Services	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	4200 E PACIFIC COAST HWY	None	LONG BEACH	CA	90804	2107	19	06037	33.78981346	-118.1439033	Los Angeles County
123359	Fee-for-Service	1881600260	1881600260	1	1	WALGREEN CO	7/10/1990	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1130 BIRD AVE	None	SAN JOSE	CA	95125	1700	43	06085	37.3105694	-121.8949819	Santa Clara County
123439	Fee-for-Service	1346332954	1346332954	1	1	WYOMING MEDICAL CENTER	3/22/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1233 E 2ND ST	None	CASPER	WY	82601	2988	00	None	42.848307	-106.3082565	Natrona County
123443	Fee-for-Service	1851677553	1851677553	1	1	WANG, KEVIN K OD	10/24/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1721 WESTWIND DR	SUITE B	BAKERSFIELD	CA	93301	3026	15	06029	35.37519935	-119.0425415	Kern County
123473	Fee-for-Service	1356308159	1356308159	1	1	WEISS, LAWRENCE M MD	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	41422	22	Pathology (M.D. only)	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
123485	Fee-for-Service	1528486479	1528486479	1	1	WONG, KIMBERLY A MD	6/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139747	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
123487	Fee-for-Service	1467592733	1467592733	1	1	WEINBERG, ROBERT A MD	7/14/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	43861	40	Pediatrics	0	In state provider	#5A	24953 PASEO DE VALENCIA	None	LAGUNA HILLS	CA	92653	4342	30	06059	33.60028568	-117.7010887	Orange County
123495	Fee-for-Service	1962750562	1962750562	1	1	WHEELER MALENAB, BETHANY T	8/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
123512	Fee-for-Service	1336790641	1336790641	1	1	WILSON, ZAEKEYA OT	11/25/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8215 ROCHESTER AVE.	SUITE 110	RANCHO CUCAMONGA	CA	91730	0727	36	06071	34.10428657	-117.5456898	San Bernardino County
123557	Fee-for-Service	1306851670	1306851670	1	1	WALGREEN CO	10/20/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4172 N 1ST ST	None	FRESNO	CA	93726	4312	10	06019	36.79362	-119.772244	Fresno County
123600	Fee-for-Service	1831413400	1831413400	1	1	WEAH, MALON LORPU	1/15/2025	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1064 14TH ST	None	OAKLAND	CA	94607	2701	01	06001	37.80924387	-122.2843564	Alameda County
123620	Fee-for-Service	1447243811	1447243811	1	1	WY, TOMAS MD	11/8/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51576	None	None	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
123622	Fee-for-Service	1629114178	1629114178	1	1	WINDSOR HAMPTON CARE CTR LLC	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	442 E HAMPTON ST	None	STOCKTON	CA	95204	5519	39	06077	37.9752643	-121.2921419	San Joaquin County
123675	Fee-for-Service	1629098447	1629098447	1	1	WILSHIRE ONCOLOGY MED	5/28/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GRP INC	1910 ROYALTY DR	None	POMONA	CA	91767	3021	19	06037	34.07871356	-117.7454184	Los Angeles County
123702	Fee-for-Service	1093873614	1093873614	1	1	WOLF, V STUART MD APC	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	35960	41	Internal Medicine	0	In state provider	None	3625 MARTIN LUTHER KING	STE 9	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
123727	Fee-for-Service	1346332954	1346332954	1	1	WYOMING MEDICAL CENTER	3/22/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1233 E 2ND ST	None	CASPER	WY	82601	2988	00	None	42.848307	-106.3082565	Natrona County
123819	Fee-for-Service	1760478259	1760478259	1	1	WELLBORN, COLVIN C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	84666	20	Orthopedic Surgery	0	In state provider	MISSION ORTHO SURG SPORT	1201 E OCEAN AVE	STE B	LOMPOC	CA	93436	7082	42	06083	34.63888288	-120.4436487	Santa Barbara County
123863	Fee-for-Service	1083792808	1083792808	1	1	WHITTLE-RANDOLPH,BERNICE	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79818	08	Family Practice	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
123877	Fee-for-Service	1982654695	1982654695	1	1	WAGNER WIKLER, BONNIE R	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	DR BONNIE WAGNER	591 CAMINO DE LA REINA	STE 918	SAN DIEGO	CA	92108	3111	37	06073	32.76632791	-117.1616245	San Diego County
123922	Fee-for-Service	1669006037	1669006037	1	1	WOLFMAN, LISA H CCC-SLP	4/27/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
123927	Fee-for-Service	1205935988	1205935988	1	1	WONG, HAK P MD	6/30/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60841	01	General Practice	0	In state provider	None	4059 E OLYMPIC BLVD	None	LOS ANGELES	CA	90023	3330	19	06037	34.0189155	-118.187091	Los Angeles County
123962	Fee-for-Service	1629098447	1629098447	1	1	WILSHIRE ONCOLOGY MED	5/28/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GRP INC	1910 ROYALTY DR	None	POMONA	CA	91767	3021	19	06037	34.07871356	-117.7454184	Los Angeles County
123990	Fee-for-Service	1093873614	1093873614	1	1	WOLF, V STUART MD APC	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	35960	08	Family Practice	0	In state provider	None	3625 MARTIN LUTHER KING	STE 9	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
124043	Fee-for-Service	1497422539	1497422539	1	1	WALSH, JODI LCSW	11/20/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
124074	Fee-for-Service	1932270790	1932270790	1	1	WENGER, DENNIS R MD	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	41317	20	Orthopedic Surgery	0	In state provider	None	8001 FROST ST	None	SAN DIEGO	CA	92123	2746	37	06073	32.802147	-117.151371	San Diego County
124105	Fee-for-Service	1083717581	1083717581	1	1	WANG, ZHAO CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1673 W BROADWAY	STE 5B	ANAHEIM	CA	92802	1109	30	06059	33.82892153	-117.9403245	Orange County
124109	Fee-for-Service	1770905697	1770905697	1	1	WALDRON, AMY LMFT	2/20/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
124111	Fee-for-Service	1710906060	1710906060	1	1	WANG, XIA MD	5/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	92460	30	Radiology	0	In state provider	None	1524 MCHENRY AVENUE	SUITE 430	MODESTO	CA	95350	4567	50	06099	37.666233	-120.993933	Stanislaus County
124115	Fee-for-Service	1700087400	1700087400	1	1	WONG, SUZANNE K MD	8/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102152	30	Radiology	0	In state provider	None	400 PARNASSUA AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
124117	Fee-for-Service	1962454348	1962454348	1	1	WANG, STEVEN Y MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70517	05	Anesthesiology	0	In state provider	None	3939 J ST	STE 310	SACRAMENTO	CA	95819	3666	34	06067	38.570211	-121.45374	Sacramento County
124118	Fee-for-Service	1851943377	1851943377	1	2	WEBER TECH, INC.	10/11/2021	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	765 N MAIN ST	127	CORONA	CA	92880	1440	33	06065	33.892072	-117.5636837	Riverside County
124162	Fee-for-Service	1972598316	1972598316	1	1	WILSON, WILLIAM L MD	7/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	44872	05	Anesthesiology	0	In state provider	None	8881 FLETCHER PKWY	STE 360	LA MESA	CA	91942	6103	37	06073	32.78442148	-117.0073814	San Diego County
124164	Fee-for-Service	1194877613	1194877613	1	1	WILSON, BRIDGET M RN	3/1/2003	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
124172	Fee-for-Service	1245486984	1245486984	1	1	WANG, MICHELLE Z MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	104742	05	Anesthesiology	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
124227	Fee-for-Service	1245389659	1245389659	1	1	WONG, CHARLTON MD	8/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72453	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
124257	Fee-for-Service	1629253562	1629253562	1	1	WILSON, CAROLYN G	2/26/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
124276	Fee-for-Service	1093873614	1093873614	1	1	WOLF, V STUART MD APC	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	35960	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3625 MARTIN LUTHER KING	STE 9	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
124313	Fee-for-Service	1992021463	1992021463	1	1	WASHBURN, DESTRY G DO	5/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11909	41	Internal Medicine	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92552	3927	33	06065	33.912117	-117.195849	Riverside County
124326	Fee-for-Service	1548657745	1548657745	1	1	WATSON, SARAH N MD	10/7/2022	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	146852	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
124331	Fee-for-Service	1376704668	1376704668	1	1	WALKER, TRAVIS A MD	3/7/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	8731 W PICO BLVD	None	LOS ANGELES	CA	90035	2205	19	06037	34.05456946	-118.3824636	Los Angeles County
124368	Fee-for-Service	1366474033	1366474033	1	1	WU, THOMAS Y MD	4/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82939	30	Radiology	0	In state provider	None	2110 PROFESSIONAL DR	STE 100	ROSEVILLE	CA	95661	3752	31	06061	38.74234873	-121.2521259	Placer County
124369	Fee-for-Service	1154568277	1154568277	1	1	WERTZ, BARBARA L CRNA	6/13/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	5176 HILL RD E.	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
124391	Fee-for-Service	1215496088	1215496088	1	1	WARD, ALEX MD	6/6/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182409	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
124405	Fee-for-Service	1134130214	1134130214	1	1	WILLIAMS, LANCELOT L MD INC	9/1/2000	207L00000X	NA	Other	026	PHYSICIANS	46503	05	Anesthesiology	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
124407	Fee-for-Service	1184861163	1184861163	1	2	WHITE, JEFFREY W DR	7/29/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	352 COALINGA PLZ	None	COALINGA	CA	93210	1704	10	06019	36.14070253	-120.3617744	Fresno County
124421	Fee-for-Service	1861978819	1861978819	1	1	WAGNER, ANDREW T CRNA	12/17/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
124432	Fee-for-Service	1619673415	1619673415	1	1	WARDELL LARSON, JULIA G	5/18/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
124433	Fee-for-Service	1124687959	1124687959	1	1	WU, CRYSTAL K MD	6/30/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
124445	Fee-for-Service	1245247105	1245247105	1	1	WONG, DAVID M DO	1/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7751	08	Family Practice	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
124447	Fee-for-Service	1245619808	1245619808	1	1	WANNAMAKER, ERIC J MD	4/23/2021	390200000X	NA	Other	026	PHYSICIANS	171130	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
124451	Fee-for-Service	1144435876	1144435876	1	1	WEST, CRYSTAL C LMFT	10/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
124461	Fee-for-Service	1316058795	1316058795	1	1	WANDISAN AND ROSETE MED	5/17/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP	4600 S TRACY BLVD	STE 107	TRACY	CA	95377	8105	39	06077	37.698111	-121.4345315	San Joaquin County
124465	Fee-for-Service	1851318174	1851318174	1	1	WAL-MART STORES, INC	10/6/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101989	701 W CENTRAL AVE	None	LOMPOC	CA	93436	2829	42	06083	34.66090647	-120.465126	Santa Barbara County
124467	Fee-for-Service	1679836928	1679836928	1	1	WILLEY, MELISSA M OD	1/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 JULES STEIN PLAZA	1-340	LOS ANGELES	CA	90095	0001	19	06037	34.06489065	-118.4443287	Los Angeles County
124477	Fee-for-Service	1255405650	1255405650	1	1	WHATCOTT, SPENCER H OD	8/16/1991	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 MCHENRY AVE	STE 77	MODESTO	CA	95350	4318	50	06099	37.668681	-120.991734	Stanislaus County
124491	Fee-for-Service	1174787469	1174787469	1	1	WONG, GRACE K OD	3/27/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9428 VALLEY BLVD	STE 201	ROSEMEAD	CA	91770	1513	19	06037	34.0811223	-118.0635319	Los Angeles County
124504	Fee-for-Service	1487677944	1487677944	1	1	WHITE, RONALD L MD	2/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134516	05	Anesthesiology	0	In state provider	None	460 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13140416	-121.6141951	Sutter County
124517	Fee-for-Service	1518613678	1518613678	1	1	WIETZKE, MATTHEW OCS	11/8/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
124534	Fee-for-Service	1215910989	1215910989	1	1	WENDT, JOANNE J PHD	1/1/2000	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CLINICAL PSYCHOLOGIST IN	135 E 3RD AVE	STE B	ESCONDIDO	CA	92025	4252	37	06073	33.12022391	-117.0793824	San Diego County
124541	Fee-for-Service	1912307935	1912307935	1	1	WAL-MART STORES, INC	6/15/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1400 LEAD HILL BLVD	None	ROSEVILLE	CA	95661	2949	31	06061	38.7483256	-121.256596	Placer County
124590	Fee-for-Service	1639127954	1639127954	1	1	WAJDA, JEFFERY L DO	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13235	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
124621	Fee-for-Service	1497843932	1497843932	1	1	WATTS, GERALDINE A	12/19/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	43839 N 15TH ST WEST	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
124624	Fee-for-Service	1205896933	1205896933	1	1	WILCOX, WILLIAM R MD	8/24/2004	174400000X	NA	Other	026	PHYSICIANS	67651	40	Pediatrics	0	In state provider	None	1400 BRISTOL ST N	STE 240	NEWPORT BEACH	CA	92660	2981	30	06059	33.65928642	-117.8694286	Orange County
124643	Fee-for-Service	1477637783	1477637783	1	1	WOLFE, ANTHONY M MD	1/1/1979	207RN0300X	NA	Nephrology	026	PHYSICIANS	19347	45	Nephrology (Renal-Kidney)	0	In state provider	None	77 CASA ST	STE 204	SAN LUIS OBISPO	CA	93405	5882	40	06079	35.29306786	-120.6650709	San Luis Obispo County
124658	Fee-for-Service	1780001156	1780001156	1	1	WROE, PETER C MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140676	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
124693	Fee-for-Service	1538660360	1538660360	1	1	WU, NIKKI B CCC-SLP	3/23/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	21515 HAWTHORNE BLVD	STE G100	TORRANCE	CA	90503	6503	19	06037	33.83306687	-118.3530111	Los Angeles County
124700	Fee-for-Service	1932666849	1932666849	1	1	WHITAKER, MARY	11/1/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1860 PENNSYLVANIA AVE	SUITE 305	FAIRFIELD	CA	94533	3590	48	06095	38.261952	-122.0498745	Solano County
124712	Fee-for-Service	1831235290	1831235290	1	1	WINDSOR ROSEWOOD CARE CT	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1911 OAK PARK BLVD	None	PLEASANT HILL	CA	94523	4601	07	06013	37.93369052	-122.0746005	Contra Costa County
124737	Fee-for-Service	1174738553	1174738553	1	1	WU, XIPU JACK MD	11/27/2007	207R00000X	NA	Other	026	PHYSICIANS	69486	41	Internal Medicine	0	In state provider	None	18391 E COLIMA ROAD	#207	ROWLAND HEIGHTS	CA	91748	2730	19	06037	33.98844297	-117.9041666	Los Angeles County
124739	Fee-for-Service	1225105091	1225105091	1	1	WONG, IRENE T OD	8/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	765 W COLLEGE ST	None	LOS ANGELES	CA	90012	1181	19	06037	34.0661756	-118.2435934	Los Angeles County
124752	Fee-for-Service	1801948112	1801948112	1	1	WILDER, RICHARD MD	5/1/1995	2085R0001X	NA	Other	026	PHYSICIANS	70907	30	Radiology	0	In state provider	None	4501 X ST	STE G126	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
124765	Fee-for-Service	1740711134	1740711134	1	1	WIBISONO, YUDI DO	8/14/2020	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	18128	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
124787	Fee-for-Service	1710240106	1710240106	1	1	WADE, ALANA M MD	1/18/2022	2085R0204X	NA	Other	026	PHYSICIANS	149980	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
124794	Fee-for-Service	1871699520	1871699520	1	1	WEISS, MICHAEL A DO	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	5260	40	Pediatrics	0	In state provider	None	455 S MAIN STREET	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
124833	Fee-for-Service	1518974005	1518974005	2	1	WINN, VIRGINIA D MD	5/9/2024	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	65542	15	Obstetrics (D.O. only)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
124864	Fee-for-Service	1245676667	1245676667	1	1	WAL-MART STORES INC	7/22/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2121 IMPERIAL AVE	None	SAN DIEGO	CA	92102	3826	37	06073	32.7062565	-117.144432	San Diego County
124899	Fee-for-Service	1346255353	1346255353	1	1	WALGREEN CO	1/14/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 S SANDERSON AVE	None	HEMET	CA	92545	9047	33	06065	33.728832	-117.0066995	Riverside County
124902	Fee-for-Service	1619458841	1619458841	1	1	WIGGINS, ARIEL M LCSW	3/21/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
124930	Fee-for-Service	1477637783	1477637783	1	1	WOLFE, ANTHONY M MD	1/1/1979	207RN0300X	NA	Nephrology	026	PHYSICIANS	19347	41	Internal Medicine	0	In state provider	None	77 CASA ST	STE 204	SAN LUIS OBISPO	CA	93405	5882	40	06079	35.29306786	-120.6650709	San Luis Obispo County
124934	Fee-for-Service	1023399276	1023399276	1	1	WHITAKER, RICHARD N	9/30/2011	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	8283 GROVE AVE	SUITE 104	RANCHO CUCAMONGA	CA	91730	3138	36	06071	34.10380433	-117.6285116	San Bernardino County
124972	Fee-for-Service	1811976640	1811976640	1	1	WALTHOUR, CHRISTOPHER S	9/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52856	20	Orthopedic Surgery	0	In state provider	MD	1409 E BRIGGSMORE AVE	None	MODESTO	CA	95355	2707	50	06099	37.66742737	-120.9731413	Stanislaus County
124988	Fee-for-Service	1942423215	1942423215	1	1	WOODS, REINA M LCSW	10/2/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5256 MISSION BLVD	None	RIVERSIDE	CA	92509	4624	33	06065	33.99261717	-117.3987262	Riverside County
125024	Fee-for-Service	1356387781	1356387781	1	1	WENGER, ROGER S PHD	7/3/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11374 MOUNTAIN VIEW AVE	STE A	LOMA LINDA	CA	92354	3450	36	06071	34.0465275	-117.2436991	San Bernardino County
125037	Fee-for-Service	1841723863	1841723863	1	1	WONG, JOANNA C MD	7/8/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	172613	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
125040	Fee-for-Service	1801948112	1801948112	1	1	WILDER, RICHARD MD	5/1/1995	2085R0001X	NA	Other	026	PHYSICIANS	70907	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X ST	STE G126	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
125052	Fee-for-Service	1215355391	1215355391	1	1	WU, ABEL MD	2/12/2018	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	140015	13	Neurology (M.D. only)	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
125071	Fee-for-Service	1063812212	1063812212	1	1	WESTWOOD HEALTHCARE &	10/11/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTRE LP	12121 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2515	19	06037	34.04022957	-118.4640699	Los Angeles County
125103	Fee-for-Service	1164441895	1164441895	1	1	WILSON, EDWARD J MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69144	01	General Practice	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
125127	Fee-for-Service	1174559074	1174559074	1	1	WASSERBAUER, SARA M MD	8/15/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89620	41	Internal Medicine	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
125143	Fee-for-Service	1831728120	1831728120	1	1	WANG, ERIC K MD	8/20/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
125171	Fee-for-Service	1174188270	1174188270	1	1	WILLOW CREEK POST ACUTE LLC	2/26/2020	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	650 W ALLUVIAL AVE	None	CLOVIS	CA	93611	6716	10	06019	36.84478151	-119.7257805	Fresno County
125177	Fee-for-Service	1629272794	1629272794	1	1	WALGREEN CO	10/5/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3521 DEL PASO RD	None	SACRAMENTO	CA	95835	2800	34	06067	38.65608	-121.541625	Sacramento County
125188	Fee-for-Service	1861516007	1861516007	1	1	WALDROP, GARY DANIEL	5/1/2001	No Taxonomy Provided	NA	None	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	DAN'S OPTICAL	4601 SHASTA DAM BLVD	None	SHASTA LAKE	CA	96019	9413	45	06089	40.68050765	-122.3633233	Shasta County
125204	Fee-for-Service	1518272566	1518272566	1	1	WU, ERICA P MD	1/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120401	15	Obstetrics (D.O. only)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
125225	Fee-for-Service	1285605014	1285605014	1	1	WU, JIM Y MD	12/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51365	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
125229	Fee-for-Service	1407989908	1407989908	1	1	WILLIAMS, AMY J LCSW	5/9/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
125258	Fee-for-Service	1134389810	1134389810	1	1	WANG, CHARLES MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136871	41	Internal Medicine	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
125274	Fee-for-Service	1376517292	1376517292	1	1	WALKER, BRUCE J MD	11/16/2022	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	62652	None	None	0	In state provider	None	1145 E CLARK AVE STE I	None	SANTA MARIA	CA	93455	5171	42	06083	34.8650893	-120.4170345	Santa Barbara County
125275	Fee-for-Service	1669773206	1669773206	1	1	WEESE, TYSON J MD	11/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117507	08	Family Practice	0	In state provider	None	3800 DALE RD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
125292	Fee-for-Service	1184769853	1184769853	2	1	WELCOME PHARMACY INC	6/23/2017	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18379 PIONEER BLVD	None	ARTESIA	CA	90701	5532	19	06037	33.8649963	-118.0822695	Los Angeles County
125333	Fee-for-Service	1477545242	1477545242	1	1	WELCH, THOMAS W CRNA	2/11/2019	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
125334	Fee-for-Service	1871591917	1871591917	2	1	WOLFF, LINDA L	12/1/2002	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	6940 PACIFIC AVE	None	STOCKTON	CA	95207	2602	39	06077	38.01336589	-121.3212507	San Joaquin County
125340	Fee-for-Service	1003394594	1003394594	1	1	WALKER, MONTERYA D LCSW	12/5/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
125345	Fee-for-Service	1033113600	1033113600	1	1	WONG, MICHAEL C MD INC	4/17/2007	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	34771	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4282 GENESEE AVE	STE 201	SAN DIEGO	CA	92117	4964	37	06073	32.82092667	-117.1828683	San Diego County
125392	Fee-for-Service	1164441895	1164441895	1	1	WILSON, EDWARD J MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69144	41	Internal Medicine	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
125395	Fee-for-Service	1982933180	1982933180	1	1	WEST COAST UROLOGY	8/12/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	48911	None	None	0	In state provider	None	1901 HOLSER WALK	SUITE 310	OXNARD	CA	93036	2633	56	06111	34.22020891	-119.1546204	Ventura County
125433	Fee-for-Service	1679670327	1679670327	1	1	WITMAN, AMY B MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	77904	41	Internal Medicine	0	In state provider	None	310 SANTA FE DR	STE 209	ENCINITAS	CA	92024	5110	37	06073	33.038406	-117.285354	San Diego County
125473	Fee-for-Service	1669713608	1669713608	1	1	WARNER UNIFIED SCHOOL	3/15/2012	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	30951 HIGHWAY 79	None	WARNER SPRINGS	CA	92086	0008	37	06073	33.27514492	-116.6429946	San Diego County
125479	Fee-for-Service	1316278070	1316278070	1	1	WATTS-WHITE, PAULA MD	9/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	55408	40	Pediatrics	0	In state provider	None	635 ANDERSON ROAD	STE 12A	DAVIS	CA	95616	3505	57	06113	38.5487623	-121.7587554	Yolo County
125490	Fee-for-Service	1518272566	1518272566	1	1	WU, ERICA P MD	1/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120401	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
125505	Fee-for-Service	1629194634	1629194634	1	1	WANG, ROBERT C MD	9/30/1984	207NS0135X	NA	Dermatology	026	PHYSICIANS	38816	07	Dermatology	0	In state provider	None	210 N GARFIELD AVE	STE 302	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
125539	Fee-for-Service	1841794567	1841794567	2	1	WILSON, LAURA A MD	5/30/2024	207SG0201X	NA	Other	026	PHYSICIANS	165832	40	Pediatrics	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
125547	Fee-for-Service	1629655444	1629655444	1	1	WILSON, ALEXIS	1/16/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	317 S CARRILLO RD	None	OJAI	CA	93023	3604	56	06111	34.43910034	-119.2643768	Ventura County
125567	Fee-for-Service	1760450845	1760450845	2	2	WING, J GERALD OD	11/5/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1901 MITCHELL RD	STE C	CERES	CA	95307	2400	50	06099	37.60176287	-120.9387462	Stanislaus County
125569	Fee-for-Service	1942402110	1942402110	1	1	WHITESIDE, MICHAEL B MD	3/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152041	30	Radiology	0	In state provider	None	559 ABBOTT ST	None	SALINAS	CA	93901	4325	27	06053	36.66284132	-121.6420108	Monterey County
125601	Fee-for-Service	1861407157	1861407157	1	1	WALGREEN CO	3/5/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6325 FAIR OAKS BLVD	None	CARMICHAEL	CA	95608	4809	34	06067	38.616075	-121.329243	Sacramento County
125616	Fee-for-Service	1457038861	1457038861	1	1	WEI, GARY CRNA	11/27/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
125655	Fee-for-Service	1295296390	1295296390	1	1	WELLCARE PHARMACY LLC	6/17/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17530 HAWTHORNE BLVD	None	TORRANCE	CA	90504	3110	19	06037	33.8715988	-118.3523672	Los Angeles County
125708	Fee-for-Service	1629349410	1629349410	1	1	WIPFF, ERIN K NP	11/8/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
125787	Fee-for-Service	1881952679	1881952679	1	1	WORCESTER, LEYA E LCSW	10/26/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
125835	Fee-for-Service	1942391602	1942391602	1	1	WONG, ANGELA LIYAR MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70091	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
125864	Fee-for-Service	1356391239	1356391239	1	1	WOODRUFF, PRESCOTT G MD	12/18/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	84392	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
125865	Fee-for-Service	1043834302	1043834302	1	1	WATSON, LACEY E CNP	7/8/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2280 HARRISON AVE	SUITE B	EUREKA	CA	95501	3200	12	06023	40.78745765	-124.1396643	Humboldt County
125867	Fee-for-Service	1457341851	1457341851	2	3	WESTPAC LABS, INC.	9/12/2017	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	361 HOSPITAL ROAD	STE 222	NEWPORT BEACH	CA	92663	3512	30	06059	33.62579141	-117.9299554	Orange County
125887	Fee-for-Service	1891021671	1891021671	1	1	WAGNER, GWENDOLYNE M PHD	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	26282	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	None	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
125941	Fee-for-Service	1619036357	1619036357	1	1	WANG, XUNZHANG MD	4/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74544	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
125973	Fee-for-Service	1437513702	1437513702	1	1	WHITE, MICHELLE	5/27/2016	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	5558 CAPELLA PLACE	None	RANCHO CUCAMONGA	CA	91739	2279	36	06071	34.15318024	-117.5023393	San Bernardino County
125993	Fee-for-Service	1235140930	1235140930	1	1	WALLACE, SANDRA L MD	2/28/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	40391	77	Infectious Disease	0	In state provider	None	50 BELLEFONTAINE ST	STE 303	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
125995	Fee-for-Service	1992781389	1992781389	1	1	WARD, JUDY L CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
126047	Fee-for-Service	1487824942	1487824942	1	1	WIEDEMANN, GRETA A CRNA	2/17/2009	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
126151	Fee-for-Service	1356391239	1356391239	1	1	WOODRUFF, PRESCOTT G MD	12/18/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	84392	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
126172	Fee-for-Service	1861719742	1861719742	1	1	WILLIAMSON, ERIC M MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118441	13	Neurology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	SUITE 3000	LOS ANGELES	CA	90033	4606	19	06037	34.06269295	-118.2030006	Los Angeles County
126230	Fee-for-Service	1619036357	1619036357	1	1	WANG, XUNZHANG MD	4/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74544	41	Internal Medicine	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
126259	Fee-for-Service	1437513702	1437513702	1	1	WHITE, MICHELLE	5/27/2016	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	5558 CAPELLA PLACE	None	RANCHO CUCAMONGA	CA	91739	2279	36	06071	34.15318024	-117.5023393	San Bernardino County
126274	Fee-for-Service	1396163804	1396163804	1	1	WU-FIENBERG, YUEWEI MD	12/13/2024	208200000X	NA	General Surgery	026	PHYSICIANS	None	24	Plastic Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
126281	Fee-for-Service	1235140930	1235140930	1	1	WALLACE, SANDRA L MD	2/28/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	40391	41	Internal Medicine	0	In state provider	None	50 BELLEFONTAINE ST	STE 303	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
126310	Fee-for-Service	1053759233	1053759233	1	1	WHEATLEY, BENJAMIN M MD	1/23/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	170102	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
126363	Fee-for-Service	1063638252	1063638252	1	1	WARD, LISA A LCSW	12/10/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
126402	Fee-for-Service	1083139471	1083139471	1	1	WILBERDING, NICOLE PHD	8/11/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
126450	Fee-for-Service	1669982237	1669982237	1	1	WELLSPACE HEALTH	2/4/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	216 N LINCOLN WAY	SUITE 10	GALT	CA	95632	1715	34	06067	38.257623	-121.3008435	Sacramento County
126484	Fee-for-Service	1033351382	1033351382	1	1	WONG, FRANCIS D DO	1/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13370	None	None	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
126491	Fee-for-Service	1346940632	1346940632	1	1	WALTON, LISA M LMFT	10/13/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
126492	Fee-for-Service	1134359557	1134359557	1	1	WALGREEN CO	8/19/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #11261	520 PALMETTO AVE	None	PACIFICA	CA	94044	1842	41	06081	37.64899922	-122.4912289	San Mateo County
126511	Fee-for-Service	1346557014	1346557014	1	21	WASHINGTON TOWNSHIP MEDICAL	10/15/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	FOUNDATION	2287 MOWRY AVE	C	FREMONT	CA	94538	1622	01	06001	37.55664244	-121.9818434	Alameda County
126554	Fee-for-Service	1518065861	1518065861	1	1	WILSON, SAMUEL E MD	11/27/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	28352	02	General Surgery	0	In state provider	DEPT OF SURGERY	UCLA MEDICAL CENTER	None	LOS ANGELES	CA	90024	0000	19	06037	34.06531814	-118.44621	Los Angeles County
126566	Fee-for-Service	1659383891	1659383891	1	1	WEINER, JONATHAN M MD	1/1/1998	174400000X	NA	Other	026	PHYSICIANS	60499	41	Internal Medicine	0	In state provider	None	1355 S SAN PEDRO ST	None	LOS ANGELES	CA	90015	3117	19	06037	34.03243628	-118.2543121	Los Angeles County
126567	Fee-for-Service	1780699066	1780699066	1	1	WALGREEN CO	11/16/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	840 OAKDALE RD	None	MODESTO	CA	95355	4509	50	06099	37.654353	-120.957403	Stanislaus County
126579	Fee-for-Service	1649285925	1649285925	1	1	WALGREEN CO	1/20/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7787 SUNRISE BLVD	None	CITRUS HEIGHTS	CA	95610	2309	34	06067	38.706741	-121.2724305	Sacramento County
126581	Fee-for-Service	1194799890	1194799890	1	1	WILLIAM WESLEY BARNEY	6/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1380 E MEDICAL CENTER DR	None	ST GEORGE	UT	84790	2123	00	None	37.097622	-113.553828	Washington County
126600	Fee-for-Service	1801167887	1801167887	1	1	WANG, AILEEN	10/5/2023	207RE0101X	NA	Endocrinology	026	PHYSICIANS	131136	None	None	0	In state provider	None	355 ABBOTT STREET	200	SALINAS	CA	93901	4483	27	06053	36.66552031	-121.6439174	Monterey County
126606	Fee-for-Service	1013091396	1013091396	1	1	WANG, JAMES T MD	3/26/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	79462	07	Dermatology	0	In state provider	None	29833 SANTA MARGARITA PK	SUITE 100	RANCHO SANTA MARG	CA	92688	3619	30	06059	33.63792372	-117.6108629	Orange County
126617	Fee-for-Service	1811902141	1811902141	1	1	WALGREEN CO	8/2/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9031 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2046	19	06037	33.9038495	-118.1420904	Los Angeles County
126739	Fee-for-Service	1669982237	1669982237	1	1	WELLSPACE HEALTH	2/4/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	216 N LINCOLN WAY	SUITE 10	GALT	CA	95632	1715	34	06067	38.257623	-121.3008435	Sacramento County
126768	Fee-for-Service	1972522407	1972522407	1	1	WEINSTEIN, RICHARD L MD	2/1/1973	207R00000X	NA	Other	026	PHYSICIANS	33113	41	Internal Medicine	0	In state provider	None	2255 YGNACIO VALLEY RD	STE K	WALNUT CREEK	CA	94598	3349	07	06013	37.92242643	-122.0301696	Contra Costa County
126796	Fee-for-Service	1043620578	1043620578	1	1	WALSH, JEFFREY P MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139613	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
126797	Fee-for-Service	1346557014	1346557014	1	21	WASHINGTON TOWNSHIP MEDICAL	10/15/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	2287 MOWRY AVE	C	FREMONT	CA	94538	1622	01	06001	37.55664244	-121.9818434	Alameda County
126823	Fee-for-Service	1083950018	1083950018	1	1	WESTRA, DAVID L MD A	3/4/2013	207T00000X	NA	General Surgery	026	PHYSICIANS	93870	14	Neurological Surgery	0	In state provider	PROFESSIONAL CORPORATION	168 N BRENT ST	STE 408	VENTURA	CA	93003	2817	56	06111	34.27448266	-119.2572489	Ventura County
126828	Fee-for-Service	1750423539	1750423539	1	1	WHITMAN, MARK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5633 N LIDGERWOOD ST	None	SPOKANE	WA	99208	1224	00	None	47.709423	-117.406944	Spokane County
126840	Fee-for-Service	1073575114	1073575114	1	1	WEBER,QUINN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3460 S PIONEER PKWY	None	WEST VALLEY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
126861	Fee-for-Service	1184795536	1184795536	1	1	WU, TZUHAO	11/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95897	None	None	0	In state provider	None	200 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.56922202	-121.969682	Alameda County
126866	Fee-for-Service	1487309241	1487309241	1	1	WEQURE INC.	10/1/2022	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2083 COMPTON AVE	203	CORONA	CA	92881	7283	33	06065	33.848091	-117.536172	Riverside County
126897	Fee-for-Service	1104028380	1104028380	1	1	WILSON, PAUL N MD	8/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112847	05	Anesthesiology	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
126920	Fee-for-Service	1508889932	1508889932	1	1	WEINTZ, ERIC MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75465	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
127002	Fee-for-Service	1548006141	1548006141	1	1	WAKEFIELD, CHANTAL M	7/16/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
127033	Fee-for-Service	1376800318	1376800318	1	1	WOODBURY, BLAIR J MD	3/3/2021	207P00000X	NA	Other	026	PHYSICIANS	171038	None	None	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
127052	Fee-for-Service	1386728954	1386728954	1	1	WINTERS, BRUCE A MD	7/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	26894	18	Ophthalmology	0	In state provider	None	1212 COLOMA WAY	None	ROSEVILLE	CA	95661	4646	31	06061	38.73674675	-121.2709264	Placer County
127108	Fee-for-Service	1598034084	1598034084	1	2	WILLIAMS, CHERMEL LMFT	4/13/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9033 BASELINE ROAD	M	RANCHO CUCAMONGA	CA	91730	1157	36	06071	34.12151248	-117.6080805	San Bernardino County
127125	Fee-for-Service	1548549165	1548549165	1	1	WARAICH, AMNA M MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	118041	40	Pediatrics	0	In state provider	None	ROSS AND IMPERIAL AVE	None	EL CENTRO	CA	92243	4398	13	06025	32.781483	-115.5696885	Imperial County
127146	Fee-for-Service	1306253315	1306253315	1	1	WALKER, EMILY M NP	6/21/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
127160	Fee-for-Service	1821280983	1821280983	1	1	WILKERSON, CARA LMFT	10/23/2018	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	54470 MARIAN VIEW DR	None	IDYLLWILD	CA	92549	0001	33	06065	33.74130353	-116.7112054	Riverside County
127186	Fee-for-Service	1811268063	1811268063	1	1	WEBER, LAI	7/18/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
127193	Fee-for-Service	1346269420	1346269420	1	1	WILLIAMS-LIJBERS, GRETTA M	5/16/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	611 ABBOTT ST	100	SALINAS	CA	93901	4389	27	06053	36.66192801	-121.6413283	Monterey County
127199	Fee-for-Service	1912297961	1912297961	1	1	WALL, ANJI E MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143537	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
127231	Fee-for-Service	1437315967	1437315967	1	1	WONG, DONOVAN A MD	11/26/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	103766	-	NOT APPLICABLE	0	In state provider	None	4760 S SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	19	06037	34.00134941	-118.4039837	Los Angeles County
127247	Fee-for-Service	1871660704	1871660704	1	1	WILLIS, ROSETTA L MD	11/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	36060	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
127249	Fee-for-Service	1376645663	1376645663	1	1	WONG, JANIS	11/1/1994	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 E BIDWELL ST	STE 101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
127274	Fee-for-Service	1518412865	1518412865	1	1	WARREN, SARAH N CRNA	8/23/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
127366	Fee-for-Service	1184702342	1184702342	1	1	WOOD, KARYN D PT	12/1/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1252 BROADWAY	SUITE B	PLACERVILLE	CA	95667	5806	09	06017	38.73128098	-120.7852781	El Dorado County
127378	Fee-for-Service	1326332545	1326332545	1	1	WILKINSON, ROBERT D DO	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
127387	Fee-for-Service	1538823760	1538823760	1	1	WAGNER, AMELIE C MD	7/29/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176166	08	Family Practice	0	In state provider	None	40700 CALIFORNIA OAKS RD	STE 208	MURRIETA	CA	92562	5789	33	06065	33.57067363	-117.2045035	Riverside County
127408	Fee-for-Service	1710102777	1710102777	1	1	WATSON, JOHN W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38792	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
127435	Fee-for-Service	1881011328	1881011328	1	1	WU YOUNG, MIMI MD	8/14/2023	208200000X	NA	General Surgery	026	PHYSICIANS	188308	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
127468	Fee-for-Service	1730301656	1730301656	1	1	WENG, PATRICIA L MD	11/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56152	45	Nephrology (Renal-Kidney)	0	In state provider	None	10833 LE CONTE AVE	SUITE 265	LOS ANGELES	CA	90095	0001	19	06037	34.06373445	-118.443537	Los Angeles County
127489	Fee-for-Service	1881685527	1881685527	1	1	WESTERN RADIATION	1/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONCOLOGY, INC	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
127507	Fee-for-Service	1619798758	1619798758	1	1	WONG, CARLY OT	3/18/2025	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	423 IMPERIAL HWY	None	FULLERTON	CA	92835	1146	30	06059	33.91749052	-117.925452	Orange County
127533	Fee-for-Service	1558768309	1558768309	1	1	WONG, BARRY S DO	7/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14004	None	None	0	In state provider	None	9089 BASELINE ROAD	SUITE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
127640	Fee-for-Service	1518232958	1518232958	1	1	WOOD, MATTHEW D MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130198	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
127719	Fee-for-Service	1215954532	1215954532	1	1	WAL-MART STORES, INC	10/4/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101972	2700 LAS POSITAS RD	None	LIVERMORE	CA	94551	9619	01	06001	37.69865039	-121.7679925	Alameda County
127756	Fee-for-Service	1730301656	1730301656	1	1	WENG, PATRICIA L MD	11/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56152	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	SUITE 265	LOS ANGELES	CA	90095	0001	19	06037	34.06373445	-118.443537	Los Angeles County
127770	Fee-for-Service	1912912296	1912912296	1	1	WALGREEN COMPANY	1/17/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8770 W PICO BLVD	None	LOS ANGELES	CA	90035	2211	19	06037	34.05467857	-118.3832934	Los Angeles County
127776	Fee-for-Service	1407919624	1407919624	1	1	WELLS, SUZAN G CNM	4/27/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2189	49	06097	38.471625	-122.7259935	Sonoma County
127784	Fee-for-Service	1649208638	1649208638	1	1	WALLACE KECSKES, DIANE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74951	01	General Practice	0	In state provider	None	732 N RUSSELL AVE	None	CLOVIS	CA	93611	0329	10	06019	36.84373622	-119.6967329	Fresno County
127791	Fee-for-Service	1154650927	1154650927	1	1	WASHBURN, JENNIFER M CNP	10/28/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
127845	Fee-for-Service	1477021764	1477021764	1	1	WARBURTON, ROBERT NP	3/15/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
127899	Fee-for-Service	1376766477	1376766477	1	1	WAGNER, TRACEY	4/25/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
127982	Fee-for-Service	1619194743	1619194743	1	1	WEISSMAN, BARBARA Y S MD	5/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72285	36	Psychiatry	0	In state provider	None	751 S BASCOM	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
127988	Fee-for-Service	1780815654	1780815654	1	1	WALGREEN CO	12/6/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16100 VENTURA BLVD	None	ENCINO	CA	91436	2502	19	06037	34.1563861	-118.484096	Los Angeles County
127995	Fee-for-Service	1326483363	1326483363	1	2	WOLESKY, CHRISTIANNE M LCSW	10/26/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	802 MAGNOLIA AVE	STE 207	CORONA	CA	92879	3157	33	06065	33.8596449	-117.5529774	Riverside County
127996	Fee-for-Service	1578727756	1578727756	1	1	WONG, MELISSA C MD	10/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110373	08	Family Practice	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
128008	Fee-for-Service	1104866383	1104866383	1	1	WALLMAN, JAMES K	2/28/1988	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	64273	30	Radiology	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
128022	Fee-for-Service	1477804862	1477804862	1	1	WAL-MART STORES, INC	12/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2735 E EASTLAND CNT DR	None	WEST COVINA	CA	91791	1622	19	06037	34.07391899	-117.885447	Los Angeles County
128032	Fee-for-Service	1427229467	1427229467	1	1	WILCOX, ROBERT E	10/30/2007	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	4165 REGENTS PARK ROW	STE 265	LA JOLLA	CA	92037	1417	37	06073	32.87298741	-117.2164541	San Diego County
128043	Fee-for-Service	1558737320	1558737320	1	1	WEST HILLS PATHOLOGY	3/14/2016	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CONSULTANTS	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
128077	Fee-for-Service	1467073999	1467073999	1	1	WONG, FELIX K OD	6/23/2023	390200000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	720 MAGNOLIA AVENUE	SUITE A-4	CORONA	CA	92879	3119	33	06065	33.8581661	-117.5555574	Riverside County
128121	Fee-for-Service	1013013317	1013013317	1	1	WEISS, IRWIN K MD	11/30/1991	2080P0203X	NA	Other	026	PHYSICIANS	74628	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
128134	Fee-for-Service	1851455372	1851455372	1	1	WILLIAMS, CHARLES W CNS	3/1/2003	No Taxonomy Provided	NA	None	085	CLINICAL NURSE SPECIALIST X-OVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	5040 BRABANT CT	None	ELK GROVE	CA	95757	3295	34	06067	38.399958	-121.446936	Sacramento County
128165	Fee-for-Service	1215010731	1215010731	1	1	WU, JOSEPH C MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	51572	36	Psychiatry	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
128220	Fee-for-Service	1912028572	1912028572	1	1	WALDO, PATRICIA G LMFT	10/17/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5767 HILLVIEW PARK AVE	None	VAN NUYS	CA	91401	4019	19	06037	34.17516846	-118.424313	Los Angeles County
128258	Fee-for-Service	1093002024	1093002024	1	1	WEISS, SOL MD INC	1/1/1979	193400000X	NA	Other	026	PHYSICIANS	29165	08	Family Practice	0	In state provider	None	22030 SHERMAN WAY	STE 118	CANOGA PARK	CA	91303	1891	19	06037	34.20099551	-118.6071615	Los Angeles County
128312	Fee-for-Service	1932287539	1932287539	1	1	WYSS, STEPHAN P MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52389	36	Psychiatry	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
128313	Fee-for-Service	1518034735	1518034735	1	1	WONG, JOHNNY TZY K MD	10/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	80091	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
128329	Fee-for-Service	1730354820	1730354820	1	1	WULFSTAT, AMANDA A MD	4/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103634	41	Internal Medicine	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
128339	Fee-for-Service	1316120157	1316120157	1	1	WALIA, SUKHPREET S MD	4/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100753	41	Internal Medicine	0	In state provider	None	11234 ANDERSON ST	STE 1405	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
128342	Fee-for-Service	1508408717	1508408717	1	1	WHITEHOUSE, DAILEY LCSW	2/15/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
128376	Fee-for-Service	1487662276	1487662276	1	1	WANG, NEIL P N DO	1/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89521	3861	00	None	39.52483792	-119.7968314	Washoe County
128389	Fee-for-Service	1851449870	1851449870	1	1	WIDJAJA, ROFINA MD	4/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93499	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
128434	Fee-for-Service	1811262959	1811262959	1	1	WANG, ERIC D MD	7/12/2020	390200000X	NA	Other	026	PHYSICIANS	127787	24	Plastic Surgery	0	In state provider	None	101 THE CITY DR S	BLDG 55	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
128452	Fee-for-Service	1194187393	1194187393	1	1	WU, ANDREW H MD	12/2/2020	207L00000X	NA	Other	026	PHYSICIANS	152118	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
128463	Fee-for-Service	1003809765	1003809765	1	1	WILSON, LISHA L MD	4/28/2009	207R00000X	NA	Other	026	PHYSICIANS	73584	41	Internal Medicine	0	In state provider	None	1025 HOWARD ST	None	SAN FRANCISCO	CA	94103	2823	38	06075	37.77917967	-122.4078176	San Francisco County
128536	Fee-for-Service	1437738655	1437738655	1	1	WANG, YUN MD	5/6/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
128556	Fee-for-Service	1083669675	1083669675	1	1	WRENCH, JOHN D MD	10/16/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70652	30	Radiology	0	In state provider	None	345 S A ST	None	OXNARD	CA	93030	5804	56	06111	34.19938431	-119.1786013	Ventura County
128589	Fee-for-Service	1326200247	1326200247	1	1	WORKMAN, JOHN J MD	7/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109313	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
128599	Fee-for-Service	1609856426	1609856426	1	1	WOOD, TERRY D MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54832	18	Ophthalmology	0	In state provider	None	11370 ANDERSON STREET	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
128600	Fee-for-Service	1124734116	1124734116	1	1	WRIGHT, NANCY	2/17/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
128657	Fee-for-Service	1205869195	1205869195	1	1	WHEEER, CHRISTINE A MD	8/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	43774	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	RM B186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
128666	Fee-for-Service	1376691238	1376691238	1	1	WU, CARSON J MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	62435	30	Radiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
128671	Fee-for-Service	1962990523	1962990523	1	1	WELLS, JEFF MD	3/25/2021	207P00000X	NA	Other	026	PHYSICIANS	167283	None	None	0	In state provider	None	1303 EAST HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
128678	Fee-for-Service	1043210578	1043210578	1	1	WANG, MATTHEW S MD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	14785 JEFFREY RD	STE 107	IRVINE	CA	92618	0410	30	06059	33.68773634	-117.7707575	Orange County
128723	Fee-for-Service	1922417518	1922417518	1	1	WONG, THOMAS W OD	9/21/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND ST	STE 2	POMONA	CA	91766	2007	19	06037	34.05845654	-117.7423951	Los Angeles County
128731	Fee-for-Service	1871956193	1871956193	1	1	WINKLER, AARON E MD	7/30/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	168571	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
128776	Fee-for-Service	1760788095	1760788095	1	1	WEEKS, ANDREW C MD	11/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	158457	01	General Practice	0	In state provider	None	513 PARNASSUS AVE	S738	SAN FRANCISCO	CA	94143	0476	38	06075	37.76344756	-122.4581992	San Francisco County
128778	Fee-for-Service	1427050830	1427050830	1	1	WEIDOFF, PAUL M JR MD	5/18/1999	207L00000X	NA	Other	026	PHYSICIANS	55182	05	Anesthesiology	0	In state provider	None	3939 J ST	STE 310	SACRAMENTO	CA	95819	3666	34	06067	38.570211	-121.45374	Sacramento County
128805	Fee-for-Service	1831644004	1831644004	1	1	WANG, JESSICA A MD	10/30/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184694	08	Family Practice	0	In state provider	None	15503 VENTURA BLVD	240, 340, 350	ENCINO	CA	91436	3115	19	06037	34.15483303	-118.4722163	Los Angeles County
128865	Fee-for-Service	1043225311	1043225311	1	1	WALGREEN CO	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2238 WESTBOROUGH BLVD	None	S SAN FRANCISCO	CA	94080	5405	41	06081	37.64408241	-122.4516996	San Mateo County
128966	Fee-for-Service	1093745523	1093745523	1	1	WRONG, BARON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CASTLE MEDICAL CENTER	640 ULUKAHIKI STREET	None	KAILUA	HI	96734	4454	00	None	21.38090913	-157.758388	Honolulu County
128975	Fee-for-Service	1285020123	1285020123	1	2	WILSON, MAUD	8/28/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	144243	40	Pediatrics	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
128999	Fee-for-Service	1659605475	1659605475	1	1	WESTHOUT, FRANKLIN D MD	11/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	109577	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
129001	Fee-for-Service	1245429257	1245429257	1	1	WIENS, ELIZABETH M LCSW	1/23/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	801 TRAEGER AVE	STE 209	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
129045	Fee-for-Service	1114621745	1114621745	1	1	WARTMAN, ELICIA C PHD	12/3/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
129050	Fee-for-Service	1396869327	1396869327	1	1	WALSH, LANCE P MD	5/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98108	34	Urology and Urological Surgery	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
129057	Fee-for-Service	1659456507	1659456507	1	1	WALGREEN CO	3/15/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	800 E LUGONIA AVE	None	REDLANDS	CA	92374	2550	36	06071	34.07000118	-117.1731789	San Bernardino County
129065	Fee-for-Service	1770548562	1770548562	1	1	WILLIAMS, JOHN C DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1950 ROSALINE AVE	None	REDDING	CA	96001	2543	45	06089	40.57330004	-122.3943613	Shasta County
129068	Fee-for-Service	1972987840	1972987840	1	1	WONG, JAMES R MD	9/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146930	41	Internal Medicine	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91346	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
129092	Fee-for-Service	1831644004	1831644004	1	1	WANG, JESSICA A MD	10/30/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184694	41	Internal Medicine	0	In state provider	None	15503 VENTURA BLVD	240, 340, 350	ENCINO	CA	91436	3115	19	06037	34.15483303	-118.4722163	Los Angeles County
129093	Fee-for-Service	1881609188	1881609188	1	1	WESMAN, ROBERT M MD	12/31/1980	174400000X	NA	Other	026	PHYSICIANS	29964	04	Otology, Laryngology, Rhinology	0	In state provider	None	744 52ND ST	STE 4200	OAKLAND	CA	94609	1810	01	06001	37.83734299	-122.2677613	Alameda County
129101	Fee-for-Service	1134269723	1134269723	1	1	WESTPHAL, LYNN M MD	4/30/1988	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	63611	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
129131	Fee-for-Service	1093951949	1093951949	1	1	WALKER, GRAHAM A MD	8/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115729	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
129135	Fee-for-Service	1306273206	1306273206	1	1	WECARE REHAB SERVICES INC	11/19/2021	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
129173	Fee-for-Service	1134185093	1134185093	1	1	WEST, WILLIAM MD	7/29/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	16204	40	Pediatrics	0	In state provider	None	2333 N CALIFORNIA ST	None	STOCKTON	CA	95204	5531	39	06077	37.97483395	-121.2908171	San Joaquin County
129181	Fee-for-Service	1427063197	1427063197	1	1	WASSEF, EZZAT W MD INC	4/27/1999	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	30443	20	Orthopedic Surgery	0	In state provider	None	5750 DOWNEY AVE	STE 308	LAKEWOOD	CA	90712	1482	19	06037	33.859611	-118.1511435	Los Angeles County
129216	Fee-for-Service	1467546721	1467546721	1	1	WEISS, JOHN H MD	6/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	53094	13	Neurology (M.D. only)	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
129218	Fee-for-Service	1336156330	1336156330	1	1	WALGREEN CO	2/15/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	965 GENEVA AVE	None	SAN FRANCISCO	CA	94112	3423	38	06075	37.71584494	-122.4397176	San Francisco County
129225	Fee-for-Service	1831681774	1831681774	1	1	WANG, KEVIN MD	8/19/2021	208M00000X	NA	Other	026	PHYSICIANS	164220	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
129243	Fee-for-Service	1023015906	1023015906	1	1	WALKER, MICHAEL D MD	1/1/1982	261Q00000X	NA	Other	026	PHYSICIANS	36377	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
129259	Fee-for-Service	1114968393	1114968393	1	3	WONG, JACQUELINE C MD	2/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	84867	41	Internal Medicine	0	In state provider	None	610 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1186	19	06037	34.06881064	-118.1228976	Los Angeles County
129298	Fee-for-Service	1164626057	1164626057	1	1	WHITE, JAMES F LMFT	7/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	399 E HIGHLAND AVE	STE 401	SAN BERNARDINO	CA	92402	3862	36	06071	34.1358627	-117.2757898	San Bernardino County
129358	Fee-for-Service	1720542293	1720542293	1	1	WONCIK, AUDREY	11/16/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4434 HARDING AVE	None	LOS ANGELES	CA	90066	6123	19	06037	33.99345856	-118.4253359	Los Angeles County
129413	Fee-for-Service	1114279080	1114279080	1	1	WARREN, JASON R MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117866	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
129434	Fee-for-Service	1114346582	1114346582	1	1	WALKER, MALIKEA D LCSW	5/4/2016	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	621 W 2ND STREET	SUITE 260	ANTIOCH	CA	94509	1282	07	06013	38.01684704	-121.8141311	Contra Costa County
129452	Fee-for-Service	1154300929	1154300929	1	1	WITTENBERG, HUNT KEITH	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	333 N SMITH AVE	None	ST PAUL	MN	55102	0000	00	None	44.94251219	-93.1074995	Ramsey County
129479	Fee-for-Service	1083217574	1083217574	1	1	W GROUP MARRIAGE AND FAMILY	1/11/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	COUNSELING, CORP	3711 LONG BEACH BLVD	# 4001	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
129496	Fee-for-Service	1881097095	1881097095	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	280 NEWPORT CENTER DR	STE 100	NEWPORT BEACH	CA	92660	7541	30	06059	33.610266	-117.8727975	Orange County
129530	Fee-for-Service	1215953013	1215953013	1	1	WU, JENNIFER J MD	12/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	54702	01	General Practice	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
129531	Fee-for-Service	1821222878	1821222878	1	1	WALI, HASSIB MD	12/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151018	41	Internal Medicine	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
129568	Fee-for-Service	1912900499	1912900499	1	1	WALHOF, DEBRA S MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69664	40	Pediatrics	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
129578	Fee-for-Service	1356497168	1356497168	1	1	WALRATH, BENJAMIN D MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145052	66	Emergency Medicine (Urgent Care)	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
129599	Fee-for-Service	1932322096	1932322096	1	1	WHITTAKER, BEN D	4/20/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
129624	Fee-for-Service	1760508881	1760508881	1	1	WEIGENSBERG, MARC J MD	7/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	70460	40	Pediatrics	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1083	19	06037	34.05855992	-118.209755	Los Angeles County
129627	Fee-for-Service	1023219789	1023219789	1	1	WESTERN LIVING CONCEPTS	6/20/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	247 TREADWAY DR	None	CLOVERDALE	CA	95425	4401	49	06097	38.78252946	-123.0165332	Sonoma County
129639	Fee-for-Service	1285841437	1285841437	2	1	WAHAB, RAED A MD	10/1/2021	207RC0200X	NA	Other	026	PHYSICIANS	161771	None	None	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
129647	Fee-for-Service	1720542293	1720542293	1	1	WONCIK, AUDREY	11/16/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4434 HARDING AVE	None	LOS ANGELES	CA	90066	6123	19	06037	33.99345856	-118.4253359	Los Angeles County
129772	Fee-for-Service	1275065039	1275065039	1	1	WONG, WESLEY O MD	6/11/2020	390200000X	NA	Other	026	PHYSICIANS	158779	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
129774	Fee-for-Service	1750524674	1750524674	1	1	WRIGHTSMAN, DANIEL L MFT	7/5/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52398	-	NOT APPLICABLE	0	In state provider	None	5900 STATE FARM DRIVE	SUITE 200	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
129793	Fee-for-Service	1700227931	1700227931	1	1	WANG, SHIRLEY L MD	8/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142943	01	General Practice	0	In state provider	None	2220 E FIRST ST	None	LOS ANGELES	CA	90033	3902	19	06037	34.04441482	-118.2116257	Los Angeles County
129817	Fee-for-Service	1114968393	1114968393	1	4	WONG, JACQUELINE C MD	2/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	84867	41	Internal Medicine	0	In state provider	None	416 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1296	19	06037	34.066746	-118.1228545	Los Angeles County
129835	Fee-for-Service	1497783708	1497783708	1	1	WEBBER, DOUGLAS A MD INC	11/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	83278	41	Internal Medicine	0	In state provider	None	3171 LOS FELIZ BLVD	STE 309	LOS ANGELES	CA	90039	1537	19	06037	34.12369709	-118.2682266	Los Angeles County
129861	Fee-for-Service	1497569693	1497569693	1	1	WEAVER, ANDREA R BIRTH DOULA	3/24/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
129906	Fee-for-Service	1821006552	1821006552	1	1	WHALEY, LAWRENCE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2700 E BROAD ST	None	MANSFIELD	TX	76063	5899	00	None	32.56919125	-97.09562468	Tarrant County
129913	Fee-for-Service	1760508881	1760508881	1	1	WEIGENSBERG, MARC J MD	7/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	70460	67	Endocrinology	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1083	19	06037	34.05855992	-118.209755	Los Angeles County
129965	Fee-for-Service	1538555735	1538555735	1	1	WAVE IMAGING LLC	7/24/2015	261QR0200X	NA	Mammography/MRI Provider	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	18785 BROOKHURST ST	STE 102	FOUNTAIN VALLEY	CA	92708	6749	30	06059	33.68987636	-117.9542321	Orange County
129997	Fee-for-Service	1881950475	1881950475	1	1	WATERS, KEVIN M MD	7/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149398	22	Pathology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	STE 3719	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
130016	Fee-for-Service	1942419817	1942419817	1	1	WOODLAND RESIDENTIAL	6/30/2005	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1571 SQUAW VALLEY DR	None	WOODLAND	CA	95776	6740	57	06113	38.665995	-121.7481124	Yolo County
130088	Fee-for-Service	1588866180	1588866180	1	1	WU, CHRISTINE A MD	6/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77986	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
130099	Fee-for-Service	1063427391	1063427391	1	1	WALGREEN CO	11/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	30251 MURRIETA RD	None	MENIFEE	CA	92584	8385	33	06065	33.684399	-117.2060495	Riverside County
130132	Fee-for-Service	1073733861	1073733861	1	1	WEST, ALISHA N MD	8/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117297	40	Pediatrics	0	In state provider	None	200 MEDICAL PLAZA	#550	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
130152	Fee-for-Service	1831367853	1831367853	1	1	WOOD, DAMON R PHD	8/18/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
130222	Fee-for-Service	1164004842	1164004842	1	1	WIGGIN, JAMIE M MD	7/8/2024	208M00000X	NA	Other	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
130238	Fee-for-Service	1447256565	1447256565	1	1	WEISS, MASON MD	3/16/1989	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	44527	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	301 N PRAIRIE AVE	STE 611	INGLEWOOD	CA	90301	4513	19	06037	33.965712	-118.3439965	Los Angeles County
130252	Fee-for-Service	1235255811	1235255811	1	1	WALKER, RAELENE M MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	60962	40	Pediatrics	0	In state provider	None	610 FREDERICK ST	FL 3	SANTA CRUZ	CA	95062	2203	44	06087	36.97965731	-122.0042799	Santa Cruz County
130260	Fee-for-Service	1295804490	1295804490	1	1	WONG, TONY W MD	10/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79385	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
130266	Fee-for-Service	1407861784	1407861784	1	1	WALGREEN CO.	9/1/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 W IMPERIAL HWY	None	LA HABRA	CA	90631	7261	30	06059	33.91736753	-117.946566	Orange County
130307	Fee-for-Service	1811551401	1811551401	1	1	WEATHERS, BRYAN	5/21/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1670 SOUTH AMPHLETT BLVD	STE 214	SAN MATEO	CA	94402	2511	41	06081	37.55945622	-122.3024868	San Mateo County
130317	Fee-for-Service	1780601203	1780601203	1	1	WANG, ALINE V MD	2/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53543	05	Anesthesiology	0	In state provider	None	3700 E SOUTH ST	None	LAKEWOOD	CA	90712	1419	19	06037	33.8601747	-118.148313	Los Angeles County
130363	Fee-for-Service	1740334978	1740334978	1	1	WILKIN, TIMOTHY J	6/21/2024	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	77	Infectious Disease	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
130396	Fee-for-Service	1487852802	1487852802	1	1	WHITTEMORE, LYNN A LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
130411	Fee-for-Service	1356391270	1356391270	1	1	WAISMAN, JAMES R MD	8/1/1998	174400000X	NA	Other	026	PHYSICIANS	25718	41	Internal Medicine	0	In state provider	None	1355 S SAN PEDRO ST	None	LOS ANGELES	CA	90015	3117	19	06037	34.03243628	-118.2543121	Los Angeles County
130419	Fee-for-Service	1073733861	1073733861	1	1	WEST, ALISHA N MD	8/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117297	84	Surgery-Head and Neck	0	In state provider	None	200 MEDICAL PLAZA	#550	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
130533	Fee-for-Service	1962123737	1962123737	1	1	WOLLIE, MARIAN COKER	11/3/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4898 WESTLAKE PARKWAY	None	SACRAMENTO	CA	95835	2092	34	06067	38.659347	-121.5418365	Sacramento County
130565	Fee-for-Service	1912385303	1912385303	1	1	WANG, TON MD	3/21/2023	208600000X	NA	General Surgery	026	PHYSICIANS	175743	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
130572	Fee-for-Service	1063762896	1063762896	1	1	WESTERN HEALTH RESOURCES	1/11/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9245 HWY 53	None	LOWER LAKE	CA	95457	0739	17	06033	38.91518874	-122.6122823	Lake County
130573	Fee-for-Service	1679572192	1679572192	1	1	WEISSBERG, DANIEL L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	20123	30	Radiology	0	In state provider	None	1100 W STEWART DRIVE	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
130622	Fee-for-Service	1679895965	1679895965	1	1	WHEELER, RACHEL B NP	6/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
130624	Fee-for-Service	1508972290	1508972290	1	1	WRIGHT, DALE R DPM	1/1/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	501 SOUTH SHORE CENTER	E	ALAMEDA	CA	94501	2982	01	06001	37.75884896	-122.2528366	Alameda County
130672	Fee-for-Service	1326887787	1326887787	1	1	WOO, BRIANNE OD	7/2/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1300 N VERMONT AVE	SUITE 101	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
130679	Fee-for-Service	1558603977	1558603977	1	1	WISE, SHANNON P CNM	7/30/2024	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	14500 ROSCOE BLVD	FLOOR 4 OFFICE 58	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
130693	Fee-for-Service	1700804382	1700804382	1	1	WITHERS, GREGORY J MD	11/30/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	27800	14	Neurological Surgery	0	In state provider	None	301 W HUNTINGTON DR	STE 407	ARCADIA	CA	91007	1504	19	06037	34.13481053	-118.0425638	Los Angeles County
130695	Fee-for-Service	1629462619	1629462619	1	1	WALKER, ANNE M MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154353	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
130698	Fee-for-Service	1356391270	1356391270	1	1	WAISMAN, JAMES R MD	8/1/1998	174400000X	NA	Other	026	PHYSICIANS	25718	78	Neoplastic Diseases/Oncology	0	In state provider	None	1355 S SAN PEDRO ST	None	LOS ANGELES	CA	90015	3117	19	06037	34.03243628	-118.2543121	Los Angeles County
130711	Fee-for-Service	1831638626	1831638626	1	1	WARTINGER, HILLARY H	5/8/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	582 S SUNNYVALE AVE	None	SUNNYVALE	CA	94086	6125	43	06085	37.36886669	-122.0316101	Santa Clara County
130714	Fee-for-Service	1114237732	1114237732	1	1	WALVICK, MATTHEW D DO	11/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11687	41	Internal Medicine	0	In state provider	None	2255 YGNACIO VALLEY RD	SUITE N	WALNUT CREEK	CA	94598	3349	07	06013	37.92242643	-122.0301696	Contra Costa County
130757	Fee-for-Service	1629015466	1629015466	1	1	WEILERT, MICHAEL MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38379	None	None	0	In state provider	None	FRESNO COMM HOSP	None	FRESNO	CA	93715	0000	10	06019	36.73686918	-119.7908332	Fresno County
130797	Fee-for-Service	1033287685	1033287685	1	1	WAYS, SUSAN C MD	5/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	63946	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2209 COFFEE RD	STE I	MODESTO	CA	95355	2360	50	06099	37.674603	-120.975788	Stanislaus County
130820	Fee-for-Service	1962123737	1962123737	1	1	WOLLIE, MARIAN COKER	11/3/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4898 WESTLAKE PARKWAY	None	SACRAMENTO	CA	95835	2092	34	06067	38.659347	-121.5418365	Sacramento County
130830	Fee-for-Service	1699788349	1699788349	1	1	WELDEN, ARNOLD O MD	6/27/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	42350	08	Family Practice	0	In state provider	None	922 N CHERRY ST	None	TULARE	CA	93274	2210	54	06107	36.22074423	-119.337598	Tulare County
130841	Fee-for-Service	1902205735	1902205735	1	1	WALDRON, KRISTINA M LMFT	7/28/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28494 WESTINGHOUSE PL	304	VALENCIA	CA	91355	0930	19	06037	34.44221561	-118.5989564	Los Angeles County
130907	Fee-for-Service	1679663439	1679663439	1	1	WELDON, CHERYL A LMFT	10/20/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
130947	Fee-for-Service	1841554524	1841554524	1	1	WU, YEN-YING MD	8/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121789	30	Radiology	0	In state provider	None	11370 ANDERSON ST	STE 1700	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
131022	Fee-for-Service	1366427221	1366427221	1	2	WETZEL, PAUL D MD	1/29/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	71477	41	Internal Medicine	0	In state provider	None	850 FAIR OAKS AVE	STE 100	ARROYO GRANDE	CA	93420	3923	40	06079	35.11274104	-120.588873	San Luis Obispo County
131034	Fee-for-Service	1881157717	1881157717	1	1	WONG, EVA L DPM	7/24/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	635 ANDERSON RD STE 19	None	DAVIS	CA	95616	3505	57	06113	38.54876426	-121.7587542	Yolo County
131121	Fee-for-Service	1215009212	1215009212	1	1	WEST SACRAMENTO PEDIATRIC	8/29/2005	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1035 JEFFERSON BLVD	1	WEST SACRAMENTO	CA	95691	3343	57	06113	38.57339903	-121.523861	Yolo County
131191	Fee-for-Service	1730360017	1730360017	1	1	WILCOX, NICOLE MD	5/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	97781	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	6201	43	06085	37.37715796	-122.0651926	Santa Clara County
131205	Fee-for-Service	1538400809	1538400809	1	1	WIKERT, ERIN LMFT	10/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
131285	Fee-for-Service	1033124136	1033124136	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2551 W MAIN ST	None	ALHAMBRA	CA	91801	1652	19	06037	34.09530369	-118.1513792	Los Angeles County
131314	Fee-for-Service	1366427221	1366427221	1	2	WETZEL, PAUL D MD	1/29/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	71477	10	Gastroenterology (M.D. only)	0	In state provider	None	850 FAIR OAKS AVE	STE 100	ARROYO GRANDE	CA	93420	3923	40	06079	35.11274104	-120.588873	San Luis Obispo County
131318	Fee-for-Service	1104964204	1104964204	1	1	WENDI M NORRIS, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
131325	Fee-for-Service	1417213711	1417213711	1	1	WOOLFREY, JOHN R MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128588	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
131371	Fee-for-Service	1356335913	1356335913	1	1	WEINSTEIN, ALEX J MD	6/30/1993	208800000X	NA	Other	026	PHYSICIANS	59210	10	Gastroenterology (M.D. only)	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4355	42	06083	34.42967671	-119.7228362	Santa Barbara County
131405	Fee-for-Service	1639185234	1639185234	1	1	WEEKS, BRIAN H	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77272	None	None	0	In state provider	None	6645 ALVARADO RD	STE 4000	SAN DIEGO	CA	92120	5208	37	06073	32.7772577	-117.0575222	San Diego County
131406	Fee-for-Service	1629549084	1629549084	1	1	WESTERN HEALTH RESOURCES	3/17/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	SERVICES	1007 LIVE OAK BLVD	STE B3	YUBA CITY	CA	95991	3454	51	06101	39.14368281	-121.6207923	Sutter County
131433	Fee-for-Service	1710992789	1710992789	1	1	WALGREEN CO	9/1/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	WALGREENS #04788	1465 E WILLIAM ST	None	CARSON CITY	NV	89701	3278	00	None	39.171267	-119.751516	Consolidated Municipality of Carson City
131438	Fee-for-Service	1386671493	1386671493	1	1	WILLIAM BIRCK, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2827 FORT MISSOULA RD	None	MISSOULA	MT	59804	7408	00	None	46.847151	-114.0480405	Missoula County
131461	Fee-for-Service	1386182061	1386182061	1	1	WINDSOR BAKERSFIELD	8/1/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE LLC	6212 TUDOR WAY	None	BAKERSFIELD	CA	93306	7069	15	06029	35.41046246	-118.9354057	Kern County
131478	Fee-for-Service	1033267828	1033267828	1	1	WANG, JEFFREY L MD	12/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86916	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
131545	Fee-for-Service	1528346061	1528346061	1	1	WIN, THIENGI MD	7/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130109	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
131600	Fee-for-Service	1083677959	1083677959	1	1	WADDELL, BARRY L MD	5/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83161	05	Anesthesiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
131628	Fee-for-Service	1740860121	1740860121	1	1	WU, JASON DO	9/17/2024	208M00000X	NA	Other	026	PHYSICIANS	22338	41	Internal Medicine	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
131633	Fee-for-Service	1669596144	1669596144	1	1	WILSON, JANEEN L LMFT	7/26/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
131638	Fee-for-Service	1467868885	1467868885	1	1	WILLSON, KYLE W DPM	9/12/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
131639	Fee-for-Service	1396775037	1396775037	1	2	WOMEN TO WOMEN MEDICAL	3/2/2010	193400000X	NA	Other	026	PHYSICIANS	62868	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2603 PATTERSON RD	SUITE #1	RIVERBANK	CA	95367	3407	50	06099	37.73272653	-120.949119	Stanislaus County
131640	Fee-for-Service	1609076637	1609076637	1	1	WILLCOX, NEVENA P MD	8/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111703	41	Internal Medicine	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6253	07	06013	37.98252	-121.8030615	Contra Costa County
131659	Fee-for-Service	1588712301	1588712301	1	1	WHARFIELD, NANCY R MD	3/31/1993	207R00000X	NA	Other	026	PHYSICIANS	74629	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
131689	Fee-for-Service	1629549084	1629549084	1	1	WESTERN HEALTH RESOURCES	3/17/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	SERVICES	1007 LIVE OAK BLVD	STE B3	YUBA CITY	CA	95991	3454	51	06101	39.14368281	-121.6207923	Sutter County
131717	Fee-for-Service	1750688743	1750688743	1	1	WALLACE, RANDY G NP	7/9/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
131805	Fee-for-Service	1093550865	1093550865	1	1	WITMER, SALLY LCSW	11/29/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
131810	Fee-for-Service	1275227522	1275227522	1	1	WESTVIEW TRANSPORTATION LLC	10/3/2023	342000000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	4901 70TH ST	None	SAN DIEGO	CA	92115	1802	37	06073	32.76786836	-117.0469953	San Diego County
131819	Fee-for-Service	1710207212	1710207212	1	1	WANG, MELISSA L MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130745	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
131833	Fee-for-Service	1528346061	1528346061	1	1	WIN, THIENGI MD	7/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130109	41	Internal Medicine	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
131850	Fee-for-Service	1336507870	1336507870	1	1	WOMEN ELITE CARE INC	2/11/2019	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	102198	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25425 ORCHARD VILLAGE RD	270	VALENCIA	CA	91355	2935	19	06037	34.39014682	-118.5481743	Los Angeles County
131877	Fee-for-Service	1841259595	1841259595	1	1	WOLF, HEATHER MD	12/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104913	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
131908	Fee-for-Service	1366861916	1366861916	1	1	WELEBIR, SVETLANA	6/14/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
131943	Fee-for-Service	1447262795	1447262795	1	1	WEST,PAULA A MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85519	47	Miscellaneous	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
131944	Fee-for-Service	1386792299	1386792299	1	1	WOO, CYNTHIA D OD	10/18/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4339 ELKHORN BLVD	STE B6	SACRAMENTO	CA	95842	3776	34	06067	38.695743	-121.3618005	Sacramento County
131957	Fee-for-Service	1053467852	1053467852	1	1	WALKER, LINDA K MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	1	Border provider	None	3001 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1126	00	None	42.25288307	-121.7896138	Klamath County
131970	Fee-for-Service	1770654709	1770654709	1	1	WILKINS, ALAN J MD	7/31/1985	207R00000X	NA	Other	026	PHYSICIANS	50984	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
132104	Fee-for-Service	1710207212	1710207212	1	1	WANG, MELISSA L MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130745	40	Pediatrics	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
132118	Fee-for-Service	1013906080	1013906080	1	1	WILLIAMSON, JULIE A	12/27/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
132121	Fee-for-Service	1558735639	1558735639	1	1	WALGREEN CO	2/19/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 16TH ST	RM 1200	SAN FRANCISCO	CA	94158	2545	38	06075	37.769553	-122.390109	San Francisco County
132238	Fee-for-Service	1033712435	1033712435	1	1	WEATHERSPOON, SHAVON M CNP	8/23/2021	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3737 MARTIN LUTHER KING	# 605B	LYNWOOD	CA	90262	3513	19	06037	33.92872742	-118.2006921	Los Angeles County
132239	Fee-for-Service	1841249745	1841249745	1	1	WEDLOW, CAMILLE E MD	12/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144816	01	General Practice	0	In state provider	None	550 ST CHARLES DR	STE 200	THOUSAND OAKS	CA	91360	3973	56	06111	34.18543014	-118.8777916	Ventura County
132244	Fee-for-Service	1467483313	1467483313	1	1	WELLIS, VINIT MD	10/31/1995	207LP3000X	NA	Other	026	PHYSICIANS	78752	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
132265	Fee-for-Service	1235157611	1235157611	1	1	WEEKS, ROGER D MD	1/1/1979	207W00000X	NA	Ophthalmology	026	PHYSICIANS	24319	18	Ophthalmology	0	In state provider	None	47 MARIA DR	STE 814	PETALUMA	CA	94954	3560	49	06097	38.25083868	-122.6203398	Sonoma County
132269	Fee-for-Service	1346647559	1346647559	1	1	WUNNER, VESTA B LCSW	5/6/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2910 H STREET	SUITES 106,109,112,205	EUREKA	CA	95501	4408	12	06023	40.78177748	-124.1613638	Humboldt County
132283	Fee-for-Service	1871668483	1871668483	1	1	WARNEKE,JAMES A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
132324	Fee-for-Service	1073575114	1073575114	1	2	WEBER,QUINN MD	6/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	630 MEDICAL DR	None	BOUNTIFUL	UT	84010	4908	00	None	40.88671331	-111.8683023	Davis County
132347	Fee-for-Service	1477570729	1477570729	1	1	WAL-MART PHARM #10-2494	4/13/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 VISTA WAY	None	OCEANSIDE	CA	92054	5600	37	06073	33.18090891	-117.3455254	San Diego County
132365	Fee-for-Service	1093790305	1093790305	1	2	WARDEN, NANCY MD	1/26/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	47331	None	None	0	In state provider	None	6555 COYLE AVE	STE 310	CARMICHAEL	CA	95608	0303	34	06067	38.66859	-121.3118055	Sacramento County
132447	Fee-for-Service	1811927494	1811927494	1	1	WAMSLEY, MARIA ALISSA MD	10/31/1995	207R00000X	NA	Other	026	PHYSICIANS	76076	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
132457	Fee-for-Service	1811075922	1811075922	1	1	WAECHTER, ANTHONY F MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82645	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
132524	Fee-for-Service	1699780601	1699780601	1	1	WALGREEN CO	9/9/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W BASE LINE ST	None	SAN BERNARDINO	CA	92411	1707	36	06071	34.12130051	-117.314487	San Bernardino County
132574	Fee-for-Service	1063674190	1063674190	1	1	WISNIEWSKI, PAUL J DO	6/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	9062	02	General Surgery	0	In state provider	None	400 NORTH PEPPER AVE	MOB STE 308	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
132592	Fee-for-Service	1578528386	1578528386	1	1	WOOD, SALLY M PHD	9/15/1987	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	604 3RD ST	None	DAVIS	CA	95616	4553	57	06113	38.54455485	-121.7411906	Yolo County
132595	Fee-for-Service	1316067069	1316067069	1	1	WOLFSOHN-GLUZMAN,	12/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89556	05	Anesthesiology	0	In state provider	STEFANY, D MD	1600 N ROSE AVE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
132613	Fee-for-Service	1386054591	1386054591	1	1	WALKER, SARAH MD	8/19/2019	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	161613	20	Orthopedic Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
132665	Fee-for-Service	1386683076	1386683076	1	1	WONG, KENDALL L MD	6/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	69165	30	Radiology	0	In state provider	None	869 N CHERRY STREET	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
132672	Fee-for-Service	1861870842	1861870842	1	1	WILLIS, NINA S DO	9/10/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16140	08	Family Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
132685	Fee-for-Service	1437207230	1437207230	1	1	WYNNE, EILEEN T DO	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	6278	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
132700	Fee-for-Service	1285701474	1285701474	1	1	WRIGHT, SUSIE P OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1183 E FOOTHILL BLVD	None	UPLAND	CA	91786	9999	36	06071	34.10724648	-117.6359175	San Bernardino County
132763	Fee-for-Service	1104552967	1104552967	1	1	WELLNESS MEDICAL TRANSPORTAT	4/21/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ION LLC	1941 GATEWAY BLVD	SUITE 104	FRESNO	CA	93727	1641	10	06019	36.76812766	-119.7268137	Fresno County
132772	Fee-for-Service	1285769059	1285769059	2	1	WU, FRANCIS M MD	1/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85198	30	Radiology	0	In state provider	None	23101 SHERMAN PL	STE 407	WEST HILLS	CA	91307	2032	19	06037	34.20099112	-118.6297991	Los Angeles County
132776	Fee-for-Service	1750627360	1750627360	1	1	WATERHOUSE, DAWN L PT	10/24/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1800 WESTWIND DR	500	BAKERSFIELD	CA	93301	3055	15	06029	35.37531587	-119.0424856	Kern County
132789	Fee-for-Service	1255723490	1255723490	1	1	WEST COVINA MEDICAL CENTER,	4/4/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	725 S ORANGE AVENUE	None	WEST COVINA	CA	91790	2614	19	06037	34.07079634	-117.9445034	Los Angeles County
132842	Fee-for-Service	1518428994	1518428994	1	1	WASSERMANN, TRAVIS MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	177287	None	None	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	4685	55	06109	37.97749352	-120.3700335	Tuolumne County
132852	Fee-for-Service	1174137160	1174137160	1	1	WESTERLAND, MARISSA MD	7/12/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191052	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
132874	Fee-for-Service	1205164050	1205164050	1	1	WEXNER, SAGE MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123563	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH STREET	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
133076	Fee-for-Service	1396148516	1396148516	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	23961 CALLE DE LA MAGDAL	STE 243	LAGUNA HILLS	CA	92653	3616	30	06059	33.60999658	-117.7126577	Orange County
133083	Fee-for-Service	1326096397	1326096397	1	1	WHITNEY GOLDNER	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
133089	Fee-for-Service	1336277730	1336277730	1	1	WARGULA, ALANNA L DPM	3/10/2014	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	175 PARK ST	None	LAKEPORT	CA	95453	4803	17	06033	39.04282879	-122.9140827	Lake County
133124	Fee-for-Service	1720227028	1720227028	1	1	WATSON, RABINDRA R MD	5/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	95656	10	Gastroenterology (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
133158	Fee-for-Service	1922070127	1922070127	1	1	WILLIAMS, JANE MD APC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68304	02	General Surgery	0	In state provider	None	1225 CENTRAL AVE	STE 12	MCKINLEYVILLE	CA	95519	5301	12	06023	40.92735821	-124.1008356	Humboldt County
133176	Fee-for-Service	1568424687	1568424687	2	1	WILLIAM LEROY WILSON, M.D.,	3/4/2021	208VP0014X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	RE	5565 GROSSMONT CENTER DR	BLGD 3, SUITE 540	LA MESA	CA	91942	3024	37	06073	32.77978322	-117.0094766	San Diego County
133256	Fee-for-Service	1285935585	1285935585	1	1	WONG, JERRY T MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136242	22	Pathology (M.D. only)	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
133265	Fee-for-Service	1700986775	1700986775	1	1	WREDEN, DON L MD	9/30/1984	207R00000X	NA	Other	026	PHYSICIANS	55741	41	Internal Medicine	0	In state provider	None	1 SCRIPPS DR	STE 203	SACRAMENTO	CA	95825	6206	34	06067	38.573181	-121.4118135	Sacramento County
133281	Fee-for-Service	1053320291	1053320291	1	1	WITTENBERG, ANDREW G MD	9/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88534	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
133316	Fee-for-Service	1902340011	1902340011	1	1	WANG, JAEYUN JANE MD	4/2/2023	208600000X	NA	General Surgery	026	PHYSICIANS	177426	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
133380	Fee-for-Service	1487979878	1487979878	1	1	WANG, LILY C MD	9/10/2018	390200000X	NA	Other	026	PHYSICIANS	155662	34	Urology and Urological Surgery	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
133387	Fee-for-Service	1376839449	1376839449	1	1	WOLOSZYN, JAKUB MD	9/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124914	02	General Surgery	0	In state provider	None	797 E FREMONT AVE	None	SUNNYVALE	CA	94087	2805	43	06085	37.35232537	-122.0183236	Santa Clara County
133409	Fee-for-Service	1063732758	1063732758	1	1	WALLACE, IAN MD	3/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119017	08	Family Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
133463	Fee-for-Service	1255790150	1255790150	1	1	WELCH, KYLE D OT	7/22/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
133464	Fee-for-Service	1801988308	1801988308	1	1	WHITING, NEIL K MD	12/16/1988	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	25635	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
133503	Fee-for-Service	1245301084	1245301084	1	1	WILSON, STEPHEN M MD	8/5/2008	174400000X	NA	Other	026	PHYSICIANS	23030	02	General Surgery	0	In state provider	None	100 E VALENCIA MESA DR	SUITE 101	FULLERTON	CA	92835	3810	30	06059	33.89343304	-117.9279349	Orange County
133545	Fee-for-Service	1285935585	1285935585	1	1	WONG, JERRY T MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136242	68	Hematology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
133560	Fee-for-Service	1104831486	1104831486	1	1	WALGREEN CO	11/1/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4331 ANTELOPE RD	None	SACRAMENTO	CA	95843	6022	34	06067	38.704653	-121.36293	Sacramento
133608	Fee-for-Service	1053460477	1053460477	1	1	WANG, EDWARD H MD	1/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80125	45	Nephrology (Renal-Kidney)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
133670	Fee-for-Service	1558532317	1558532317	1	1	WAN, EE L MD	5/25/2010	208M00000X	NA	Other	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2640 E BARNETT RD	None	MEDFORD	OR	97504	4301	00	None	42.31645852	-122.834421	Jackson County
133691	Fee-for-Service	1831118934	1831118934	1	1	WICKRAMASINGHE, HIMANSHU	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	56078	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
133693	Fee-for-Service	1356773501	1356773501	1	1	WAL-MART STORES INC	11/25/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1333 N MOUNTAIN AVE	None	ONTARIO	CA	91762	1105	36	06071	34.082343	-117.6718275	San Bernardino County
133703	Fee-for-Service	1629265095	1629265095	1	1	WONG, CAROLYN H DPM	5/16/2018	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3616 E 1ST ST	None	LOS ANGELES	CA	90063	2326	19	06037	34.03597969	-118.1884647	Los Angeles County
133710	Fee-for-Service	1053338467	1053338467	1	1	WAL-MART PHARM. 10-2242	1/23/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	440 N EUCLID ST	None	ANAHEIM	CA	92801	5505	30	06059	33.836238	-117.9380295	Orange County
133734	Fee-for-Service	1104901933	1104901933	1	1	WANG, WAYLENE MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	60679	30	Radiology	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
133746	Fee-for-Service	1528563384	1528563384	1	1	WILSON, ALEXANDRA G DO	10/18/2024	208600000X	NA	General Surgery	026	PHYSICIANS	22508	02	General Surgery	0	In state provider	None	2911 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	44	06087	36.98821335	-121.978125	Santa Cruz County
133749	Fee-for-Service	1588853014	1588853014	1	1	WADEKAR, MITALI MD	3/30/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	110765	None	None	0	In state provider	None	1300 N. VERMONT AVE.	None	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
133770	Fee-for-Service	1790973162	1790973162	1	1	WILLIAM F RESH M.D., SKIN AN	2/9/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	SKIN CANCER MEDICAL GROU	655 EUCLID AVE	SUITE 304	NATIONAL CITY	CA	91950	2978	37	06073	32.68353398	-117.082625	San Diego County
133822	Fee-for-Service	1053328005	1053328005	1	1	WAXMAN, ALAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
133846	Fee-for-Service	1417032079	1417032079	1	1	WAGNER, RICHARD A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 N WILMOT RD	None	TUCSON	AZ	85711	2602	00	None	32.227209	-110.8556595	Pima County
133861	Fee-for-Service	1417447061	1417447061	1	1	WANG, SHUYU MD	11/17/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	164279	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
133874	Fee-for-Service	1467457390	1467457390	1	1	WILLIAMS, RICHARD A MD	9/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	40188	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1334 W COVINA BLVD	STE 102	SAN DIMAS	CA	91773	3211	19	06037	34.097067	-117.833751	Los Angeles County
133923	Fee-for-Service	1467909473	1467909473	1	2	WILSTEIN, LAUREN M NP	9/10/2018	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
133950	Fee-for-Service	1639152838	1639152838	1	1	WRIGHT, AARON J NP	1/9/2007	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	None	SACRAMENTO	CA	95820	1532	34	06067	38.546091	-121.447305	Sacramento County
133976	Fee-for-Service	1073541140	1073541140	1	1	WOOD, TODD E PT	2/1/1999	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	22038 OLD 44 DR	STE A	PALO CEDRO	CA	96073	8707	45	06089	40.56384214	-122.2377098	Shasta County
133981	Fee-for-Service	1831118934	1831118934	1	1	WICKRAMASINGHE, HIMANSHU	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	56078	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
133986	Fee-for-Service	1992248553	1992248553	1	1	WILLIAMS, MAYRA N CCC-SLP	1/19/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 S HAVEN AVE	SUITE 190	ONTARIO	CA	91761	2969	36	06071	34.046307	-117.576387	San Bernardino County
134000	Fee-for-Service	1982071122	1982071122	1	1	WHITE, JEFFREY S LMFT	10/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	606 E MILL ST	None	SAN BERNARDINO	CA	92415	0010	36	06071	34.09217051	-117.271935	San Bernardino County
134040	Fee-for-Service	1184790438	1184790438	1	1	WISKERCHEN, MAUREEN J	11/30/1991	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7510 CLAIREMONT MESA BLV	STE 100	SAN DIEGO	CA	92111	1539	37	06073	32.83274153	-117.1574235	San Diego County
134096	Fee-for-Service	1790883668	1790883668	1	1	WISE, BRIGHAM J MD	3/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106000	20	Orthopedic Surgery	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
134169	Fee-for-Service	1902903578	1902903578	1	1	WU, MONTE M MD	4/9/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68069	45	Nephrology (Renal-Kidney)	0	In state provider	None	2905 TELEGRAPH AVE	None	BERKELEY	CA	94705	2063	01	06001	37.85736641	-122.2594952	Alameda County
134195	Fee-for-Service	1144552217	1144552217	1	1	WALGREEN CO	4/21/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	490 W HUNTINGON DR	None	MONROVIA	CA	91016	3202	19	06037	34.14020217	-118.0094777	Los Angeles County
134253	Fee-for-Service	1407873813	1407873813	1	1	WAL-MART STORES, INC	2/3/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-2621	255 COCHRAN ST	None	SIMI VALLEY	CA	93065	6276	56	06111	34.28104389	-118.7921609	Ventura County
134351	Fee-for-Service	1831388206	1831388206	1	1	WARDEH, ROOBA MD	10/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9448	22	Pathology (M.D. only)	0	In state provider	None	2700 N MAIN ST	STE 506	SANTA ANA	CA	92705	6637	30	06059	33.7737545	-117.8687284	Orange County
134375	Fee-for-Service	1275680829	1275680829	1	1	WU, CHIEN-KO MD	5/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38491	41	Internal Medicine	0	In state provider	None	991 N TUSTIN ST	STE 101	ORANGE	CA	92867	5900	30	06059	33.80406172	-117.8356368	Orange County
134456	Fee-for-Service	1902903578	1902903578	1	1	WU, MONTE M MD	4/9/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68069	41	Internal Medicine	0	In state provider	None	2905 TELEGRAPH AVE	None	BERKELEY	CA	94705	2063	01	06001	37.85736641	-122.2594952	Alameda County
134479	Fee-for-Service	1396812848	1396812848	1	1	WHITAKER, ASHLEY	11/27/2007	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
134483	Fee-for-Service	1720315336	1720315336	1	1	WALLACE, ROBERT J NP	5/28/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
134567	Fee-for-Service	1770002313	1770002313	1	1	WATERS, VALERIE L NP	10/30/2017	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
134615	Fee-for-Service	1295865400	1295865400	1	1	WOMEN'S CARE OB/GYN	6/17/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL GROUP INC	1019 W LA PALMA AVE	SUITE B	ANAHEIM	CA	92801	3664	30	06059	33.84719151	-117.931329	Orange County
134648	Fee-for-Service	1750781472	1750781472	1	1	WICARE LLC	3/26/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7050 OWENSMOUTH	SUITE 200	CANOGA PARK	CA	91303	4207	19	06037	34.19870174	-118.6015313	Los Angeles County
134649	Fee-for-Service	1699473892	1699473892	1	1	WARD, STEPHANIE LCSW	10/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1103 BUTTE HOUSE RD	SUITE E	YUBA CITY	CA	95991	3109	51	06101	39.14536728	-121.6306637	Sutter County
134676	Fee-for-Service	1174763288	1174763288	1	1	WEST, RAENA D LCSW	4/27/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2910 H STREET	SUITES 106,109,112,205	EUREKA	CA	95501	4408	12	06023	40.78177748	-124.1613638	Humboldt County
134720	Fee-for-Service	1982090189	1982090189	1	1	WONG, DAVID MD	6/2/2022	207L00000X	NA	Other	026	PHYSICIANS	145364	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
134724	Fee-for-Service	1497768030	1497768030	1	1	WASKIEWICZ, THOMAS J MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69143	66	Emergency Medicine (Urgent Care)	0	In state provider	None	218 N SANTA ANITA ST	None	SAN GABRIEL	CA	91775	2918	19	06037	34.10510572	-118.1045763	Los Angeles County
134830	Fee-for-Service	1093996738	1093996738	1	1	WELLBOUND OF SAN LEANDRO LLC	7/17/2008	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1040 DAVIS ST	STE 101	SAN LEANDRO	CA	94577	1513	01	06001	37.72211908	-122.1667007	Alameda County
134833	Fee-for-Service	1841271459	1841271459	1	1	WEST VIRGINIA UNIVERSITY	4/15/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITALS, INC	ONE MEDICAL CENTER DRIVE	None	MORGANTOWN	WV	26505	3404	00	None	39.65333742	-79.95924145	Monongalia County
134837	Fee-for-Service	1811270077	1811270077	1	1	WOODMAN AVENUE CORPORATION	11/10/2011	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	OWNER/OPERATION	7720 WOODMAN AVE	None	PANORAMA CITY	CA	91402	6527	19	06037	34.210485	-118.430894	Los Angeles County
134915	Fee-for-Service	1447412093	1447412093	1	1	WALTON, TRICIA P LMFT	2/4/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
134944	Fee-for-Service	1922534916	1922534916	1	1	WELL CARE CONGREGATE LIVING	11/1/2018	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14926 VOSE STREET	None	VAN NUYS	CA	91405	2931	19	06037	34.19842352	-118.458351	Los Angeles County
134955	Fee-for-Service	1891187209	1891187209	1	1	WU, VICTORIA MD	7/19/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
134991	Fee-for-Service	1386833721	1386833721	1	1	WETTSTEIN, JOHN ROBERT	12/31/1992	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	SEQUOIA ORTHOPEDIC CO	301 W NOBLE AVE	None	VISALIA	CA	93277	2633	54	06107	36.326169	-119.294739	Tulare County
135006	Fee-for-Service	1851592497	1851592497	1	1	WALKER, JAMES DO	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
135049	Fee-for-Service	1861470791	1861470791	1	1	WOLF, KARL K MD	12/4/1986	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	24460	08	Family Practice	0	In state provider	None	520 E CENTER ST	None	MANTECA	CA	95336	4720	39	06077	37.79906255	-121.2105195	San Joaquin County
135098	Fee-for-Service	1053706291	1053706291	1	1	WANG, XIAO MD	9/21/2022	207P00000X	NA	Other	026	PHYSICIANS	179053	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
135120	Fee-for-Service	1841271459	1841271459	1	1	WEST VIRGINIA UNIVERSITY	4/15/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITALS, INC	ONE MEDICAL CENTER DRIVE	None	MORGANTOWN	WV	26505	3404	00	None	39.65333742	-79.95924145	Monongalia County
135179	Fee-for-Service	1871904979	1871904979	1	1	WANG, BOYU DO	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16224	41	Internal Medicine	0	In state provider	None	1020 29TH ST	STE 120	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
135233	Fee-for-Service	1013314699	1013314699	1	1	WEL-MOR PSYCHOLOGY GROUP, IN	10/13/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	C	4019 WESTERLY PL	102	NEWPORT BEACH	CA	92660	2317	30	06059	33.66363214	-117.8681749	Orange County
135265	Fee-for-Service	1386081354	1386081354	1	1	WANG, CHRISTOPHER P MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148546	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1720 CESAR E CHAVEZ AVE	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
135269	Fee-for-Service	1538131966	1538131966	1	1	WONG, JEFFREY A MD	2/28/1992	174400000X	NA	Other	026	PHYSICIANS	72487	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
135336	Fee-for-Service	1861470791	1861470791	1	1	WOLF, KARL K MD	12/4/1986	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	24460	01	General Practice	0	In state provider	None	520 E CENTER ST	None	MANTECA	CA	95336	4720	39	06077	37.79906255	-121.2105195	San Joaquin County
135394	Fee-for-Service	1063847150	1063847150	1	1	WANTZ, RACHEL A NP	10/27/2020	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
135399	Fee-for-Service	1487175584	1487175584	1	1	WU, MENG-HUA OD	1/31/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
135504	Fee-for-Service	1205612660	1205612660	1	1	WALKER, MADISSON OT	1/29/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3416 AMERICAN RIVER DR	STE B	SACRAMENTO	CA	95864	5753	34	06067	38.569212	-121.3840755	Sacramento County
135524	Fee-for-Service	1518922178	1518922178	1	1	WARLEN, MARK E MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	52492	18	Ophthalmology	0	In state provider	None	3720 3RD AVE	None	SAN DIEGO	CA	92103	4112	37	06073	32.745555	-117.1627775	San Diego County
135545	Fee-for-Service	1316022205	1316022205	1	1	WILKINSON, JOHN W. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	54383 HOSPITAL ROAD	None	KAPAAU	HI	96755	0000	00	None	20.23176242	-155.7971949	Hawaii County
135557	Fee-for-Service	1538131966	1538131966	1	1	WONG, JEFFREY A MD	2/28/1992	174400000X	NA	Other	026	PHYSICIANS	72487	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
135582	Fee-for-Service	1225224116	1225224116	1	1	WHITE, AMY M MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104984	30	Radiology	0	In state provider	None	300 PASTEUR DR	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
135586	Fee-for-Service	1477958478	1477958478	1	1	WAL-MART STORE INC	6/12/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3131 N CEDAR AVE	None	FRESNO	CA	93703	1532	10	06019	36.778959	-119.7545175	Fresno County
135593	Fee-for-Service	1689090060	1689090060	1	1	WATKINS, JUSTEN DO MD	8/29/2018	390200000X	NA	Other	026	PHYSICIANS	13585	None	None	0	In state provider	None	7774 CHERRY AVE	None	FONTANA	CA	92336	4014	36	06071	34.11281482	-117.488717	San Bernardino County
135601	Fee-for-Service	1235679127	1235679127	1	1	WEBB, AUTUMN LMFT	11/26/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
135662	Fee-for-Service	1942606744	1942606744	1	2	WOUND MD PC	1/19/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	75 N 13TH STREET	None	SAN JOSE	CA	95112	3439	43	06085	37.34299596	-121.8788519	Santa Clara County
135664	Fee-for-Service	1043741010	1043741010	1	1	WOLSIEFER-LEAK, HANNAH	11/15/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	520 MEDICAL CENTER DRIVE	SUITE 201	MEDFORD	OR	97504	4334	00	None	42.318801	-122.831728	Jackson County
135669	Fee-for-Service	1013351865	1013351865	1	1	WANG, EUGENE MD	10/1/2019	208600000X	NA	General Surgery	026	PHYSICIANS	162561	02	General Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
135691	Fee-for-Service	1922428754	1922428754	1	1	WHEELER, ADAM P MD	5/18/2021	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	None	None	1	Border provider	None	3006 S MARYLAND PKWY	STE 690	LAS VEGAS	NV	89109	2297	00	None	36.135288	-115.1368705	Clark County
135741	Fee-for-Service	1679757470	1679757470	1	1	WOODWARD, MEGAN M	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
135811	Fee-for-Service	1518922178	1518922178	1	1	WARLEN, MARK E MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	52492	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3720 3RD AVE	None	SAN DIEGO	CA	92103	4112	37	06073	32.745555	-117.1627775	San Diego County
135814	Fee-for-Service	1265556583	1265556583	1	1	WILLIAMS, RENE E	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43237	None	None	0	In state provider	None	1314 N NORMA ST	None	RIDGECREST	CA	93555	2509	15	06029	35.64494824	-117.6787309	Kern County
135841	Fee-for-Service	1982775615	1982775615	1	1	WALLACE, SCOTT R	2/22/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
135874	Fee-for-Service	1952321044	1952321044	1	1	WHITEMAN, JANE E MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65539	38	Geriatrics	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
135928	Fee-for-Service	1114954278	1114954278	1	1	WOLFSOHN, MARC D MD	6/1/1977	207L00000X	NA	Other	026	PHYSICIANS	34454	05	Anesthesiology	0	In state provider	None	11999 SAN VICENTE BLVD	STE 440	LOS ANGELES	CA	90049	5042	19	06037	34.05233327	-118.4727195	Los Angeles County
135940	Fee-for-Service	1366606832	1366606832	1	1	WARREN, EILEEN PHD	1/30/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1140 RAILROAD ST	None	PASO ROBLES	CA	93446	2532	40	06079	35.62645486	-120.6881426	San Luis Obispo County
135992	Fee-for-Service	1083609150	1083609150	1	1	WASHINGTON REGIONAL MEDICAL	4/3/2024	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER	3215 N NORTHHILLS BLVD	None	FAYETTEVILLE	AR	72703	4007	00	None	36.109287	-94.160007	Washington County
135998	Fee-for-Service	1437237252	1437237252	1	1	WIRJO, MAX MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	39830	05	Anesthesiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
136049	Fee-for-Service	1588761001	1588761001	1	1	WILLIAMS, JULIO E MD	12/7/2022	208G00000X	NA	General Surgery	026	PHYSICIANS	171431	None	None	0	In state provider	None	1355 EAST ST	SUITE 200	REDDING	CA	96001	0801	45	06089	40.58628506	-122.3887911	Shasta County
136081	Fee-for-Service	1972747582	1972747582	1	1	WOODFIN, MICHELLE Y MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114418	05	Anesthesiology	0	In state provider	None	11370 ANDERSON ST	SUITE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
136099	Fee-for-Service	1992182000	1992182000	1	1	WANG, HANJAY MD	8/12/2024	208G00000X	NA	General Surgery	026	PHYSICIANS	143896	33	Thoracic Surgery	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
136116	Fee-for-Service	1598713653	1598713653	1	1	WOODBURN, DOUGLAS A MD	8/31/1993	208600000X	NA	General Surgery	026	PHYSICIANS	53167	02	General Surgery	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
136128	Fee-for-Service	1053511527	1053511527	1	1	WINTER, THOMAS C MD	12/10/2019	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
136151	Fee-for-Service	1306255294	1306255294	1	1	WINTERS, DEBORAH L LPCC	3/11/2021	101YA0400X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	250 E EASY ST	6B	SIMI VALLEY	CA	93065	1769	56	06111	34.27813821	-118.7938166	Ventura County
136162	Fee-for-Service	1952321044	1952321044	1	1	WHITEMAN, JANE E MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65539	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
136181	Fee-for-Service	1902839699	1902839699	1	1	WHITELAW, KEVIN MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	59070	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
136198	Fee-for-Service	1548749989	1548749989	1	1	WATKINS DIALYSIS LLC	11/8/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	841 SAN BRUNO AVE W	None	SAN BRUNO	CA	94066	3443	41	06081	37.62821976	-122.4179614	San Mateo County
136216	Fee-for-Service	1932128410	1932128410	1	1	WU, LIHONG MD	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79643	78	Neoplastic Diseases/Oncology	0	In state provider	None	1043 ELM AVE	STE 104	LONG BEACH	CA	90813	3244	19	06037	33.779655	-118.1880065	Los Angeles County
136256	Fee-for-Service	1811595044	1811595044	1	1	WETZEL, JESSE M OD	4/8/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 PALMDALE RD	STE B-10	ADELANTO	CA	92301	6709	36	06071	34.50671749	-117.4015485	San Bernardino County
136277	Fee-for-Service	1083609150	1083609150	1	1	WASHINGTON REGIONAL MEDICAL	4/3/2024	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER	3215 N NORTHHILLS BLVD	None	FAYETTEVILLE	AR	72703	4007	00	None	36.109287	-94.160007	Washington County
136306	Fee-for-Service	1518064864	1518064864	1	1	WANG, CYNTHIA P MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77305	41	Internal Medicine	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	6203	43	06085	37.37715796	-122.0651926	Santa Clara County
136309	Fee-for-Service	1346449048	1346449048	1	1	WILSON, MICHAEL P MD	7/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101485	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
136338	Fee-for-Service	1134644099	1134644099	1	1	WIN, THIDA MD INC	12/26/2017	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	105869	77	Infectious Disease	0	In state provider	None	100 S RAYMOND AVE	None	ALHAMBRA	CA	91801	3166	19	06037	34.09027878	-118.1450083	Los Angeles County
136371	Fee-for-Service	1588178115	1588178115	1	1	WEST VALLEY HOSPICE, INC	9/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14349 VICTORY BLVD	STE 203A	VAN NUYS	CA	91401	1950	19	06037	34.18669646	-118.4460435	Los Angeles County
136410	Fee-for-Service	1346411329	1346411329	1	2	WITTLER, MICAH L DO	5/30/2022	207P00000X	NA	Other	026	PHYSICIANS	10199	None	None	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
136415	Fee-for-Service	1578941597	1578941597	1	1	WILSON, ZENUS J MD	12/18/2019	171000000X	NA	Other	026	PHYSICIANS	143838	01	General Practice	0	In state provider	None	5575 RUFFIN RD	STE 100	SAN DIEGO	CA	92123	1380	37	06073	32.83605627	-117.1266464	San Diego County
136448	Fee-for-Service	1396112496	1396112496	1	1	WEATHERSON, JENNA NP	6/24/2020	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
136504	Fee-for-Service	1932128410	1932128410	1	1	WU, LIHONG MD	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79643	68	Hematology	0	In state provider	None	1043 ELM AVE	STE 104	LONG BEACH	CA	90813	3244	19	06037	33.779655	-118.1880065	Los Angeles County
136563	Fee-for-Service	1255685590	1255685590	1	1	WALLIS, JANE O	7/24/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
136564	Fee-for-Service	1629036843	1629036843	1	1	WANG, VALERIE M MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	70879	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
136605	Fee-for-Service	1720308166	1720308166	1	1	WATERS, JENLI D MD	7/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	100917	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
136622	Fee-for-Service	1346423449	1346423449	1	1	WILBERFORCE, SIDNEY H MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117191	34	Urology and Urological Surgery	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
136627	Fee-for-Service	1104867100	1104867100	1	1	WILLIAM J LEHRICH, DPM	2/10/1982	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1580 VALENCIA ST	STE 109	SAN FRANCISCO	CA	94110	4420	38	06075	37.74746923	-122.4202583	San Francisco County
136635	Fee-for-Service	1407896004	1407896004	1	1	WALTER, MICHAEL A MD	9/1/1998	207L00000X	NA	Other	026	PHYSICIANS	42604	05	Anesthesiology	0	In state provider	None	3033 W ORANGE AVE	None	ANAHEIM	CA	92804	3156	30	06059	33.82476552	-117.994914	Orange County
136657	Fee-for-Service	1588178115	1588178115	1	1	WEST VALLEY HOSPICE, INC	9/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14349 VICTORY BLVD	STE 203A	VAN NUYS	CA	91401	1950	19	06037	34.18669646	-118.4460435	Los Angeles County
136675	Fee-for-Service	1407948052	1407948052	1	1	WESTERLUND, L ERIK MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79569	20	Orthopedic Surgery	0	In state provider	None	320 SANTA FE DR	STE 204	ENCINITAS	CA	92024	5179	37	06073	33.038847	-117.285579	San Diego County
136755	Fee-for-Service	1679511232	1679511232	1	1	WURSTER,SARAH MD	4/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	413 LILLY RD NE	None	OLYMPIA	WA	98506	0000	00	None	47.052801	-122.847462	Thurston County
136763	Fee-for-Service	1477627784	1477627784	1	1	WOO, HAROLD S DO	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9500	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
136780	Fee-for-Service	1790926319	1790926319	1	1	WALGREEN CO	9/10/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2293 RIVER OAKS BLVD	None	PLUMAS LAKE	CA	95961	9194	58	06115	39.01987812	-121.5507996	Yuba County
136783	Fee-for-Service	1003253097	1003253097	1	1	WANG, CINDY Y H LMFT	7/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	245 E OLIVE AVE	STE 400	BURBANK	CA	91502	1214	19	06037	34.18145335	-118.3081834	Los Angeles County
136789	Fee-for-Service	1629136684	1629136684	1	1	WHITAKER, SAMUEL R MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	44301	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	2888 LONG BEACH BLVD	STE 150	LONG BEACH	CA	90806	1560	19	06037	33.809706	-118.189343	Los Angeles County
136814	Fee-for-Service	1417963661	1417963661	1	1	WU, TAI-HING	8/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	46692	None	None	0	In state provider	None	415 W VALLEY BLVD	STE 219	SAN GABRIEL	CA	91776	3728	19	06037	34.07948039	-118.1058412	Los Angeles County
136873	Fee-for-Service	1669465928	1669465928	1	1	WEAVER, RONALD S MD INC	9/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	30118	41	Internal Medicine	0	In state provider	None	633 AERICK ST	None	INGLEWOOD	CA	90301	1978	19	06037	33.9635805	-118.345563	Los Angeles County
136895	Fee-for-Service	1407801640	1407801640	1	1	WEST ALLIS MEMORIAL HOSP	10/12/2006	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	8901 W LINCOLN AVE	None	WEST ALLIS	WI	53227	2409	00	None	43.00267654	-88.02345316	Milwaukee County
136942	Fee-for-Service	1487708970	1487708970	1	1	WEXLER, ELISA S	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
136951	Fee-for-Service	1265447551	1265447551	1	1	WALGREEN COMPANY	11/2/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6325 ROSEMEAD BLVD	None	SAN GABRIEL	CA	91775	1933	19	06037	34.11410169	-118.0737024	Los Angeles County
136960	Fee-for-Service	1497794127	1497794127	1	1	WILLIAMS, SCOTT MD	10/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1255 HILYARD ST	None	EUGENE	OR	97401	3718	00	None	44.04647879	-123.0820996	Lane County
137005	Fee-for-Service	1912984436	1912984436	1	1	WESTBIE, DONALD K MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	25918	41	Internal Medicine	0	In state provider	None	4460 BLACK AVE	STE G	PLEASANTON	CA	94566	6139	01	06001	37.67215839	-121.8770704	Alameda County
137019	Fee-for-Service	1295904852	1295904852	1	1	WALKER, CHRISTINA N NP	2/27/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
137068	Fee-for-Service	1376874867	1376874867	1	1	WAL MART STORES INC	6/9/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL MART PHARMACY 105134	5075 GOSFORD RD	None	BAKERSFIELD	CA	93313	4993	15	06029	35.308782	-119.095407	Kern County
137077	Fee-for-Service	1629136684	1629136684	1	1	WHITAKER, SAMUEL R MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	44301	04	Otology, Laryngology, Rhinology	0	In state provider	None	2888 LONG BEACH BLVD	STE 150	LONG BEACH	CA	90806	1560	19	06037	33.809706	-118.189343	Los Angeles County
137101	Fee-for-Service	1508835786	1508835786	1	1	WONG, JENNIFER L MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63866	01	General Practice	0	In state provider	None	1310 W STEWART DR	STE 603	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
137148	Fee-for-Service	1861925067	1861925067	1	1	WYCLIFFE, RYAN D DO	7/1/2022	390200000X	NA	Other	026	PHYSICIANS	19615	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
137153	Fee-for-Service	1275773640	1275773640	1	1	WRIGHT, STEVEN J DO	10/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11867	04	Otology, Laryngology, Rhinology	0	In state provider	None	632 W GIBSON ROAD	None	WOODLAND	CA	95695	5143	57	06113	38.66314048	-121.794696	Yolo County
137180	Fee-for-Service	1356471700	1356471700	1	1	WESLEY, ALESIA A MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46770	-	NOT APPLICABLE	0	In state provider	None	15305 RAYEN STREET	None	NORTH HILLS	CA	91343	5117	19	06037	34.23191048	-118.4657625	Los Angeles County
137182	Fee-for-Service	1407801640	1407801640	1	1	WEST ALLIS MEMORIAL HOSP	10/12/2006	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	8901 W LINCOLN AVE	None	WEST ALLIS	WI	53227	2409	00	None	43.00267654	-88.02345316	Milwaukee County
137228	Fee-for-Service	1215544788	1215544788	1	1	WHITE, RACHEL LMFT	1/12/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21243 VENTURA BLVD	118	WOODLAND HILLS	CA	91364	2162	19	06037	34.16736368	-118.5947825	Los Angeles County
137280	Fee-for-Service	1144863440	1144863440	1	1	WILLIAMSON, CAYLEIGH A CRNA	7/28/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
137295	Fee-for-Service	1912984436	1912984436	1	1	WESTBIE, DONALD K MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	25918	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4460 BLACK AVE	STE G	PLEASANTON	CA	94566	6139	01	06001	37.67215839	-121.8770704	Alameda County
137317	Fee-for-Service	1417591744	1417591744	1	1	WEST COAST PODIATRY, INC	7/14/2021	261QP1100X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	724 MEDICAL CENTER DR E	STE 102	CLOVIS	CA	93611	6811	10	06019	36.84107334	-119.6587409	Fresno County
137348	Fee-for-Service	1306189980	1306189980	1	1	WOO, KATRINA A MD	7/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	136740	40	Pediatrics	0	In state provider	None	97 SAN MARIN DRIVE	None	NOVATO	CA	94945	1100	21	06041	38.12173729	-122.6048491	Marin County
137387	Fee-for-Service	1508835786	1508835786	1	1	WONG, JENNIFER L MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63866	08	Family Practice	0	In state provider	None	1310 W STEWART DR	STE 603	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
137404	Fee-for-Service	1427213123	1427213123	1	1	WU, SERENA MD	8/16/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	110076	None	None	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
137472	Fee-for-Service	1710129952	1710129952	1	1	WILLEY, ERIN K MD	6/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
137485	Fee-for-Service	1225066855	1225066855	1	1	WATSON, WALTER W MD	1/1/1998	207L00000X	NA	Other	026	PHYSICIANS	41555	None	None	0	In state provider	None	12440 FIRESTONE BLVD	STE 101	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
137492	Fee-for-Service	1467423301	1467423301	1	1	WONG, GRACE K OD	9/1/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11540 SANTA MONICA BLVD	STE 202	LOS ANGELES	CA	90025	7905	19	06037	34.04524404	-118.452534	Los Angeles County
137592	Fee-for-Service	1760182539	1760182539	1	1	WAMAGATTA, GRACE WANJIRU	5/8/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	5952 SYCAMORE CANYON	APT 2033	RIVERSIDE	CA	92507	0796	33	06065	33.94317615	-117.2991367	Riverside County
137645	Fee-for-Service	1154811925	1154811925	1	1	WEYAND, AUDREY M	2/3/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
137652	Fee-for-Service	1053321562	1053321562	1	1	WANG, CHARLES V MD	10/16/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55654	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
137664	Fee-for-Service	1265406268	1265406268	1	1	WEINSTOCK, KEN D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	92787	36	Psychiatry	0	In state provider	None	1301 SOUTHPOINT BLVD	None	PETALUMA	CA	94954	6858	49	06097	38.26109022	-122.6476782	Sonoma County
137665	Fee-for-Service	1477595189	1477595189	1	1	WADHWA, ASHISH K MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75692	04	Otology, Laryngology, Rhinology	0	In state provider	MED CORP	12630 MONTE VISTA RD	STE 206	POWAY	CA	92064	2530	37	06073	32.99533582	-117.0560031	San Diego County
137697	Fee-for-Service	1609943620	1609943620	1	1	WHEELER, TIMOTHY W MD	1/1/1982	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	39666	84	Surgery-Head and Neck	0	In state provider	None	1330 SAN BERNARDINO RD	None	UPLAND	CA	91786	4928	36	06071	34.10294486	-117.6325059	San Bernardino County
137727	Fee-for-Service	1649679168	1649679168	1	1	WINCHELL JONES, ELISABETH L	11/28/2018	106H00000X	NA	Mental Health Outpatient Services	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	MFT	340 RANCHEROS DRIVE	SUITE 166	SAN MARCOS	CA	92069	2900	37	06073	33.1388667	-117.1563523	San Diego County
137732	Fee-for-Service	1639374234	1639374234	1	1	WU, JENNIFER N MD	10/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106480	34	Urology and Urological Surgery	0	In state provider	None	27303 SLEEPY HOLLOW AVE	SOUTH	HAYWARD	CA	94545	4203	01	06001	37.63208871	-122.0939191	Alameda County
137754	Fee-for-Service	1942618533	1942618533	1	1	WANG, QINGRU MD	3/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152100	40	Pediatrics	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
137780	Fee-for-Service	1669514527	1669514527	1	2	WESTERN PACIFIC MED-CORP	3/1/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	7232 CANBY AVENUE	SUITE 4, 5, 6	RESEDA	CA	91335	3006	19	06037	34.2021268	-118.5347602	Los Angeles County
137782	Fee-for-Service	1811663594	1811663594	1	1	WONG, CRESTLEY P OD	7/19/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.28825369	-120.4963159	Merced County
137812	Fee-for-Service	1154400893	1154400893	1	1	WONG, VANSEN MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	54437	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
137813	Fee-for-Service	1144725227	1144725227	1	1	WY, TOM JOSHUA DO	10/3/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	21290	None	None	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
137829	Fee-for-Service	1689633729	1689633729	1	1	WANG, HUAN-YOU MD	3/24/2009	207ZH0000X	NA	Other	026	PHYSICIANS	86331	22	Pathology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
137833	Fee-for-Service	1790896140	1790896140	1	1	WRIGHT, CHERYL D MD	11/30/1989	207RR0500X	NA	Other	026	PHYSICIANS	43238	83	Rheumatology	0	In state provider	SHARP REES-STEALY CORP	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
137854	Fee-for-Service	1043399793	1043399793	1	1	WONG, ROY K MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35925	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
137855	Fee-for-Service	1003068420	1003068420	1	1	WONG, CHRISTINA W MD	6/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111288	08	Family Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
137861	Fee-for-Service	1063599918	1063599918	1	1	WANG, CYNTHIA B MD	12/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82128	07	Dermatology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
137869	Fee-for-Service	1700306743	1700306743	1	1	WAHOME, ERICK NDERITU	5/3/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3420 SPRING WHEAT ST	None	PERRIS	CA	92570	5670	33	06065	33.74526044	-117.2080907	Riverside County
137883	Fee-for-Service	1760182539	1760182539	1	1	WAMAGATTA, GRACE WANJIRU	5/8/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	5952 SYCAMORE CANYON	APT 2033	RIVERSIDE	CA	92507	0796	33	06065	33.94317615	-117.2991367	Riverside County
137930	Fee-for-Service	1326599093	1326599093	1	1	WYMAN, LIBERTY S LMFT	12/6/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 S 2ND AVE	STE 105	BARSTOW	CA	92311	2854	36	06071	34.894656	-117.0262295	San Bernardino County
137988	Fee-for-Service	1629207394	1629207394	1	1	WINNICKI, ERICA D MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108028	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
138052	Fee-for-Service	1093246472	1093246472	1	1	WANG, REGINA MD	12/17/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158104	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
138058	Fee-for-Service	1679646681	1679646681	1	1	WEBB, HEATHER R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
138068	Fee-for-Service	1669514527	1669514527	1	2	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	7232 CANBY AVENUE	SUITE 4, 5, 6	RESEDA	CA	91335	3006	19	06037	34.2021268	-118.5347602	Los Angeles County
138083	Fee-for-Service	1184811952	1184811952	1	2	WOO, BENJAMIN K MD	3/22/2023	2084P0800X	NA	Psychiatry	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
138086	Fee-for-Service	1295957470	1295957470	1	1	WASSEF, SHERIF B MD	6/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	80202	30	Radiology	0	In state provider	None	2800 L STREET	STE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
138097	Fee-for-Service	1043271380	1043271380	1	1	WESTCOM RAD MED GRP INC	3/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	2231 S WESTERN AVE	None	LOS ANGELES	CA	90018	1302	19	06037	34.03512469	-118.3090138	Los Angeles County
138098	Fee-for-Service	1881960920	1881960920	1	1	WEST HOLLYWOOD VEIN CLINIC	8/21/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	PC	7901 SANTA MONICA BLVD	STE 101	WEST HOLLYWOOD	CA	90046	5178	19	06037	34.09089561	-118.3615405	Los Angeles County
138141	Fee-for-Service	1043399793	1043399793	1	1	WONG, ROY K MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35925	41	Internal Medicine	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
138154	Fee-for-Service	1700306743	1700306743	1	1	WAHOME, ERICK NDERITU	5/3/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3420 SPRING WHEAT ST	None	PERRIS	CA	92570	5670	33	06065	33.74526044	-117.2080907	Riverside County
138220	Fee-for-Service	1720180383	1720180383	1	1	WAGMAN, LAWRENCE D MD	7/29/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55578	02	General Surgery	0	In state provider	None	1010 W LA VETA	STE 470	ORANGE	CA	92868	4305	30	06059	33.78028244	-117.8635552	Orange County
138234	Fee-for-Service	1255331203	1255331203	1	1	WHITAKER, DAVID H DO	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8427	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
138275	Fee-for-Service	1629207394	1629207394	1	1	WINNICKI, ERICA D MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108028	45	Nephrology (Renal-Kidney)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
138355	Fee-for-Service	1598034084	1598034084	1	1	WILLIAMS, CHERMEL LMFT	8/20/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7365 CARNELIAN ST	STE 202	RANCHO CUCAMONGA	CA	91730	1100	36	06071	34.12038413	-117.6160525	San Bernardino County
138389	Fee-for-Service	1881960920	1881960920	1	1	WEST HOLLYWOOD VEIN CLINIC	8/21/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	PC	7901 SANTA MONICA BLVD	STE 101	WEST HOLLYWOOD	CA	90046	5178	19	06037	34.09089561	-118.3615405	Los Angeles County
138402	Fee-for-Service	1083465264	1083465264	1	1	WILSON, THOMAS T LCSW	5/17/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
138409	Fee-for-Service	1063701068	1063701068	1	1	WETTERSTEN, NICHOLAS W MD	6/14/2018	207RA0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	122511	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
138430	Fee-for-Service	1518972520	1518972520	1	1	WALGREEN CO	5/3/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5451 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5613	19	06037	34.0981319	-118.3087069	Los Angeles County
138447	Fee-for-Service	1326197658	1326197658	1	1	WONG, JONATHAN M MD	9/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86114	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
138468	Fee-for-Service	1851701049	1851701049	1	1	WHITE, CHRISLYN L MD	2/8/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	138135	09	Gynecology (D.O. only)	0	In state provider	None	365 HAWTHORNE AVE	STE 301	OAKLAND	CA	94609	3113	01	06001	37.82079728	-122.2633226	Alameda County
138475	Fee-for-Service	1588625164	1588625164	1	1	WONG, JAMES HONG OD	2/27/2003	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1826 BUCHANAN ST	STE A	SAN FRANCISCO	CA	94115	3211	38	06075	37.78696345	-122.4300353	San Francisco County
138513	Fee-for-Service	1467589325	1467589325	1	1	WILLARD, CYNTHIA L MD	8/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	55890	01	General Practice	0	In state provider	None	1828 E CESAR E CHAVEZ AV	SUITE 5000	LOS ANGELES	CA	90033	2487	19	06037	34.05023174	-118.2154927	Los Angeles County
138514	Fee-for-Service	1760629158	1760629158	1	1	WANG, JANET L MD	3/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120525	68	Hematology	0	In state provider	None	2850 COMMERCIAL CROSSING	None	SANTA CRUZ	CA	95065	1702	44	06087	36.98796413	-121.9825327	Santa Cruz County
138560	Fee-for-Service	1699039438	1699039438	1	1	WU, DAVID MD	10/30/2023	207RC0200X	NA	Other	026	PHYSICIANS	179707	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
138569	Fee-for-Service	1972518983	1972518983	1	1	WALGREEN CO	11/22/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	27983 SLOAN CANYON RD	None	CASTAIC	CA	91384	2594	19	06037	34.49476297	-118.6260515	Los Angeles County
138583	Fee-for-Service	1508447715	1508447715	1	1	WADA, CLARE A DO	8/1/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22952	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
138592	Fee-for-Service	1336407329	1336407329	1	1	WONG, LEE L MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142938	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
138642	Fee-for-Service	1992751945	1992751945	1	1	WOORI MEDICAL CENTER COR	3/1/2001	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	266 S HARVARD BLVD	FL 2	LOS ANGELES	CA	90004	4372	19	06037	34.069221	-118.3041245	Los Angeles County
138661	Fee-for-Service	1902973761	1902973761	1	1	WOLFE, MARGARET A	10/11/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	12100 EUCLID ST	None	GARDEN GROVE	CA	92840	3304	30	06059	33.786882	-117.9410535	Orange County
138675	Fee-for-Service	1881960920	1881960920	1	1	WEST HOLLYWOOD VEIN CLINIC	8/21/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PC	7901 SANTA MONICA BLVD	STE 101	WEST HOLLYWOOD	CA	90046	5178	19	06037	34.09089561	-118.3615405	Los Angeles County
138754	Fee-for-Service	1851701049	1851701049	1	1	WHITE, CHRISLYN L MD	2/8/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	138135	15	Obstetrics (D.O. only)	0	In state provider	None	365 HAWTHORNE AVE	STE 301	OAKLAND	CA	94609	3113	01	06001	37.82079728	-122.2633226	Alameda County
138804	Fee-for-Service	1760629158	1760629158	1	1	WANG, JANET L MD	3/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120525	78	Neoplastic Diseases/Oncology	0	In state provider	None	2850 COMMERCIAL CROSSING	None	SANTA CRUZ	CA	95065	1702	44	06087	36.98796413	-121.9825327	Santa Cruz County
138809	Fee-for-Service	1760952873	1760952873	1	1	WALDON, SYDNEY CNP	12/3/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2700 HOMESTEAD RD	None	SANTA CLARA	CA	95051	5353	43	06085	37.33899611	-121.9746975	Santa Clara County
138827	Fee-for-Service	1710692280	1710692280	1	1	WOMENS HEALTH CENTER OF SILI	5/23/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	CON VALLEY	2495 HOSPITAL DR	SUITE 505	MOUNTAIN VIEW	CA	94040	4157	43	06085	37.369341	-122.0817635	Santa Clara County
138833	Fee-for-Service	1043639016	1043639016	1	1	WILGA, LYDIA G MD	5/30/2018	207R00000X	NA	Other	026	PHYSICIANS	137510	None	None	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
138834	Fee-for-Service	1295740587	1295740587	1	1	WALGREEN CO	6/30/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1219 N CEDAR AVE	None	FRESNO	CA	93703	4313	10	06019	36.75818686	-119.7545378	Fresno County
138855	Fee-for-Service	1366977100	1366977100	1	1	WHELAN, ADRIAN MD	7/30/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	163343	45	Nephrology (Renal-Kidney)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
138930	Fee-for-Service	1215618871	1215618871	1	1	WALKER, RILEY NP	9/6/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	844 JACKMAN	None	EL CAJON	CA	92020	3053	37	06073	32.806089	-116.9734565	San Diego County
138950	Fee-for-Service	1689967812	1689967812	1	1	WOOD, RYAN W DPM	8/7/2012	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
138955	Fee-for-Service	1962964882	1962964882	1	1	WILHELMI, ALEC M	1/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177715	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
138962	Fee-for-Service	1538174818	1538174818	1	1	WALGREENS CO	7/24/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #05528	4041 N SIERRA WAY	None	SAN BERNARDINO	CA	92407	3816	36	06071	34.16544	-117.2850005	San Bernardino County
138999	Fee-for-Service	1427098102	1427098102	1	1	WALLACE, MARK S MD	9/30/1991	207LP2900X	NA	Other	026	PHYSICIANS	72906	05	Anesthesiology	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
139027	Fee-for-Service	1538241773	1538241773	1	1	WEBB, LEWIS PSYD	4/3/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
139036	Fee-for-Service	1982135794	1982135794	1	1	WLODARCZYK, JORDAN MD	7/17/2019	2086S0120X	NA	General Surgery	026	PHYSICIANS	158242	85	Surgery-Pediatric	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
139085	Fee-for-Service	1750434007	1750434007	1	1	WADE, PATRICK D LCSW	12/8/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
139237	Fee-for-Service	1013058726	1013058726	1	1	WESTIN ENTERPRISES, INC	4/19/2006	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CARSON ADULT DAY HEALTH	23517 MAIN ST	STE 110	CARSON	CA	90745	5241	19	06037	33.81129174	-118.2756933	Los Angeles County
139266	Fee-for-Service	1427048693	1427048693	1	1	WANG, YUJEN MD	5/25/2022	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	-	None	None	1	Border provider	None	1867 WILLIAMS HWY	STE 107	GRANTS PASS	OR	97527	5854	00	None	42.41747435	-123.3387141	Josephine County
139291	Fee-for-Service	1023474442	1023474442	1	1	WINTZ, DIANE A MD INC	12/19/2016	193400000X	NA	Other	026	PHYSICIANS	138581	01	General Practice	0	In state provider	None	7901 FROST STREET	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
139306	Fee-for-Service	1316439979	1316439979	1	1	WOMENS OBGYN	3/12/2020	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	RNIA PROFESSIONAL MEDICA	1111 SONOMA AVENUE	SUITE 202	SANTA ROSA	CA	95405	4559	49	06097	38.442042	-122.700033	Sonoma County
139348	Fee-for-Service	1821259458	1821259458	1	1	WERNER, R AARON OD	8/12/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2650 JAMACHA RD	STE 155	EL CAJON	CA	92019	4319	37	06073	32.74399718	-116.9320709	San Diego County
139352	Fee-for-Service	1053417725	1053417725	1	1	WIKHOLM, GARY D MD	1/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	247 W HARVARD BLVD	None	SANTA PAULA	CA	93060	3223	56	06111	34.34517723	-119.0758733	Ventura County
139357	Fee-for-Service	1447837661	1447837661	1	1	WU, CONSTANCE MD	10/2/2024	207R00000X	NA	Other	026	PHYSICIANS	191824	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
139373	Fee-for-Service	1417054768	1417054768	1	1	WU, TINA MD	10/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76843	41	Internal Medicine	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
139392	Fee-for-Service	1295213379	1295213379	1	1	WANG, JING	10/4/2018	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
139493	Fee-for-Service	1952475279	1952475279	1	1	WALL, JAMES K MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89820	02	General Surgery	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
139501	Fee-for-Service	1679659080	1679659080	1	1	WYCKOFF, STEPHANIE M MD	3/29/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	69149	None	None	0	In state provider	None	3628 E IMPERIAL HWY	STE 200	LYNWOOD	CA	90262	2646	19	06037	33.93070837	-118.2044557	Los Angeles County
139504	Fee-for-Service	1891872644	1891872644	1	1	WINDSOR GARDENS CONVALESCENT	3/1/1990	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL INC	915 S CRENSHAW RD	None	LOS ANGELES	CA	90019	1938	19	06037	34.05586896	-118.3223689	Los Angeles County
139524	Fee-for-Service	1255536413	1255536413	1	1	WHEAT, SHANNON J MD	2/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120902	05	Anesthesiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91368	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
139544	Fee-for-Service	1659300499	1659300499	1	1	WEST COAST HEARING & BAL	12/13/2005	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	ANCE CENTER	2876 N SYCAMORE RD	STE 303	SIMI VALLEY	CA	93065	0000	56	06111	34.28795345	-118.7438659	Ventura County
139560	Fee-for-Service	1164486767	1164486767	1	1	WULFF, KRISTEN M MD	8/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73144	30	Radiology	0	In state provider	None	559 ABBOTT ST	None	SALINAS	CA	93901	4325	27	06053	36.66284132	-121.6420108	Monterey County
139578	Fee-for-Service	1023474442	1023474442	1	1	WINTZ, DIANE A MD INC	12/19/2016	193400000X	NA	Other	026	PHYSICIANS	138581	02	General Surgery	0	In state provider	None	7901 FROST STREET	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
139604	Fee-for-Service	1255392510	1255392510	1	1	WESTCOM RADIOLOGY MEDICAL	1/25/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	13222 BLOOMFIELD AVE	None	NORWALK	CA	90650	3249	19	06037	33.910785	-118.0644915	Los Angeles County
139622	Fee-for-Service	1225329303	1225329303	1	1	WU, YING MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126483	83	Rheumatology	0	In state provider	None	200 N WAYTE LANE	None	FRESNO	CA	93701	2124	10	06019	36.74509575	-119.7836786	Fresno County
139638	Fee-for-Service	1588963573	1588963573	1	1	WEISHAUS, KENT A LCSW	10/18/2012	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	54240 RIDGEVIEW DR	STE 203	IDYLLWILD	CA	92549	0001	33	06065	33.74443331	-116.7145497	Riverside County
139685	Fee-for-Service	1093822108	1093822108	1	1	WOODS, JAMI MD	7/16/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	168758	36	Psychiatry	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
139725	Fee-for-Service	1881685527	1881685527	1	8	WESTERN RADIATION ONCOLOGY I	2/2/2023	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	32	Radiation Therapy (D.O. only)	0	In state provider	NC	125 SOUTH DRIVE	None	MOUNTAIN VIEW	CA	94040	4310	43	06085	37.36722947	-122.079033	Santa Clara County
139783	Fee-for-Service	1922108778	1922108778	1	1	WACHTEL, ANDREW S MD	5/31/1985	207RP1001X	NA	Pulmonology	026	PHYSICIANS	51967	None	None	0	In state provider	None	266 S HARVARD BLVD	None	LOS ANGELES	CA	90004	4372	19	06037	34.069221	-118.3041245	Los Angeles County
139844	Fee-for-Service	1508946310	1508946310	1	1	WANG, TIEN C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
139868	Fee-for-Service	1922071646	1922071646	1	1	WAGNER, BARRY A OD	1/17/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12000 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3319	19	06037	34.18665451	-118.394541	Los Angeles County
139882	Fee-for-Service	1801999065	1801999065	1	1	WELSH OSGA, BARBARA	1/3/1983	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3505 CAMINO DEL RIO S	STE 238	SAN DIEGO	CA	92108	4037	37	06073	32.77756386	-117.1185135	San Diego County
139907	Fee-for-Service	1225329303	1225329303	1	1	WU, YING MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126483	41	Internal Medicine	0	In state provider	None	200 N WAYTE LANE	None	FRESNO	CA	93701	2124	10	06019	36.74509575	-119.7836786	Fresno County
139927	Fee-for-Service	1518498518	1518498518	1	1	WAHAB, ALAHA MD	10/29/2021	207R00000X	NA	Other	026	PHYSICIANS	164615	None	None	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
139928	Fee-for-Service	1184063471	1184063471	1	1	WAL-MART STORES, INC	9/16/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1330 E GRAND AVE	None	ESCONDIDO	CA	92027	0319	37	06073	33.12873931	-117.0618582	San Diego County
139957	Fee-for-Service	1851538409	1851538409	1	1	WANG, SHEILA E LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
139971	Fee-for-Service	1942982624	1942982624	1	1	WESTERN OPTOMETRIC CENTER IN	8/14/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	C	237 N WESTERN AVE	None	LOS ANGELES	CA	90004	4107	19	06037	34.07572244	-118.3091724	Los Angeles County
139985	Fee-for-Service	1538128715	1538128715	1	1	WONG, MARILYN MD	6/1/1999	2083P0901X	NA	Adult Primary Care	026	PHYSICIANS	63867	01	General Practice	0	In state provider	None	1600 HOLLOWAY AVE	None	SAN FRANCISCO	CA	94132	1722	38	06075	37.72087043	-122.4782195	San Francisco County
140004	Fee-for-Service	1750308003	1750308003	1	1	WAL-MART STORES INC	9/22/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10 2292	1275 N AZUSA AVE	None	COVINA	CA	91722	1246	19	06037	34.102548	-117.9077875	Los Angeles County
140008	Fee-for-Service	1497218143	1497218143	1	1	WALGREEN CO	9/6/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	866 CAMPUS DR	None	STANFORD	CA	94305	8508	43	06085	37.4223113	-122.1635566	Santa Clara County
140066	Fee-for-Service	1932171956	1932171956	1	1	WAMPOLD, DAVID B MD	9/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	22505	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2 MEDICAL PLAZA DR	STE 175	ROSEVILLE	CA	95661	3049	31	06061	38.76507948	-121.2477476	Placer County
140092	Fee-for-Service	1275382392	1275382392	1	1	WYNN MEDICAL CENTER PEDIATRI	7/25/2024	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CS-MEDICINE	401 N. GARFIELD AVE	203	MONTEREY PARK	CA	91754	1207	19	06037	34.066305	-118.122906	Los Angeles County
140102	Fee-for-Service	1184702730	1184702730	1	1	WONG, TERRELLA K MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71923	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
140289	Fee-for-Service	1275734097	1275734097	1	1	WU, HUI ZHEN CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	700 S STONEMAN AVE	APT E	ALHAMBRA	CA	91801	5822	19	06037	34.08889282	-118.1213711	Los Angeles County
140299	Fee-for-Service	1548215601	1548215601	1	1	WALTERS, WALTER L MD	8/14/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80201	05	Anesthesiology	0	In state provider	None	825 DELBON AVENUE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
140340	Fee-for-Service	1013095900	1013095900	1	1	WAGNER, MICHAEL VINCENT	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	52985	09	Gynecology (D.O. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
140380	Fee-for-Service	1275382392	1275382392	1	1	WYNN MEDICAL CENTER PEDIATRI	7/25/2024	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	CS-MEDICINE	401 N. GARFIELD AVE	203	MONTEREY PARK	CA	91754	1207	19	06037	34.066305	-118.122906	Los Angeles County
140446	Fee-for-Service	1972059285	1972059285	1	1	WITMAN, LAUREN	3/6/2018	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	740 S PLACENTIA AVE	STE 100	PLACENTIA	CA	92870	6832	30	06059	33.86285731	-117.8822066	Orange County
140469	Fee-for-Service	1467511121	1467511121	1	1	WAXMAN, BART D MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74586	05	Anesthesiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
140483	Fee-for-Service	1336251628	1336251628	1	1	WAI, SAN S MD AMC	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	56447	41	Internal Medicine	0	In state provider	None	2211 W MAGNOLIA BLVD	STE 230	BURBANK	CA	91506	1762	19	06037	34.1728873	-118.3320905	Los Angeles County
140497	Fee-for-Service	1376149476	1376149476	1	1	WERTHEIMER, BEVERLY LCSW	12/11/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
140521	Fee-for-Service	1396891982	1396891982	1	1	WISNER, BENJAMIN P MD	1/5/2025	208800000X	NA	Other	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	42	06083	34.45144647	-119.7604485	Santa Barbara County
140536	Fee-for-Service	1699778399	1699778399	1	1	WONG, DOUGLAS S MD	5/31/1991	174400000X	NA	Other	026	PHYSICIANS	45487	30	Radiology	0	In state provider	None	FRESNO & R STREET	None	FRESNO	CA	93715	0000	10	06019	36.741663	-119.7841005	Fresno County
140553	Fee-for-Service	1932257540	1932257540	1	1	WINTERS JOINT USD	9/9/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	909 W GRANT AVE	None	WINTERS	CA	95694	1543	57	06113	38.51996791	-121.9849088	Yolo County
140593	Fee-for-Service	1457422347	1457422347	1	1	WEINBERGER, MICHAEL W MD	5/31/1990	2086X0206X	NA	General Surgery	026	PHYSICIANS	70994	34	Urology and Urological Surgery	0	In state provider	None	2880 ATLANTIC AVE	STE 130	LONG BEACH	CA	90806	1717	19	06037	33.809382	-118.185001	Los Angeles County
140614	Fee-for-Service	1285711242	1285711242	1	1	WELLE, THOMAS J MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7124	20	Orthopedic Surgery	0	In state provider	None	1662 DOMINICAN WAY	None	SANTA CRUZ	CA	95065	1522	44	06087	36.99033079	-121.9816507	Santa Cruz County
140629	Fee-for-Service	1013095900	1013095900	1	1	WAGNER, MICHAEL VINCENT	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	52985	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
140685	Fee-for-Service	1962618496	1962618496	1	1	WON, SUETFEI N NP	6/5/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
140730	Fee-for-Service	1023461720	1023461720	1	1	WANG, MINJUN LPCC	12/7/2020	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11 AIRPORT BLVD.	204	SOUTH SAN FRANCIS	CA	94080	6517	41	06081	37.64980148	-122.4083953	San Mateo County
140731	Fee-for-Service	1073516597	1073516597	1	1	WHISLER, CHARLES E MD	1/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90232	18	Ophthalmology	0	In state provider	None	966 CASS ST	STE 100	MONTEREY	CA	93940	4540	27	06053	36.5924291	-121.8964192	Monterey County
140733	Fee-for-Service	1760750590	1760750590	1	1	WINARKO, OLIVIA C MD	3/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115395	40	Pediatrics	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
140749	Fee-for-Service	1144201625	1144201625	1	1	WEISER, THOMAS G MD	10/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	84864	02	General Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
140750	Fee-for-Service	1043880818	1043880818	1	1	WRAY, ELIZABETH LMFT	7/28/2021	103TP2701X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25000 AVENUE STANFORD	167	VALENCIA	CA	91355	4553	19	06037	34.43847322	-118.5729968	Los Angeles County
140775	Fee-for-Service	1669628137	1669628137	1	1	WOOD, DOMINICA N MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	108946	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
140825	Fee-for-Service	1144250994	1144250994	1	1	WONG, SUSIE YIN-PENG	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42888	18	Ophthalmology	0	In state provider	None	18617 GALE AVE	None	ROWLAND HEIGHTS	CA	91748	1342	19	06037	33.99456206	-117.896939	Los Angeles County
140847	Fee-for-Service	1578570529	1578570529	1	1	WOOD, MARK G MD APC	3/7/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	27304	18	Ophthalmology	0	In state provider	C/0 THOMAS E KURTH	7075 N SHARON	None	FRESNO	CA	93720	3329	10	06019	36.83882737	-119.7590708	Fresno County
140872	Fee-for-Service	1467571471	1467571471	1	1	WALGREEN CO	10/3/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	988 SIERRA ST	None	KINGSBURG	CA	93631	1554	10	06019	36.51781851	-119.5567515	Fresno County
140880	Fee-for-Service	1457422347	1457422347	1	1	WEINBERGER, MICHAEL W MD	5/31/1990	2086X0206X	NA	General Surgery	026	PHYSICIANS	70994	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2880 ATLANTIC AVE	STE 130	LONG BEACH	CA	90806	1717	19	06037	33.809382	-118.185001	Los Angeles County
140901	Fee-for-Service	1932287091	1932287091	1	1	WIN, THEIN MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62530	01	General Practice	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
140902	Fee-for-Service	1932546173	1932546173	1	1	WARD, NICHOLAS T MD	6/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129359	66	Emergency Medicine (Urgent Care)	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
140973	Fee-for-Service	1568616563	1568616563	1	1	WONG, PATRICK L MD	11/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	114089	25	Physical Medicine and Rehabilitation	0	In state provider	None	12 UPPER RAGSDALE	None	MONTEREY	CA	93940	7885	27	06053	36.57482436	-121.8101797	Monterey County
140979	Fee-for-Service	1700850633	1700850633	1	1	WEAR, RICHARD B MD	1/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	52672	41	Internal Medicine	0	In state provider	None	65 N MADISON ST	STE 800	PASADENA	CA	91101	2038	19	06037	34.14705803	-118.1384317	Los Angeles County
140981	Fee-for-Service	1285860445	1285860445	1	1	WOLSTAN & GOLDBERG EYE ASSOC	1/31/2017	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	IATES INC A MEDICAL CORP	23600 TELO AVE	SUITE 100	TORRANCE	CA	90505	4035	19	06037	33.81215054	-118.3384029	Los Angeles County
141017	Fee-for-Service	1932119385	1932119385	2	1	WU, KESHENG MD	2/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	66735	41	Internal Medicine	0	In state provider	None	9209 COLOMA RD	STE 4500	WHITTIER	CA	90605	1823	19	06037	33.9505367	-118.0054552	Los Angeles County
141106	Fee-for-Service	1023004116	1023004116	1	1	WEINSTEIN, JOEL A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	49173	02	General Surgery	0	In state provider	None	75 NIELSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7937089	Santa Cruz County
141130	Fee-for-Service	1477548659	1477548659	1	1	WEBB, THOMAS D MD	7/31/1995	207L00000X	NA	Other	026	PHYSICIANS	42606	None	None	0	In state provider	None	11601 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2907	19	06037	34.04458879	-118.4542015	Los Angeles County
141133	Fee-for-Service	1376682302	1376682302	1	1	WOOFTER, CHAD R MD	3/29/2019	207QS1201X	NA	Adult Primary Care	026	PHYSICIANS	98346	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
141158	Fee-for-Service	1932257755	1932257755	1	1	WINNICK, JEROLD A MD	9/30/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	45695	18	Ophthalmology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
141191	Fee-for-Service	1881272904	1881272904	1	1	WAI, MATTHEW	11/27/2024	207R00000X	NA	Other	026	PHYSICIANS	22172	41	Internal Medicine	0	In state provider	None	4500 BROCKTON AVE.	SUITE 305	RIVERSIDE	CA	92501	4027	33	06065	33.97785263	-117.3836152	Riverside County
141284	Fee-for-Service	1689764540	1689764540	1	1	WOOD, BRENT L MD	10/1/2020	207ZP0105X	NA	Other	026	PHYSICIANS	156637	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
141303	Fee-for-Service	1578645180	1578645180	1	1	WESTCHESTER MED GROUP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	47	Miscellaneous	0	In state provider	% DNH MEDICAL MGMT INC	8540 S SEPULVEDA BLVD	STE 118	LOS ANGELES	CA	90045	3818	19	06037	33.96022076	-118.3961982	Los Angeles County
141305	Fee-for-Service	1407331036	1407331036	1	1	WELLWORKS PHYSICAL THERAPY A	2/20/2020	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ND REHABILITATION, INC.	500 W GLENOAKS BLVD	None	GLENDALE	CA	91202	2813	19	06037	34.15937082	-118.2644042	Los Angeles County
141312	Fee-for-Service	1164437497	1164437497	1	1	WALGREEN CO	7/23/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10407 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	5009	19	06037	34.05735528	-118.4244855	Los Angeles County
141349	Fee-for-Service	1588927552	1588927552	1	1	WONG, TIN S DO	9/1/2015	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	13729	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
141350	Fee-for-Service	1891878773	1891878773	1	1	WASOWSKI, KATHLEEN S PT	5/30/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	401 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6387	43	06085	37.36777579	-122.0276404	Santa Clara County
141545	Fee-for-Service	1750446076	1750446076	1	1	WONG, DANIEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	90765	05	Anesthesiology	0	In state provider	None	1300 NORTH VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
141585	Fee-for-Service	1790489763	1790489763	1	1	WILLIAMS, WESLEY W	11/15/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15409 ANACAPA RD	409-F	VICTORVILLE	CA	92392	2463	36	06071	34.50499906	-117.3255382	San Bernardino County
141589	Fee-for-Service	1578645180	1578645180	1	1	WESTCHESTER MED GROUP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	% DNH MEDICAL MGMT INC	8540 S SEPULVEDA BLVD	STE 118	LOS ANGELES	CA	90045	3818	19	06037	33.96022076	-118.3961982	Los Angeles County
141593	Fee-for-Service	1407331036	1407331036	1	1	WELLWORKS PHYSICAL THERAPY A	2/20/2020	225XH1200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ND REHABILITATION, INC.	500 W GLENOAKS BLVD	None	GLENDALE	CA	91202	2813	19	06037	34.15937082	-118.2644042	Los Angeles County
141602	Fee-for-Service	1477602746	1477602746	1	1	WILLIAMS, RICHARD B MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	59116	None	None	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
141622	Fee-for-Service	1811051329	1811051329	1	1	WEST, GEORGE R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	90 PARK RD	None	NOCONA	TX	76255	3600	00	None	33.7776247	-97.73161433	Montague County
141635	Fee-for-Service	1003436064	1003436064	1	32	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2027 VILLAGE LANE	204	SOLVANG	CA	93463	0000	42	06083	34.60089846	-120.1274865	Santa Barbara County
141652	Fee-for-Service	1437325503	1437325503	1	1	WATSON, LINDSEY A PHD	6/17/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	100 E WARDLOW ROAD	None	LONG BEACH	CA	90807	4417	19	06037	33.8188341	-118.1923297	Los Angeles County
141685	Fee-for-Service	1245247246	1245247246	1	1	WALGREENS CO	9/1/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #01995	40420 MURRIETA HOT SPRIN	None	MURRIETA	CA	92563	6400	33	06065	33.55639938	-117.1768413	Riverside County
141704	Fee-for-Service	1578693065	1578693065	1	1	WAY BACK	9/20/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2516 A ST	None	SAN DIEGO	CA	92102	2111	37	06073	32.71895346	-117.1397471	San Diego County
141708	Fee-for-Service	1720414550	1720414550	1	1	WONDOLOWSKI, LAUREN M MD	2/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127455	08	Family Practice	0	In state provider	None	595 CENTER AVENUE	SUITE 300	MARTINEZ	CA	94553	4634	07	06013	37.99313048	-122.1189497	Contra Costa County
141716	Fee-for-Service	1871677872	1871677872	1	1	WOODARD, TERRY L MD	7/22/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77193	41	Internal Medicine	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
141738	Fee-for-Service	1730176538	1730176538	1	1	WINDSOR CARE CENTER	10/1/1992	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	NATIONAL CITY INC	220 E 24TH ST	None	NATIONAL CITY	CA	91950	6705	37	06073	32.66277749	-117.0987777	San Diego County
141809	Fee-for-Service	1659659514	1659659514	1	1	WANG, CRYSTAL S	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
141815	Fee-for-Service	1073608543	1073608543	1	1	WANG, WILSON MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75880	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
141871	Fee-for-Service	1659765618	1659765618	1	1	WILBON, ETISHA LMFT	6/12/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	103673	-	NOT APPLICABLE	0	In state provider	None	2550 W. CLINTON AVE.	BLDG A & H	FRESNO	CA	93705	4206	10	06019	36.77202022	-119.8415276	Fresno County
141875	Fee-for-Service	1578645180	1578645180	1	1	WESTCHESTER MED GROUP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	% DNH MEDICAL MGMT INC	8540 S SEPULVEDA BLVD	STE 118	LOS ANGELES	CA	90045	3818	19	06037	33.96022076	-118.3961982	Los Angeles County
141880	Fee-for-Service	1255364998	1255364998	1	1	WEST COAST CARDIOLOGY	1/1/1996	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	MEDICAL GROUP	575 E HARDY ST	STE 104	INGLEWOOD	CA	90301	4038	19	06037	33.94909392	-118.3477665	Los Angeles County
141886	Fee-for-Service	1023206463	1023206463	1	1	WALGREEN CO	2/15/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	310 S LAKE ST	None	PASADENA	CA	91101	3537	19	06037	34.14044971	-118.1322366	Los Angeles County
141917	Fee-for-Service	1396020624	1396020624	1	1	WADHAWAN, ASHWINDER K PT	3/3/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
141918	Fee-for-Service	1174601835	1174601835	1	1	WALSH, KEVIN L MD	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	63414	41	Internal Medicine	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
141923	Fee-for-Service	1003436064	1003436064	1	32	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2027 VILLAGE LANE	204	SOLVANG	CA	93463	0000	42	06083	34.60089846	-120.1274865	Santa Barbara County
141930	Fee-for-Service	1215186275	1215186275	1	1	WOOD, KRISTINA D	9/13/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	969 BROADWAY	None	OAKLAND	CA	94607	4017	01	06001	37.80134725	-122.273069	Alameda County
141944	Fee-for-Service	1881218337	1881218337	1	1	WINTERSTEIN, KAELIA LMFT	9/9/2024	390200000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1200 PASEO CAMARILLO	155	CAMARILLO	CA	93010	6050	56	06111	34.22097448	-119.054079	Ventura County
141954	Fee-for-Service	1699201822	1699201822	1	1	WU, BINGLING JENNY MD	9/18/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	176653	None	None	0	In state provider	None	501 J ST	None	SACRAMENTO	CA	95814	2325	34	06067	38.582118	-121.499325	Sacramento County
141957	Fee-for-Service	1366765448	1366765448	1	1	WIDMAN, LARRY A MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	32397	89	Surgery-Traumatic	0	In state provider	None	190 LEAVESLEY RD	None	GILROY	CA	95020	3635	43	06085	37.01991719	-121.5728065	Santa Clara County
141979	Fee-for-Service	1689653305	1689653305	1	1	WILLIAM BEAUMONT HOSP	1/1/1998	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3601 W 13 MILE RD	None	ROYAL OAK	MI	48073	6712	00	None	42.513885	-83.193228	Oakland County
141994	Fee-for-Service	1801967831	1801967831	1	1	WAXMAN, JUDITH L MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	42943	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
142034	Fee-for-Service	1700317898	1700317898	1	1	WALLACE, ADAM B MD	7/10/2024	208200000X	NA	General Surgery	026	PHYSICIANS	161405	24	Plastic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
142039	Fee-for-Service	1962753061	1962753061	1	1	WALGREEN CO	12/17/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	925 ORANGE AVE	None	CORONADO	CA	92118	2609	37	06073	32.68677093	-117.1792108	San Diego County
142050	Fee-for-Service	1396823464	1396823464	1	1	WEISSER, RICK S MD	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	50121	40	Pediatrics	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
142069	Fee-for-Service	1487669719	1487669719	1	1	WALGREEN CO	5/23/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	128 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	2921	30	06059	33.840252	-117.889103	Orange County
142098	Fee-for-Service	1275795742	1275795742	1	1	WONG, JEREMY M MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95157	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
142104	Fee-for-Service	1073608543	1073608543	1	1	WANG, WILSON MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75880	40	Pediatrics	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
142119	Fee-for-Service	1922618917	1922618917	1	1	WEAKLEY, ALYSSA M PHD	9/29/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
142157	Fee-for-Service	1750346508	1750346508	1	1	WAI, STEVEN T MD	10/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66147	None	None	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
142158	Fee-for-Service	1275890055	1275890055	1	1	WASHINGTON, SAMUEL L MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	130105	34	Urology and Urological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
142201	Fee-for-Service	1538265236	1538265236	1	1	WONG, JAN MD	8/31/1988	208600000X	NA	General Surgery	026	PHYSICIANS	54876	02	General Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
142218	Fee-for-Service	1801174941	1801174941	1	1	WALSH, KRISTIN B MD	4/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130103	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
142245	Fee-for-Service	1366765448	1366765448	1	1	WIDMAN, LARRY A MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	32397	01	General Practice	0	In state provider	None	190 LEAVESLEY RD	None	GILROY	CA	95020	3635	43	06085	37.01991719	-121.5728065	Santa Clara County
142261	Fee-for-Service	1740357672	1740357672	1	1	WANG, EDWARD C MD	4/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78070	04	Otology, Laryngology, Rhinology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
142267	Fee-for-Service	1710904958	1710904958	1	1	WAL-MART STORES INC	11/15/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART 10-5305	1150 BROADWAY	None	CHULA VISTA	CA	91911	2707	37	06073	32.60682	-117.0830115	San Diego County
142269	Fee-for-Service	1689653305	1689653305	1	1	WILLIAM BEAUMONT HOSP	5/25/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3601 W 13 MILE RD	None	ROYAL OAK	MI	48073	6712	00	None	42.513885	-83.193228	Oakland County
142277	Fee-for-Service	1639468002	1639468002	1	1	WYATT, MATTHEW F MD	4/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	143209	05	Anesthesiology	0	In state provider	None	1601 YNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
142281	Fee-for-Service	1801967831	1801967831	1	1	WAXMAN, JUDITH L MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	42943	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
142306	Fee-for-Service	1679120356	1679120356	1	1	WATSON, BRIANA LMFT	8/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
142345	Fee-for-Service	1619395720	1619395720	1	1	WELLNESS & REHABILITATION	10/17/2014	193400000X	NA	Other	026	PHYSICIANS	121226	25	Physical Medicine and Rehabilitation	0	In state provider	MEDICINE INC	345 S HALCYON RD	None	ARROYO GRANDE	CA	93420	3817	40	06079	35.113419	-120.5915945	San Luis Obispo County
142378	Fee-for-Service	1720170293	1720170293	1	1	WALL, DAVID M MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	22662	20	Orthopedic Surgery	0	In state provider	None	9945 ARTESIA PL	None	BELLFLOWER	CA	90706	6757	19	06037	33.87488866	-118.1214268	Los Angeles County
142411	Fee-for-Service	1831238534	1831238534	1	1	WILLIAMS, JACQUES P MD	8/31/1993	207P00000X	NA	Other	026	PHYSICIANS	77765	66	Emergency Medicine (Urgent Care)	0	In state provider	None	14500 SHERMAN CIR	None	VAN NUYS	CA	91405	3052	19	06037	34.20025916	-118.4500763	Los Angeles County
142444	Fee-for-Service	1275890055	1275890055	1	1	WASHINGTON, SAMUEL L MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	130105	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
142457	Fee-for-Service	1669834958	1669834958	1	1	WHITE, HAMILTON R DO	1/10/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17455	08	Family Practice	0	In state provider	None	1011 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72827776	-121.2904066	Placer County
142497	Fee-for-Service	1740470988	1740470988	1	1	WEST,CLAIRE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5301 E GRANT RD	None	TUCSON	AZ	85712	0000	00	None	32.252391	-110.8790055	Pima County
142507	Fee-for-Service	1265051759	1265051759	1	1	WURDEMAN, TAYLOR MD	6/29/2023	2086S0120X	NA	General Surgery	026	PHYSICIANS	179993	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
142510	Fee-for-Service	1265828248	1265828248	1	1	WALTERS-DYER, AFIYA R MD	11/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154604	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
142536	Fee-for-Service	1467550699	1467550699	1	1	WINTER, BRIAN J MD	8/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76242	None	None	0	In state provider	None	950 N STATE ST	None	HEMET	CA	92543	1485	33	06065	33.763266	-116.9717935	Riverside County
142561	Fee-for-Service	1790060283	1790060283	1	1	WONG, IRENE P MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114117	40	Pediatrics	0	In state provider	None	2200 OFARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
142579	Fee-for-Service	1720041957	1720041957	1	2	WELLS, DAVID I DPM	2/21/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4101 TULLY RD	STE 102	MODESTO	CA	95356	9891	50	06099	37.69867589	-121.0127412	Stanislaus County
142689	Fee-for-Service	1083034599	1083034599	1	1	WINSLOW, KRISTEN B LMFT	8/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
142719	Fee-for-Service	1528164175	1528164175	1	1	WESTNEY, PENELOPE A MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71034	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
142753	Fee-for-Service	1982825238	1982825238	1	1	WILLIAMS, ERIC A MD	5/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91611	07	Dermatology	0	In state provider	None	200 UCLA MEDICAL PLZ	BLDG 465	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
142760	Fee-for-Service	1245340439	1245340439	1	1	WON, JAMES MD	7/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	83482	None	None	0	In state provider	None	2776 PACIFIC AVENUE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
142799	Fee-for-Service	1083648687	1083648687	1	1	WU, TSUNG-CHIEH JACKSON	2/28/1989	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	46040	67	Endocrinology	0	In state provider	None	924 WESTWOOD BLVD	STE 335	LOS ANGELES	CA	90024	2929	19	06037	34.06309787	-118.4452763	Los Angeles County
142849	Fee-for-Service	1801952593	1801952593	1	1	WESTERLUND, TERRI S CNM	10/23/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
142858	Fee-for-Service	1649211749	1649211749	1	1	WESTERN SURGICAL GROUP	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	BAIN, MARTIN A MD	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
142892	Fee-for-Service	1811605173	1811605173	1	1	WELLNESS HYDRATION CENTER A	8/9/2023	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	3727 N 1ST ST	106	FRESNO	CA	93726	5628	10	06019	36.78526681	-119.7727069	Fresno County
142945	Fee-for-Service	1114931540	1114931540	1	1	WOODS, JAMILE S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3460 PIONEER PKWY	None	W VALLEY CITY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
142954	Fee-for-Service	1447226634	1447226634	1	1	WONG, VICTOR C MD	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75544	41	Internal Medicine	0	In state provider	MULLIKIN MED CTR	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
143025	Fee-for-Service	1659799658	1659799658	1	1	WON, EUGENE J	6/20/2022	208G00000X	NA	General Surgery	026	PHYSICIANS	139647	None	None	0	In state provider	None	1310 W STEWART DR	STE 503	ORANGE	CA	92868	3856	30	06059	33.78236048	-117.8664975	Orange County
143031	Fee-for-Service	1144270612	1144270612	1	1	WOLFSON, NIKOLAJ S MD	2/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	51436	20	Orthopedic Surgery	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
143083	Fee-for-Service	1003194234	1003194234	1	1	WONG, JAMIE OD	11/1/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1895 MOWRY AVE STE 117	None	FREMONT	CA	94538	1736	01	06001	37.55909066	-121.9799265	Alameda County
143085	Fee-for-Service	1083648687	1083648687	1	1	WU, TSUNG-CHIEH JACKSON	2/28/1989	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	46040	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	924 WESTWOOD BLVD	STE 335	LOS ANGELES	CA	90024	2929	19	06037	34.06309787	-118.4452763	Los Angeles County
143094	Fee-for-Service	1750706701	1750706701	1	1	WEBBER, DIANA M PT	4/4/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
143121	Fee-for-Service	1316972656	1316972656	1	1	WATTERS, HARRY C. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	604 W WARNER RD	STE E201	CHANDLER	AZ	85225	2911	00	None	33.335388	-111.8512305	Maricopa County
143179	Fee-for-Service	1922099746	1922099746	1	1	WILSON, EUGENE W DO	10/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12160	30	Radiology	0	In state provider	None	372 WEST CPYRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
143180	Fee-for-Service	1770548349	1770548349	1	1	WILLIAM K. IMSAIS	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
143192	Fee-for-Service	1457529174	1457529174	1	1	WONG, CHRISTOPHER C MD	9/5/2008	207R00000X	NA	Other	026	PHYSICIANS	99051	41	Internal Medicine	0	In state provider	None	2100 WEBSTER STREET	SUITE 207	SAN FRANCISCO	CA	94115	2375	38	06075	37.7904826	-122.4324477	San Francisco County
143233	Fee-for-Service	1649423476	1649423476	1	1	WIJERATNE, PUSHPANJALIE	12/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101897	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
143303	Fee-for-Service	1447332036	1447332036	1	15	WELLSPACE HEALTH	1/8/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3946 NORWOOD AVE	None	SACRAMENTO	CA	95838	3300	34	06067	38.639952	-121.456359	Sacramento County
143314	Fee-for-Service	1265669360	1265669360	1	1	WARAICH, SALEEM A MD APMC	10/13/2009	207RR0500X	NA	Other	026	PHYSICIANS	93667	83	Rheumatology	0	In state provider	None	1275 N ROSE DR	STE 110	PLACENTIA	CA	92870	3919	30	06059	33.8868003	-117.8420447	Orange County
143389	Fee-for-Service	1992746689	1992746689	1	1	WAINSCHEL, LARRY A MD	3/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75066	14	Neurological Surgery	0	In state provider	None	251 COHASSET RD	STE 370	CHICO	CA	95926	2276	04	06007	39.75090044	-121.8522609	Butte County
143433	Fee-for-Service	1780690347	1780690347	2	1	WALGREEN CO	8/10/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4170 EL CAMINO REAL	None	PALO ALTO	CA	94306	4008	43	06085	37.41148135	-122.1243315	Santa Clara County
143456	Fee-for-Service	1023452042	1023452042	1	1	WALKER, JEFFREY B MD	7/18/2017	207L00000X	NA	Other	026	PHYSICIANS	134006	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
143468	Fee-for-Service	1891856381	1891856381	1	1	WEBER, SARA	5/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
143474	Fee-for-Service	1548396831	1548396831	1	1	WHITTIER PATHOLOGY MED	10/31/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
143525	Fee-for-Service	1881885374	1881885374	1	1	WEINRIT, HELEN M MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52794	05	Anesthesiology	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
143533	Fee-for-Service	1538519442	1538519442	1	1	WILLIAMS, ALEXANDRIA MD	7/1/2020	207R00000X	NA	Other	026	PHYSICIANS	167509	41	Internal Medicine	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
143555	Fee-for-Service	1649546128	1649546128	1	1	WILSON, ANDREW M MD	7/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	130664	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	8346	19	06037	34.06473399	-118.445865	Los Angeles County
143579	Fee-for-Service	1659557080	1659557080	1	1	WAL-MART STORES, INC	10/3/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8961 GREENBACK LANE	None	ORANGEVALE	CA	95662	4601	34	06067	38.679408	-121.2225525	Sacramento County
143593	Fee-for-Service	1447332036	1447332036	1	15	WELLSPACE HEALTH	6/29/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3946 NORWOOD AVE	None	SACRAMENTO	CA	95838	3300	34	06067	38.639952	-121.456359	Sacramento County
143637	Fee-for-Service	1740368547	1740368547	1	1	WENDER, DAVID A DO	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	6026	08	Family Practice	0	In state provider	None	1234 EMPIRE ST	None	FAIRFIELD	CA	94533	5711	48	06095	38.25037548	-122.049045	Solano County
143641	Fee-for-Service	1982737664	1982737664	1	1	WIKLUND, ANNE M LCSW	3/16/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
143730	Fee-for-Service	1346630159	1346630159	1	1	WANG, FRANCES S MD	2/28/2022	207R00000X	NA	Other	026	PHYSICIANS	170225	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
143737	Fee-for-Service	1861594335	1861594335	1	1	WUCHNER, MARK E MD	3/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89394	08	Family Practice	0	In state provider	None	15025 INNOVATION DR	None	SAN DIEGO	CA	92128	3409	37	06073	32.98956795	-117.0767228	San Diego County
143776	Fee-for-Service	1720424799	1720424799	1	1	WAL-MART STORES INC	7/19/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	941 ALAMO DR	None	VACAVILLE	CA	95687	5601	48	06095	38.3442395	-121.9965017	Solano County
143787	Fee-for-Service	1841677614	1841677614	1	1	WATSON, RICHARD L MD	2/2/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	150391	None	None	0	In state provider	None	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
143879	Fee-for-Service	1447332036	1447332036	1	15	WELLSPACE HEALTH	1/8/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3946 NORWOOD AVE	None	SACRAMENTO	CA	95838	3300	34	06067	38.639952	-121.456359	Sacramento County
143884	Fee-for-Service	1093863920	1093863920	1	1	WALKER, SCOTT A MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85366	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
143899	Fee-for-Service	1396007100	1396007100	1	1	WILLIAMS, JENNIFER J MD	9/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140987	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
143962	Fee-for-Service	1003436064	1003436064	1	5	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1611 S MELROSE DRIVE	F	VISTA	CA	92081	5407	37	06073	33.16662307	-117.2471325	San Diego County
143965	Fee-for-Service	1265511901	1265511901	1	1	WONG, PRESTON R MD	2/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32140	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
144003	Fee-for-Service	1750941050	1750941050	1	1	WU, LESLIE T MD	10/13/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
144006	Fee-for-Service	1104250851	1104250851	1	1	WU, EFREN F MD INC	1/2/2019	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	44100 JEFFERSON ST	STE E507	INDIO	CA	92201	2715	33	06065	33.72753404	-116.2687204	Riverside County
144014	Fee-for-Service	1023023355	1023023355	1	1	WALGREEN CO	6/21/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2976 SEPULVEDA BLVD	None	TORRANCE	CA	90505	2804	19	06037	33.82402224	-118.3392271	Los Angeles County
144022	Fee-for-Service	1700946985	1700946985	1	1	WANG, HANSEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	20997	85	Surgery-Pediatric	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
144079	Fee-for-Service	1699034645	1699034645	1	1	WONG, CHRISTINE M MD	8/28/2017	207LP3000X	NA	Other	026	PHYSICIANS	127760	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
144082	Fee-for-Service	1093851610	1093851610	1	1	WELLS, MARY M OD	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	23700 EL TORO RD	STE A1	LAKE FOREST	CA	92630	4711	30	06059	33.61837139	-117.7030159	Orange County
144113	Fee-for-Service	1326065749	1326065749	1	1	WAL-MART PHCY #10-1615	7/17/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2203 LOVERIDGE RD	None	PITTSBURG	CA	94565	5021	07	06013	38.00952608	-121.8702473	Contra Costa County
144122	Fee-for-Service	1073684973	1073684973	1	1	WONG, ROSY S MD	8/15/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63765	33	Thoracic Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
144143	Fee-for-Service	1164721411	1164721411	1	1	WU, JAMES MD	10/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125315	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
144157	Fee-for-Service	1003865866	1003865866	1	1	WONG, JIMMIE C MD	9/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91427	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
144219	Fee-for-Service	1851497002	1851497002	1	2	WHITE MEMORIAL PEDIATRIC	2/20/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	MEDICAL GROUP	1700 CESAR E CHAVEZ AVE	STE 3000	LOS ANGELES	CA	90033	2424	19	06037	34.05101259	-118.217259	Los Angeles County
144251	Fee-for-Service	1942235676	1942235676	1	1	WATSON, THOMAS D MD	8/31/1986	207P00000X	NA	Other	026	PHYSICIANS	54134	08	Family Practice	0	In state provider	VENTURA COUNTY MED CTR	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
144280	Fee-for-Service	1881832210	1881832210	1	1	WONG, STEPHANIE K DO	11/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	10648	01	General Practice	0	In state provider	None	2250 HAYES ST	SUITE 204	SAN FRANCISCO	CA	94117	1078	38	06075	37.77302042	-122.45342	San Francisco County
144285	Fee-for-Service	1982223608	1982223608	1	1	WONG, WING KEN DO	9/5/2024	207R00000X	NA	Other	026	PHYSICIANS	21139	41	Internal Medicine	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
144293	Fee-for-Service	1104250851	1104250851	1	1	WU, EFREN F MD INC	1/2/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	44100 JEFFERSON ST	STE E507	INDIO	CA	92201	2715	33	06065	33.72753404	-116.2687204	Riverside County
144309	Fee-for-Service	1700946985	1700946985	1	1	WANG, HANSEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	20997	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
144352	Fee-for-Service	1588613749	1588613749	1	1	WOLFF, LARRY J MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34846	41	Internal Medicine	0	In state provider	MEDICAL CORPORATION	5301 F ST	STE 111	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
144378	Fee-for-Service	1417909722	1417909722	1	1	WONG, PRISCILLA D MD	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	67148	None	None	0	In state provider	None	168 N BRENT ST	STE 401&402	VENTURA	CA	93003	2817	56	06111	34.27448266	-119.2572489	Ventura County
144399	Fee-for-Service	1174041586	1174041586	1	1	WOLFF, TINA LCSW	3/7/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
144410	Fee-for-Service	1073684973	1073684973	1	1	WONG, ROSY S MD	8/15/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63765	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
144496	Fee-for-Service	1831591098	1831591098	1	1	WEBER, STACY L PHD	2/20/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
144500	Fee-for-Service	1821348392	1821348392	1	1	WONG, CHARLES D DO MEDICAL	9/6/2013	208600000X	NA	General Surgery	026	PHYSICIANS	8787	20	Orthopedic Surgery	0	In state provider	CORPORATION	420 34TH STREET	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
144505	Fee-for-Service	1851497002	1851497002	1	2	WHITE MEMORIAL PEDIATRIC	2/20/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GROUP	1700 CESAR E CHAVEZ AVE	STE 3000	LOS ANGELES	CA	90033	2424	19	06037	34.05101259	-118.217259	Los Angeles County
144523	Fee-for-Service	1164955571	1164955571	1	1	WALKER, ZACHARY Y MD	7/11/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161614	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
144554	Fee-for-Service	1215970389	1215970389	1	1	WALI, VIJAY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	40187	None	None	0	In state provider	None	391 S STATE COLLEGE BLVD	STE O	BREA	CA	92821	5755	30	06059	33.91065152	-117.8886151	Orange County
144556	Fee-for-Service	1215997119	1215997119	1	1	WEISS-ISHAI, DEBRA M MD	5/8/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79075	40	Pediatrics	0	In state provider	None	2501 FOREST AVE	None	SAN JOSE	CA	95117	1118	43	06085	37.32737951	-121.950486	Santa Clara County
144599	Fee-for-Service	1194731760	1194731760	1	1	WALGREEN CO	3/24/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#4318	4129 18TH ST	None	SAN FRANCISCO	CA	94114	2407	38	06075	37.7608252	-122.4356669	San Francisco County
144646	Fee-for-Service	1013982206	1013982206	1	1	WONG, MIKE V OD APC	10/7/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PASADENA EYECARE OPTOMET	80 N LAKE AVE	STE 102	PASADENA	CA	91101	5628	19	06037	34.14747184	-118.132345	Los Angeles County
144648	Fee-for-Service	1700305158	1700305158	1	1	WELCOME HOME MIDWIFERY SERVI	1/2/2023	176B00000X	NA	Licensed Midwife	107	DOULA GROUP PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
144705	Fee-for-Service	1013919190	1013919190	1	1	WHITE, DANIEL G MD	11/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	59557	41	Internal Medicine	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
144745	Fee-for-Service	1538151808	1538151808	2	1	WEINER, BARRY E DPM	9/12/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3939 J STREET	SUITE 270	SACRAMENTO	CA	95819	3666	34	06067	38.570211	-121.45374	Sacramento County
144768	Fee-for-Service	1336105055	1336105055	1	1	WU, KENNETH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1615 DELAWARE ST	None	LONGVIEW	WA	98632	2367	00	None	46.1309207	-122.9408931	Cowlitz County
144810	Fee-for-Service	1629023874	1629023874	1	1	WINTER, ROLAND H MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	54873	20	Orthopedic Surgery	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
144840	Fee-for-Service	1215997119	1215997119	1	1	WEISS-ISHAI, DEBRA M MD	5/8/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79075	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2501 FOREST AVE	None	SAN JOSE	CA	95117	1118	43	06085	37.32737951	-121.950486	Santa Clara County
144862	Fee-for-Service	1083091003	1083091003	1	1	WANG, JEFFREY W MD	10/20/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	144162	18	Ophthalmology	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
144876	Fee-for-Service	1164607834	1164607834	1	1	WILLIAMS, SAMMIE M JR	4/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10900 E 183RD ST	STE 105	CERRITOS	CA	90703	5375	19	06037	33.86553452	-118.101933	Los Angeles County
144897	Fee-for-Service	1679789317	1679789317	1	1	WAGNER, CARLYN PT	4/19/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
144902	Fee-for-Service	1427182385	1427182385	1	1	WEEKS, CAROL L LMFT	10/4/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39350 CIVIC CENTER DR	None	FREMONT	CA	94538	2343	01	06001	37.55399458	-121.9756047	Alameda County
144918	Fee-for-Service	1295090355	1295090355	1	1	WATTS, DAVID C MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3269 STOCKTON HILL ROAD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
144923	Fee-for-Service	1831574482	1831574482	1	1	WONG, JUSTIN C DO	10/26/2018	207R00000X	NA	Other	026	PHYSICIANS	15049	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
144927	Fee-for-Service	1124448378	1124448378	1	1	WU, PATRICK R MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14287	01	General Practice	0	In state provider	None	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
144945	Fee-for-Service	1932114212	1932114212	1	1	WALGREEN CO.	2/8/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1376 KOOSER RD	None	SAN JOSE	CA	95118	3813	43	06085	37.24617512	-121.8903909	Santa Clara County
144950	Fee-for-Service	1073528089	1073528089	1	1	WALGREEN CO	2/24/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1501 W WHITTIER BLVD	None	MONTEBELLO	CA	90640	4001	19	06037	34.01184449	-118.1170258	Los Angeles County
144955	Fee-for-Service	1053496638	1053496638	1	1	WANG, YANG-CHENG MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32141	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11360 MOUNTAIN VIEW AVE	STE B	LOMA LINDA	CA	92354	3834	36	06071	34.04666844	-117.2436991	San Bernardino County
144962	Fee-for-Service	1588977524	1588977524	1	1	WOO, BRIAN D MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122565	66	Emergency Medicine (Urgent Care)	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
144994	Fee-for-Service	1679632293	1679632293	1	1	WINTER, HOWARD I MD	8/31/1995	208800000X	NA	Other	026	PHYSICIANS	66732	34	Urology and Urological Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
145021	Fee-for-Service	1730899238	1730899238	1	1	WANG, SOPHIA PT	5/25/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
145043	Fee-for-Service	1144551979	1144551979	1	1	WOO, GARMEN A MD	5/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110615	41	Internal Medicine	0	In state provider	None	2340 CLAY STREET	2ND FLOOR	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
145060	Fee-for-Service	1568633717	1568633717	1	1	WATERS, RICHARD D MD	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108812	30	Radiology	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
145089	Fee-for-Service	1740291467	1740291467	1	1	WONG, DAPHNE LYNN MD	3/1/1998	207R00000X	NA	Other	026	PHYSICIANS	60029	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
145130	Fee-for-Service	1649321332	1649321332	1	1	WONG, JENSON K MD	6/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83560	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
145141	Fee-for-Service	1598794448	1598794448	1	1	WIERZBOWSKI, WOJCIECH MD	8/31/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	49904	30	Radiology	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
145143	Fee-for-Service	1174120836	1174120836	1	1	WATTS, ALEXANDRA L CNM	12/8/2023	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
145168	Fee-for-Service	1689283756	1689283756	1	1	WARMFUL LOVE HOME HEALTH INC	7/8/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14416 HAMLIN ST	SUITE 203	VAN NUYS	CA	91401	1488	19	06037	34.18863949	-118.4472225	Los Angeles County
145186	Fee-for-Service	1053607069	1053607069	1	1	WRIGHT, CYNTHIA MSW LCSW	5/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
145219	Fee-for-Service	1215397864	1215397864	1	1	WILLS, JOSEPH B LMFT	6/1/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6 GOVERNORS LANE	STE C	CHICO	CA	95926	5590	04	06007	39.75531581	-121.8582802	Butte County
145247	Fee-for-Service	1184839896	1184839896	1	1	WILSON, THADDEUS E MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	102261	25	Physical Medicine and Rehabilitation	0	In state provider	None	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
145252	Fee-for-Service	1255795233	1255795233	1	1	WESTON, JAYE A MD	7/28/2020	208600000X	NA	General Surgery	026	PHYSICIANS	155261	33	Thoracic Surgery	0	In state provider	None	22419 KENT AVE	None	TORRANCE	CA	90505	2303	19	06037	33.824448	-118.3564765	Los Angeles County
145255	Fee-for-Service	1932367802	1932367802	1	1	WHEELER, AMBER L MD	5/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115920	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
145262	Fee-for-Service	1922329648	1922329648	1	1	WALKER, SUSAN M OT	7/18/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2636 CHURN CREEK RD	STE A	REDDING	CA	96002	1167	45	06089	40.569165	-122.3531255	Shasta County
145406	Fee-for-Service	1780842617	1780842617	1	1	WURSTLE, ADAM	11/15/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	520 MEDICAL CENTER DRIVE	SUITE 201	MEDFORD	OR	97504	4334	00	None	42.318801	-122.831728	Jackson County
145452	Fee-for-Service	1144324492	1144324492	1	1	WEEBER, MARK K MD	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	66061	41	Internal Medicine	0	In state provider	None	1425 MAGNOLIA AVE	None	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
145499	Fee-for-Service	1962473074	1962473074	1	1	WEEKS, JOHN A MD	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	38203	08	Family Practice	0	In state provider	None	15120 LAKESHORE DR	STE C	CLEARLAKE	CA	95422	8106	17	06033	38.94992211	-122.6296109	Lake County
145525	Fee-for-Service	1578902466	1578902466	1	1	WESTERN PACIFIC RE HAB	11/26/2018	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	275 VICTORIA ST	STE 1H	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
145541	Fee-for-Service	1932367802	1932367802	1	1	WHEELER, AMBER L MD	5/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115920	67	Endocrinology	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
145585	Fee-for-Service	1528592052	1528592052	1	1	WINGERT, DAWN M LMFT	4/3/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5521 SCOTTS VALLEY	SUITE 240	SCOTTS VALLEY	CA	95066	3469	44	06087	37.06023545	-122.0089953	Santa Cruz County
145588	Fee-for-Service	1578748992	1578748992	1	1	WOODSON, ADRIAN M NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	44105 15TH ST W	UNITS 401 3/5/7	LANCASTER	CA	93534	4088	19	06037	34.684218	-118.1568465	Los Angeles County
145595	Fee-for-Service	1215188701	1215188701	1	1	WRIGHT, BRENTON A MD	11/21/2017	2084N0400X	NA	Neurology	026	PHYSICIANS	152156	13	Neurology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
145597	Fee-for-Service	1881030914	1881030914	1	1	WAL-MART STORES INC	7/12/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14441 INGLEWOOD AVE	None	HAWTHORNE	CA	90250	6715	19	06037	33.90022037	-118.3613142	Los Angeles County
145646	Fee-for-Service	1225062847	1225062847	1	1	WILLIS, SANDRA E MD	11/30/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	51347	41	Internal Medicine	0	In state provider	None	4629 WHITNEY AVE	STE 2	SACRAMENTO	CA	95821	4111	34	06067	38.62841967	-121.3563671	Sacramento County
145689	Fee-for-Service	1023247525	1023247525	1	1	WALGREEN CO	12/14/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 N VENTU PARK RD	None	THOUSAND OAKS	CA	91320	2709	56	06111	34.18715094	-118.911061	Ventura County
145701	Fee-for-Service	1740635994	1740635994	1	1	WHITE KNAYZEH, LISA M MD	9/11/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	150550	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
145706	Fee-for-Service	1710992003	1710992003	1	1	WALGREEN CO	1/4/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6400 HAVEN AVE	None	RANCHO CUCAMONGA	CA	91737	3823	36	06071	34.138377	-117.575997	San Bernardino County
145746	Fee-for-Service	1134285794	1134285794	1	1	WON, CHRISTINE H MD	5/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72769	40	Pediatrics	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 300	GARDEN GROVE	CA	92843	1917	30	06059	33.77450141	-117.9123364	Orange County
145751	Fee-for-Service	1124436001	1124436001	1	1	WIN, LEI T MD	6/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145310	41	Internal Medicine	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
145758	Fee-for-Service	1518128040	1518128040	1	1	WILHELM, MATTHEW K PHD	11/18/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
145769	Fee-for-Service	1417022856	1417022856	1	1	WEISS, WILLIAM A MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72677	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
145799	Fee-for-Service	1528320231	1528320231	1	1	WILSON, SEAN P MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132553	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
145811	Fee-for-Service	1578902466	1578902466	1	1	WESTERN PACIFIC RE HAB	11/26/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	275 VICTORIA ST	STE 1H	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
145813	Fee-for-Service	1700240017	1700240017	1	1	WOOD, ERIKA L MD	7/6/2022	208800000X	NA	Other	026	PHYSICIANS	154110	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
145827	Fee-for-Service	1962722686	1962722686	1	1	WANG, YAN MD	4/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	86849	01	General Practice	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
145889	Fee-for-Service	1699887646	1699887646	1	1	WINN, DAVID B MD	9/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	87000	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
145936	Fee-for-Service	1306077292	1306077292	1	1	WORTENDYKE, JENNIFER S DO	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2400 S AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
145937	Fee-for-Service	1134515638	1134515638	1	1	WANG, XIAO YAN MD	5/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144661	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
145943	Fee-for-Service	1083645501	1083645501	1	1	WALLACE, ROGER C MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71306	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
145953	Fee-for-Service	1730340712	1730340712	1	1	WELCH-HORAN, THOMAS B MD	6/17/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
145978	Fee-for-Service	1205847720	1205847720	1	1	WAL-MART STORES INC	11/13/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-5426	40580 ALBRAE ST	None	FREMONT	CA	94538	2448	01	06001	37.51978341	-121.9847474	Alameda County
146053	Fee-for-Service	1417022856	1417022856	1	1	WEISS, WILLIAM A MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72677	40	Pediatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
146108	Fee-for-Service	1972814671	1972814671	1	1	WATTERS, LAURA E MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128941	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	77 CADILLAC DR	STE 230	SACRAMENTO	CA	95825	5453	34	06067	38.572551	-121.4181585	Sacramento County
146115	Fee-for-Service	1962722686	1962722686	1	1	WANG, YAN MD	4/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	86849	22	Pathology (M.D. only)	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
146185	Fee-for-Service	1215740675	1215740675	1	1	WHARTON, JENSON K	1/29/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	45	06089	0	0	None
146198	Fee-for-Service	1134594773	1134594773	1	1	WANG, KATHERINE Y PT	12/24/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39650 LIBERTY ST	STE 300	FREMONT	CA	94538	2227	01	06001	37.54662058	-121.9736002	Alameda County
146217	Fee-for-Service	1558756585	1558756585	1	1	WEBBER, KAREY R LMFT	8/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
146238	Fee-for-Service	1548201650	1548201650	1	1	WADHWA, PARVINDAR S MD	10/1/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	30802	41	Internal Medicine	0	In state provider	None	1781 W ROMNEYA DR	None	ANAHEIM	CA	92801	1818	30	06059	33.85067272	-117.9447342	Orange County
146261	Fee-for-Service	1598300642	1598300642	1	1	WISE MIND COUNSELING SERVICE	9/10/2020	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	S INC.	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
146287	Fee-for-Service	1427087964	1427087964	1	1	WOOD, RANDY P PHD	9/28/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	7570	-	NOT APPLICABLE	0	In state provider	None	2650 JONES WAY	SUITE 10	SIMI VALLEY	CA	93065	1215	56	06111	34.28861251	-118.745991	Ventura County
146304	Fee-for-Service	1114944451	1114944451	1	1	WAL-MART STORES, INC	1/16/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101755	4625 REDWOOD DR	None	ROHNERT PARK	CA	94928	7943	49	06097	38.36816376	-122.7145355	Sonoma County
146346	Fee-for-Service	1265872519	1265872519	1	1	WOLD, BRITTANY J MD	10/16/2021	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
146386	Fee-for-Service	1841390051	1841390051	1	2	WRONSKI, CRAIG J DO	12/2/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	5560	-	NOT APPLICABLE	0	In state provider	None	1021 4TH STREET	SUITE B	TAFT	CA	93268	2433	15	06029	35.1491189	-119.4534659	Kern County
146420	Fee-for-Service	1912272055	1912272055	1	1	WEISS, REBECCA L MD	9/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	128395	67	Endocrinology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
146496	Fee-for-Service	1871761676	1871761676	1	1	WU, PEI-YING LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
146525	Fee-for-Service	1548201650	1548201650	1	1	WADHWA, PARVINDAR S MD	10/1/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	30802	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1781 W ROMNEYA DR	None	ANAHEIM	CA	92801	1818	30	06059	33.85067272	-117.9447342	Orange County
146534	Fee-for-Service	1467861112	1467861112	1	1	WAL-MART STORES, INC	6/15/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1450 MONTEREY RD	None	SAN JOSE	CA	95112	6126	43	06085	37.31553882	-121.8728588	Santa Clara County
146546	Fee-for-Service	1598300642	1598300642	1	1	WISE MIND COUNSELING SERVICE	6/17/2021	106H00000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	S INC.	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
146557	Fee-for-Service	1003980822	1003980822	1	1	WEN, KENNETH C MD	11/24/2009	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	107067	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3080 BRISTOL ST	#600	COSTA MESA	CA	92626	7341	30	06059	33.68480996	-117.8854767	Orange County
146630	Fee-for-Service	1538102884	1538102884	1	1	WAFA, TAMIM A MD	2/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94949	05	Anesthesiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
146703	Fee-for-Service	1457693038	1457693038	1	1	WONG, KEVIN MD	9/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16184	01	General Practice	0	In state provider	None	39700 BOB HOPE DRIVE	SUITE 310	RANCHO MIRAGE	CA	92270	3267	33	06065	33.760683	-116.4080645	Riverside County
146776	Fee-for-Service	1811142235	1811142235	1	1	WALGREEN CO	3/5/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14102 RAMONA BLVD	None	BALDWIN PARK	CA	91706	3138	19	06037	34.08514059	-117.965948	Los Angeles County
146806	Fee-for-Service	1447874672	1447874672	1	1	WHYTE, AILEEN M PHD	9/28/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
146817	Fee-for-Service	1447993530	1447993530	1	1	WILSON, BRADLEY NP	4/12/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	36	06071	34.10679449	-117.3542535	San Bernardino County
146835	Fee-for-Service	1598300642	1598300642	1	1	WISE MIND COUNSELING SERVICE	9/10/2020	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	S INC.	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
146883	Fee-for-Service	1902032808	1902032808	1	1	WALKOWSKY, TIHELE L MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126354	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 S WELLS RD	STE 100	VENTURA	CA	93004	1302	56	06111	34.29321532	-119.1597424	Ventura County
146934	Fee-for-Service	1033631320	1033631320	1	1	WAGER, NATALIE P PHD	12/20/2017	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
146945	Fee-for-Service	1649369935	1649369935	1	1	WOLF, RONALD F MD	11/17/2017	208600000X	NA	General Surgery	026	PHYSICIANS	64335	02	General Surgery	0	In state provider	None	101 CITY DR S	B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
146983	Fee-for-Service	1154342699	1154342699	1	1	WALTER, MICHAEL H MD	7/5/1988	207R00000X	NA	Other	026	PHYSICIANS	63292	01	General Practice	0	In state provider	None	2006 N RIVERSIDE AVE	STE B	RIALTO	CA	92377	4697	36	06071	34.13670866	-117.3704994	San Bernardino County
147064	Fee-for-Service	1023174182	1023174182	1	1	WEST, LISA A MD	11/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103023	18	Ophthalmology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
147092	Fee-for-Service	1306861273	1306861273	1	1	WOERNER, SARAH J MD	11/1/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	34453	40	Pediatrics	0	In state provider	None	1061 E MAIN ST	STE 102	GRASS VALLEY	CA	95945	5724	29	06057	39.22945852	-121.0502754	Nevada County
147109	Fee-for-Service	1821559956	1821559956	1	1	WINN, PHOEBE A MD	8/31/2022	207PP0204X	NA	Other	026	PHYSICIANS	178293	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
147115	Fee-for-Service	1225803505	1225803505	1	1	WESTERN PHYSICAL THERAPY, IN	12/6/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 SOLANO ST	None	CORNING	CA	96021	3352	52	06103	39.92792426	-122.174722	Tehama County
147128	Fee-for-Service	1477522738	1477522738	1	1	WOODALL, LINDA O MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	69835	26	Psychiatry (child)	0	In state provider	None	1560 E CHEVY CHASE DR	STE 130	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
147146	Fee-for-Service	1518964105	1518964105	1	1	WEINBERG, DAVID M MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	62688	None	None	0	In state provider	None	8201 E SANTA ANA CANYON	None	ANAHEIM	CA	92808	2249	30	06059	33.86797826	-117.7470995	Orange County
147233	Fee-for-Service	1558573618	1558573618	1	1	WHITLING,DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13199 E MONTEVIEW BLVD	PO BOX 111719	AURORA	CO	80042	0000	00	None	39.748041	-104.834673	Adams County
147271	Fee-for-Service	1154342699	1154342699	1	1	WALTER, MICHAEL H MD	7/5/1988	207R00000X	NA	Other	026	PHYSICIANS	63292	10	Gastroenterology (M.D. only)	0	In state provider	None	2006 N RIVERSIDE AVE	STE B	RIALTO	CA	92377	4697	36	06071	34.13670866	-117.3704994	San Bernardino County
147290	Fee-for-Service	1730165754	1730165754	1	1	WILLIAMS, CAROLYN C	12/24/2002	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W PROVIDENCE AVE	None	ORANGE	CA	92868	3808	30	06059	33.78142951	-117.866583	Orange County
147358	Fee-for-Service	1538247382	1538247382	1	1	WEI, LINDA MD	6/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	76711	05	Anesthesiology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
147373	Fee-for-Service	1871529081	1871529081	1	1	WALLACH, SABINA R MD	3/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	34070	78	Neoplastic Diseases/Oncology	0	In state provider	None	9850 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1212	37	06073	32.882913	-117.226341	San Diego County
147416	Fee-for-Service	1477522738	1477522738	1	1	WOODALL, LINDA O MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	69835	36	Psychiatry	0	In state provider	None	1560 E CHEVY CHASE DR	STE 130	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
147459	Fee-for-Service	1144271834	1144271834	1	2	WALTON PEDIATRICS	3/13/2009	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1 SCRIPPS DRIVE	STE 102	SACRAMENTO	CA	95825	6206	34	06067	38.573181	-121.4118135	Sacramento County
147462	Fee-for-Service	1245568914	1245568914	1	1	WINSTON, SHERRY D LMFT	7/6/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	38804	-	NOT APPLICABLE	0	In state provider	None	7101 BAIRD AVE	None	RESEDA	CA	91335	4150	19	06037	34.1995012	-118.5373824	Los Angeles County
147464	Fee-for-Service	1174694517	1174694517	1	1	WEISS, ROBERT A MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	59901	05	Anesthesiology	0	In state provider	None	25 N 14TH ST	STE 560	SAN JOSE	CA	95112	6204	43	06085	37.34293357	-121.8775187	Santa Clara County
147494	Fee-for-Service	1174671168	1174671168	1	1	WILLIAMS, BRANDY L MD	11/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91306	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
147629	Fee-for-Service	1871980839	1871980839	1	1	WERBANETH, KATHERINE L MD	9/7/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	145481	None	None	0	In state provider	None	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	38	06075	37.78594176	-122.421322	San Francisco County
147660	Fee-for-Service	1871529081	1871529081	1	1	WALLACH, SABINA R MD	3/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	34070	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9850 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1212	37	06073	32.882913	-117.226341	San Diego County
147693	Fee-for-Service	1073704326	1073704326	1	1	WARNER, GREG Y DO	11/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9902	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
147791	Fee-for-Service	1043645468	1043645468	1	1	WEISS, SAM LCSW	4/15/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	86590	-	NOT APPLICABLE	0	In state provider	None	3939 ATLANTIC AVE	SUITE 102	LONG BEACH	CA	90807	3535	19	06037	33.830073	-118.1851065	Los Angeles County
147803	Fee-for-Service	1568077931	1568077931	1	1	WORLD HEALTH HOSPICE, INC	7/6/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	STE 299	ENCINO	CA	91436	2973	19	06037	34.15524484	-118.4756687	Los Angeles County
147849	Fee-for-Service	1770014755	1770014755	1	1	WILSON, AUGUSTINE MD	4/30/2024	208600000X	NA	General Surgery	026	PHYSICIANS	183527	02	General Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
147872	Fee-for-Service	1194172544	1194172544	1	1	WU, CHRISTOPHER C MD	7/18/2019	207P00000X	NA	Other	026	PHYSICIANS	161429	None	None	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
147884	Fee-for-Service	1366414179	1366414179	1	1	WAMSLEY, BRIAN W MD	3/24/2010	207L00000X	NA	Other	026	PHYSICIANS	50564	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
147893	Fee-for-Service	1073629507	1073629507	1	1	WILCOX, THOMAS M DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	51 W 84TH AVE	STE 210	DENVER	CO	80260	4882	00	None	39.84903146	-104.9882895	Adams County
147894	Fee-for-Service	1417238833	1417238833	1	1	WOMEN IN TRANSITION RE-ENTRY	4/17/2024	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	S	1401 E 4TH ST STE B	None	LONG BEACH	CA	90802	1869	19	06037	33.77173552	-118.1740815	Los Angeles County
147928	Fee-for-Service	1326114158	1326114158	1	1	WOMEN'S HEALTH CLINIC	5/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
147950	Fee-for-Service	1871529081	1871529081	1	1	WALLACH, SABINA R MD	3/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	34070	68	Hematology	0	In state provider	None	9850 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1212	37	06073	32.882913	-117.226341	San Diego County
147972	Fee-for-Service	1003436064	1003436064	1	48	WS AUDIOLOGY (CALIFORNIA), P	6/7/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	4206 WOODRUFF AVENUE	None	LAKEWOOD	CA	90713	3143	19	06037	33.834438	-118.116514	Los Angeles County
147982	Fee-for-Service	1992021927	1992021927	1	1	WALOFF, KEVIN R MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126067	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
148003	Fee-for-Service	1376016394	1376016394	1	1	WALGREEN CO	6/25/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16533	1100 VAN NESS AVE	STE C	SAN FRANCISCO	CA	94109	6920	38	06075	37.78594176	-122.421322	San Francisco County
148008	Fee-for-Service	1689689960	1689689960	1	1	WALGREEN CO.	7/18/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7576 SKYWAY	None	PARADISE	CA	95969	3233	04	06007	39.7699842	-121.6124155	Butte County
148061	Fee-for-Service	1306454251	1306454251	1	1	WOODWARD, CHRISTIAN J RCP	7/26/2020	2279P1005X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
148091	Fee-for-Service	1568077931	1568077931	1	1	WORLD HEALTH HOSPICE, INC	7/6/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	STE 299	ENCINO	CA	91436	2973	19	06037	34.15524484	-118.4756687	Los Angeles County
148120	Fee-for-Service	1548334824	1548334824	1	1	WANG, LYNDELL Y MD	6/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75067	14	Neurological Surgery	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
148123	Fee-for-Service	1508307927	1508307927	1	1	WHITMORE, MICHAEL R DO	7/8/2021	207R00000X	NA	Other	026	PHYSICIANS	17236	None	None	0	In state provider	None	17095 MAIN ST	None	HESPERIA	CA	92345	6004	36	06071	34.41984761	-117.2904344	San Bernardino County
148162	Fee-for-Service	1780282533	1780282533	1	1	WHITE ORCHID HOME HEALTH	3/15/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16661 VENTURA BLVD	STE 223	ENCINO	CA	91436	1944	19	06037	34.15820737	-118.496492	Los Angeles County
148175	Fee-for-Service	1417238833	1417238833	1	1	WOMEN IN TRANSITION RE-ENTRY	8/25/2024	251S00000X	NA	Other	102	DIABETES PREVENTION PROGRAM SUPPLIER	-	-	NOT APPLICABLE	0	In state provider	S	1401 E 4TH ST STE B	None	LONG BEACH	CA	90802	1869	19	06037	33.77173552	-118.1740815	Los Angeles County
148187	Fee-for-Service	1346377330	1346377330	1	1	WORTIS, NAOMI MD	3/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55831	01	General Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
148196	Fee-for-Service	1093764177	1093764177	1	1	WEINREB, ROBERT N MD	1/1/1982	207W00000X	NA	Ophthalmology	026	PHYSICIANS	33398	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
148215	Fee-for-Service	1326114158	1326114158	1	1	WOMEN'S HEALTH CLINIC	5/1/1995	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
148270	Fee-for-Service	1154890069	1154890069	1	1	WELLHEALTH LLC	1/17/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15315 MAGNOLIA BLVD	STE 418	SHERMAN OAKS	CA	91403	1177	19	06037	34.16488161	-118.4666419	Los Angeles County
148347	Fee-for-Service	1013115039	1013115039	1	1	WASSIM SHWAIKI M.D.	11/6/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	901 MACARTHUR BLVD	None	MUNSTER	IN	46321	2901	00	None	41.550678	-87.506217	Lake County
148426	Fee-for-Service	1891900890	1891900890	1	1	WU, IVAN TJ	12/17/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 CALIFORNIA AVE	SUITE 100	CORONA	CA	92881	6472	33	06065	33.86171794	-117.5440764	Riverside County
148431	Fee-for-Service	1811423775	1811423775	1	1	WOO, KENNETH K MD	2/13/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	158200	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
148445	Fee-for-Service	1306613864	1306613864	1	1	WU, STACY CNM	5/17/2024	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
148471	Fee-for-Service	1881617009	1881617009	1	1	WERTH, CHRIS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	156 WEST AVE	None	BROCKPORT	NY	14420	1229	00	None	43.220718	-77.9444685	Monroe County
148506	Fee-for-Service	1841551405	1841551405	1	1	WIN, KHIN M DO	11/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13984	41	Internal Medicine	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
148524	Fee-for-Service	1750418075	1750418075	1	1	WARNER, KATHERINE A OD	7/13/2000	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
148542	Fee-for-Service	1003436064	1003436064	1	55	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	72655 HIGHWAY 111	SUITE B3	PALM DESERT	CA	92260	3307	33	06065	33.7215903	-116.3957213	Riverside County
148546	Fee-for-Service	1003436064	1003436064	1	22	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	8915 TOWNE CENTRE	None	SAN DIEGO	CA	92122	5650	37	06073	32.86767898	-117.2071838	San Diego County
148552	Fee-for-Service	1861055220	1861055220	1	1	WOO, MATTHEW MD	8/1/2024	207L00000X	NA	Other	026	PHYSICIANS	180990	05	Anesthesiology	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
148565	Fee-for-Service	1699917492	1699917492	1	1	WEGNER, NICHOLAS MD	3/21/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	137540	20	Orthopedic Surgery	0	In state provider	None	22 CORPORATE PLAZA DR	None	NEWPORT BEACH	CA	92660	7985	30	06059	33.607602	-117.876852	Orange County
148570	Fee-for-Service	1215942313	1215942313	2	1	WALGREEN CO	8/10/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8044 LIMONITE AVE	None	RIVERSIDE	CA	92509	6107	33	06065	33.97764677	-117.4608873	Riverside County
148577	Fee-for-Service	1457448789	1457448789	1	5	WIELER & SEIN MED GRP	10/18/2012	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	23521 PASEO DE VALENCIA	SUITE 113	LAGUNA HILLS	CA	92653	3137	30	06059	33.61113028	-117.7126684	Orange County
148582	Fee-for-Service	1770523763	1770523763	2	1	WU, LULU S OD	12/5/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	22179 REDWOOD RD	None	CASTRO VALLEY	CA	94546	7107	01	06001	37.685682	-122.073576	Alameda County
148601	Fee-for-Service	1942227293	1942227293	1	1	WAL-MART STORES, INC	2/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY10-3493	1021 ARNOLD DR	None	MARTINEZ	CA	94553	4103	07	06013	37.9960101	-122.1100924	Contra Costa County
148627	Fee-for-Service	1063725802	1063725802	1	1	WARREN, JARYN L LMFT	10/23/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2501 W. SHAW AVE	STE 119	FRESNO	CA	93710	7510	10	06019	36.8064869	-119.8354798	Fresno County
148656	Fee-for-Service	1851618474	1851618474	1	1	WONG, MICHELLE M MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110551	01	General Practice	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
148671	Fee-for-Service	1861787277	1861787277	1	1	WATSON, JEROME E LMFT	1/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12180 RIDGECREST ROAD	402	VICTORVILLE	CA	92395	5902	36	06071	34.47269281	-117.2773069	San Bernardino County
148708	Fee-for-Service	1275898637	1275898637	1	1	WAL-MART STORES, INC	12/28/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	22015 HAWTHORNE BLVD	None	TORRANCE	CA	90503	7006	19	06037	33.82755381	-118.3520907	Los Angeles County
148724	Fee-for-Service	1821028358	1821028358	1	1	WRIGHT, KARA K MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68777	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	# M696	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
148729	Fee-for-Service	1366474181	1366474181	1	1	WOLF, BERNARD A MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29305	08	Family Practice	0	In state provider	A PROFESSIONAL CORP	2415 HIGH SCHOOL AVE	STE 300	CONCORD	CA	94520	1815	07	06013	37.98481374	-122.0347555	Contra Costa County
148831	Fee-for-Service	1639336472	1639336472	1	1	WEINGARTEN, DAVID M MD	11/8/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	110152	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
148832	Fee-for-Service	1003436064	1003436064	1	22	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	8915 TOWNE CENTRE	None	SAN DIEGO	CA	92122	5650	37	06073	32.86767898	-117.2071838	San Diego County
148863	Fee-for-Service	1184649220	1184649220	2	1	WONG, RONALD N MD	5/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	34227	04	Otology, Laryngology, Rhinology	0	In state provider	None	355 CAMPUS DR	STE B	HANFORD	CA	93230	4338	16	06031	36.3271295	-119.6633596	Kings County
148897	Fee-for-Service	1871617688	1871617688	1	1	WELLSPACE HEALTH	5/30/2018	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1550 JULIESSE AVE	None	SACRAMENTO	CA	95815	1803	34	06067	38.619945	-121.432131	Sacramento County
148930	Fee-for-Service	1740639228	1740639228	1	1	WOLFF, MARIYA PHD	9/19/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
148941	Fee-for-Service	1871963835	1871963835	1	1	WU, RACHEL NP	10/24/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
148956	Fee-for-Service	1700170743	1700170743	1	1	WANG, TINA MD	10/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121318	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
148966	Fee-for-Service	1205190675	1205190675	1	1	WOO, JOANNA Y DO	3/19/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	14172	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	1689	19	06037	34.15729818	-118.3277073	Los Angeles County
149080	Fee-for-Service	1497312722	1497312722	1	1	WILLIAMS, RACHEL	10/30/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	191509	40	Pediatrics	0	In state provider	None	100 MISSION BLVD	STE 2600	JACKSON	CA	95642	2536	03	06005	38.35163001	-120.7670107	Amador County
149114	Fee-for-Service	1255785804	1255785804	1	1	WANG, ANGE MD	7/30/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	150629	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
149133	Fee-for-Service	1285084095	1285084095	1	1	WILLAR, KIRSTEN A PHD	12/20/2017	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
149139	Fee-for-Service	1003436064	1003436064	1	18	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	27120 EUCALYPTUS AVENUE	SUITE F	MORENO VALLEY	CA	92555	4543	33	06065	33.93551714	-117.1876083	Riverside County
149155	Fee-for-Service	1073073797	1073073797	1	1	WILHOITE, DAVID A MD	9/12/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	180760	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
149158	Fee-for-Service	1093970618	1093970618	1	1	WONG, TIMOTHY T LMFT	3/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
149180	Fee-for-Service	1144754920	1144754920	1	1	WHELAN, SHAWN F MD	4/15/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
149188	Fee-for-Service	1437461126	1437461126	1	1	WONG, ALAN M DO	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13772	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
149197	Fee-for-Service	1891115564	1891115564	1	1	WU, ANNY T DO	7/12/2019	207R00000X	NA	Other	026	PHYSICIANS	17238	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
149205	Fee-for-Service	1265888739	1265888739	1	1	WATSON, ERIN C PSYD	3/14/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
149209	Fee-for-Service	1457706244	1457706244	1	1	WAYAND, ZARLAKHTA MD	6/27/2019	390200000X	NA	Other	026	PHYSICIANS	162582	None	None	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
149211	Fee-for-Service	1326115213	1326115213	1	1	WILMOTH, GERALD D MD	2/25/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	50495	02	General Surgery	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
149235	Fee-for-Service	1578071544	1578071544	1	1	WILKERSON, BEVERLY A PT	3/3/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
149249	Fee-for-Service	1962550848	1962550848	1	1	WHITE, MATTHEW S	1/24/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
149280	Fee-for-Service	1558565556	1558565556	1	1	WILSON, DAEDALYS R LMFT	3/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2505 VALHALLA PL	110	CHICO	CA	95928	4042	04	06007	39.761604	-121.8180955	Butte County
149292	Fee-for-Service	1023108743	1023108743	1	1	WARHOLA, SABRINA OD	1/2/2014	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2011 SOUTH BROADWAY	SUITE G	SANTA MARIA	CA	93454	7886	42	06083	34.923042	-120.436166	Santa Barbara County
149305	Fee-for-Service	1285626747	1285626747	1	1	WILLMS, DAVID C MD	7/1/1986	207RP1001X	NA	Pulmonology	026	PHYSICIANS	42091	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	225 DICKINSON ST	# H201	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
149326	Fee-for-Service	1821171000	1821171000	1	1	WINNICK, JAMES E OD	7/1/2000	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1800 FOURTH ST	None	LIVERMORE	CA	94550	4454	01	06001	37.67808567	-121.7724653	Alameda County
149333	Fee-for-Service	1699781062	1699781062	1	1	WILKINS, MARJORIE B PT	3/26/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	860 JAMACHA ROAD	SUITE 203	EL CAJON	CA	92019	3224	37	06073	32.78430676	-116.9279962	San Diego County
149385	Fee-for-Service	1770673493	1770673493	1	1	WOBUS, ELIZABETH A MD	10/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	38420	01	General Practice	0	In state provider	None	11244 PLEASANT VALLEY RD	None	PENN VALLEY	CA	95946	9413	29	06057	39.22267045	-121.2039605	Nevada County
149410	Fee-for-Service	1609901933	1609901933	1	1	WEINTRAUB, DANA L MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70652	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
149419	Fee-for-Service	1932369568	1932369568	1	1	WEINHOLD, ANA J MD	10/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117747	01	General Practice	0	In state provider	None	37491 ENTERPRISE DRIVE	None	BURNEY	CA	96013	4379	45	06089	40.88784451	-121.6526265	Shasta County
149428	Fee-for-Service	1003436064	1003436064	1	18	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	27120 EUCALYPTUS AVENUE	SUITE F	MORENO VALLEY	CA	92555	4543	33	06065	33.93551714	-117.1876083	Riverside County
149458	Fee-for-Service	1871651307	1871651307	1	1	WE WIN FOR HEALTH	2/14/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP INC	17497 MAIN ST	None	HESPERIA	CA	92345	6268	36	06071	34.41854387	-117.2814553	San Bernardino County
149511	Fee-for-Service	1487683553	1487683553	1	1	WSG ENTERPRISES	1/12/2005	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	IN & OUT MOBILITY	45275 PRICKLEY PEAR LN	STE 3	PALM DESERT	CA	92260	4313	33	06065	33.71905453	-116.3749814	Riverside County
149576	Fee-for-Service	1154307700	1154307700	1	1	WILSON, BARBARA F MD	4/1/1995	207R00000X	NA	Other	026	PHYSICIANS	71784	41	Internal Medicine	0	In state provider	None	151 N SUNRISE AVE	STE 1201A	ROSEVILLE	CA	95661	2924	31	06061	38.74746043	-121.2655348	Placer County
149612	Fee-for-Service	1881082287	1881082287	1	1	WATERMAN, RANI I OT	4/2/2018	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
149615	Fee-for-Service	1275913923	1275913923	1	1	WANG, ZI C MD	7/22/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	160289	13	Neurology (M.D. only)	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
149703	Fee-for-Service	1639469349	1639469349	1	1	WANG, TIANYI MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122202	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
149705	Fee-for-Service	1558370106	1558370106	1	1	WOODARD, SUSAN T NP	6/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
149721	Fee-for-Service	1942258736	1942258736	1	1	WINTER, LINDA A PSY	7/5/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	18315	-	NOT APPLICABLE	0	In state provider	None	5900 STATE FARM DRIVE	SUITE 200	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
149725	Fee-for-Service	1821068214	1821068214	1	1	WAXMAN, KENNETH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	32872	02	General Surgery	0	In state provider	None	COTTAGE HOSPITAL	PUEBLO AT BATH	SANTA BARBARA	CA	93102	3201	42	06083	34.43808164	-119.6577168	Santa Barbara County
149728	Fee-for-Service	1588229082	1588229082	1	1	WESTRICK, KARINA M LPCC	5/7/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
149746	Fee-for-Service	1720053572	1720053572	1	1	WILSON, MATHAN J DO	7/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	5796	08	Family Practice	0	In state provider	None	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
149812	Fee-for-Service	1922567072	1922567072	1	1	WANG, JIEXI MD	8/1/2022	207R00000X	NA	Other	026	PHYSICIANS	177092	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
149833	Fee-for-Service	1558313312	1558313312	1	1	WALTON, STEPHANIE A MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	70902	40	Pediatrics	0	In state provider	None	7275 E SOUTHGATE DR	STE 306	SACRAMENTO	CA	95823	2631	34	06067	38.493576	-121.436559	Sacramento County
149882	Fee-for-Service	1275550410	1275550410	1	1	WAL-MART STORES INC	8/23/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-2989	44009 OSGOOD RD	None	FREMONT	CA	94539	6403	01	06001	37.51246235	-121.9416033	Alameda County
149936	Fee-for-Service	1376706705	1376706705	1	1	WILLIAMS, NOLAN R MD	11/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130867	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
149942	Fee-for-Service	1134163637	1134163637	1	1	WANG, JAMES NIEN-CHIN MD	5/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8055	08	Family Practice	0	In state provider	None	3301 N EASTERN AVE	None	LOS ANGELES	CA	90032	1931	19	06037	34.083765	-118.1780795	Los Angeles County
150120	Fee-for-Service	1558313312	1558313312	1	1	WALTON, STEPHANIE A MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	70902	01	General Practice	0	In state provider	None	7275 E SOUTHGATE DR	STE 306	SACRAMENTO	CA	95823	2631	34	06067	38.493576	-121.436559	Sacramento County
150153	Fee-for-Service	1083941637	1083941637	1	1	WALGREENS CO	12/23/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #11653	1320 ENCINITAS BLVD	None	ENCINITAS	CA	92024	2844	37	06073	33.04600352	-117.2606488	San Diego County
150158	Fee-for-Service	1316034713	1316034713	1	1	WILLIAMS, ROBERTA G MD	10/30/1992	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	40696	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
150159	Fee-for-Service	1124598974	1124598974	1	1	WANG, SHARON D NP	5/1/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
150175	Fee-for-Service	1164601449	1164601449	1	1	WALI, AUTAR K MD	10/4/1996	208C00000X	NA	General Surgery	026	PHYSICIANS	32290	02	General Surgery	0	In state provider	None	155 W WILLOW ST	None	POMONA	CA	91768	1829	19	06037	34.0791853	-117.7537495	Los Angeles County
150192	Fee-for-Service	1922451590	1922451590	1	1	WALTRIP, LAUREN E	12/21/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
150223	Fee-for-Service	1588765986	1588765986	1	1	WESTSIDE PHARMACY	4/14/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1401 MISSION ST	None	SANTA CRUZ	CA	95060	4738	44	06087	36.96764928	-122.038662	Santa Cruz County
150256	Fee-for-Service	1841364783	1841364783	1	1	WANG, AMY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3181 SW SAM JACKSON PARK	None	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
150268	Fee-for-Service	1285640987	1285640987	1	1	WALGREEN CO	10/24/1988	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1333 CASTRO ST	None	SAN FRANCISCO	CA	94114	3620	38	06075	37.75083113	-122.4339936	San Francisco County
150303	Fee-for-Service	1275559288	1275559288	2	1	WANG, DEJUN MD	4/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	71575	41	Internal Medicine	0	In state provider	None	18391 E. COLIMA ROAD	SUITE 204	ROWLAND HEIGHTS	CA	91748	2730	19	06037	33.98844297	-117.9041666	Los Angeles County
150332	Fee-for-Service	1598942492	1598942492	1	1	WESTSIDE NEIGHBORHOOD	11/21/2005	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	628 W MICHELTORENA ST	None	SANTA BARBARA	CA	93101	4131	42	06083	34.41910081	-119.7158618	Santa Barbara County
150336	Fee-for-Service	1437587912	1437587912	1	1	WESTBROOK PSYCHOLOGICAL SERV	12/13/2018	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES	5931 STANLEY AVE	# 1	CARMICHAEL	CA	95608	3846	34	06067	38.622978	-121.326966	Sacramento County
150349	Fee-for-Service	1992021596	1992021596	1	1	WENDORF, KRISTEN A MD	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118440	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
150363	Fee-for-Service	1962499640	1962499640	1	1	WOOD, JEFFREY CRNA	4/26/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
150397	Fee-for-Service	1679630446	1679630446	1	1	WALDREP, DONALD MD	12/5/2022	208600000X	NA	General Surgery	026	PHYSICIANS	75982	None	None	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
150439	Fee-for-Service	1053773200	1053773200	1	1	WALSH, CHRISTOPHER L MD	12/18/2020	390200000X	NA	Other	026	PHYSICIANS	161714	None	None	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
150445	Fee-for-Service	1316034713	1316034713	1	1	WILLIAMS, ROBERTA G MD	10/30/1992	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	40696	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
150461	Fee-for-Service	1164601449	1164601449	1	1	WALI, AUTAR K MD	10/4/1996	208C00000X	NA	General Surgery	026	PHYSICIANS	32290	28	Proctology (colon and rectal)	0	In state provider	None	155 W WILLOW ST	None	POMONA	CA	91768	1829	19	06037	34.0791853	-117.7537495	Los Angeles County
150471	Fee-for-Service	1316103997	1316103997	1	1	WONG, WENDY H M DO	4/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12217	40	Pediatrics	0	In state provider	None	6235 N FRESNO STREET	SUITE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
150484	Fee-for-Service	1982775946	1982775946	1	1	WINARKO, SUDARMO MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40220	41	Internal Medicine	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
150488	Fee-for-Service	1306985049	1306985049	1	1	WEISEL, JAMES M MD	8/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98083	18	Ophthalmology	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
150489	Fee-for-Service	1962455865	1962455865	1	1	WESTERBAND, BRIGELI P MD	9/30/1987	207P00000X	NA	Other	026	PHYSICIANS	44057	41	Internal Medicine	0	In state provider	None	8725 WOODMAN AVE	None	ARLETA	CA	91331	6560	19	06037	34.22854137	-118.4350592	Los Angeles County
150518	Fee-for-Service	1255346581	1255346581	1	1	WALGREEN CO	8/22/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2600 MOWRY AVE	None	FREMONT	CA	94538	1619	01	06001	37.55561189	-121.9825927	Alameda County
150524	Fee-for-Service	1063589976	1063589976	1	1	WEINSTEIN, BARRY L MD	4/17/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65520	18	Ophthalmology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
150537	Fee-for-Service	1841249729	1841249729	1	1	WALLIS, STEVEN B OD	7/11/2009	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15972 TUSCOLA RD	STE 101	APPLE VALLEY	CA	92307	1267	36	06071	34.54144171	-117.2692593	San Bernardino County
150551	Fee-for-Service	1649300898	1649300898	1	1	WESTSIDE CENTER FOR INDE	1/7/2008	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	12901 VENICE BLVD	None	LOS ANGELES	CA	90066	3509	19	06037	33.99979516	-118.4415332	Los Angeles County
150560	Fee-for-Service	1780118802	1780118802	1	1	WILLIAMS, MARK T MD	12/5/2023	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	187615	None	None	0	In state provider	None	999 N TUSTIN AVE	STE 17	SANTA ANA	CA	92705	6504	30	06059	33.754167	-117.834191	Orange County
150603	Fee-for-Service	1659410306	1659410306	1	1	WILKINSON, KINNITH D PT	10/13/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5533 W HILLSDALE AVE	SUITE 'A'	VISALIA	CA	93291	5138	54	06107	36.329238	-119.35251	Tulare County
150624	Fee-for-Service	1437587912	1437587912	1	1	WESTBROOK PSYCHOLOGICAL SERV	12/14/2018	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES	5931 STANLEY AVE	# 1	CARMICHAEL	CA	95608	3846	34	06067	38.622978	-121.326966	Sacramento County
150636	Fee-for-Service	1982865770	1982865770	1	1	WONG, CHRISTINE S	2/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100538	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.76344756	-122.4581992	San Francisco County
150709	Fee-for-Service	1144247552	1144247552	1	1	WAL-MART STORES, INC	12/23/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102245	705 COLLEGE BLVD	None	OCEANSIDE	CA	92057	6259	37	06073	33.24079895	-117.2899202	San Diego County
150778	Fee-for-Service	1447257563	1447257563	1	1	WILLIAMS, KEITH B MD	11/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	520 MEDICAL CENTER DR	STE 201	MEDFORD	OR	97504	4334	00	None	42.318801	-122.831728	Jackson County
150885	Fee-for-Service	1811075583	1811075583	1	1	WISE, TRENTON D MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73697	40	Pediatrics	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
150903	Fee-for-Service	1104351667	1104351667	1	1	WILLCOXON, KATHARINE A NP	10/3/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
150914	Fee-for-Service	1437587912	1437587912	1	1	WESTBROOK PSYCHOLOGICAL SERV	6/24/2022	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ICES	5931 STANLEY AVE	# 1	CARMICHAEL	CA	95608	3846	34	06067	38.622978	-121.326966	Sacramento County
150933	Fee-for-Service	1326458860	1326458860	1	1	WILLIAMSON, ANGELA J	8/16/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
150979	Fee-for-Service	1558433276	1558433276	1	1	WORMAN, SCOTT L MD	8/31/1989	174400000X	NA	Other	026	PHYSICIANS	66734	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
150984	Fee-for-Service	1073539086	1073539086	1	1	WILLIAMS, WILLIAM MD	7/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117924	84	Surgery-Head and Neck	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
151001	Fee-for-Service	1033967849	1033967849	1	1	WIJESUNDARA EKANAYAKE, MIHID	6/21/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	UNI L EKANAYAKE AU	4482 BARRANCA PKWY	SUITE 175	IRVINE	CA	92604	7701	30	06059	33.68008811	-117.8015383	Orange County
151035	Fee-for-Service	1063410322	1063410322	1	1	WOODS, ELIZABETH A MD	5/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	48104	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	110 N VALERIA ST	STE 204	FRESNO	CA	93701	2167	10	06019	36.74388938	-119.7847725	Fresno County
151112	Fee-for-Service	1083989198	1083989198	1	1	WONG, JENNIFER S DO MD	12/28/2017	207P00000X	NA	Other	026	PHYSICIANS	15750	02	General Surgery	0	In state provider	None	1524 MCHENRY AVE	SUITE 370	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
151116	Fee-for-Service	1396923934	1396923934	1	1	WILSON-MARTIN, MARSHIQ L LCS	3/3/2021	171M00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	2990 INLAND EMPIRE BLVD	105	ONTARIO	CA	91764	4899	36	06071	34.069824	-117.5873175	San Bernardino County
151174	Fee-for-Service	1750418810	1750418810	1	1	WEST GASTROENTEROLOGY	4/18/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP	8110 AIRPORT BLVD	None	LOS ANGELES	CA	90045	3119	19	06037	33.96526302	-118.3852705	Los Angeles County
151201	Fee-for-Service	1437587912	1437587912	1	1	WESTBROOK PSYCHOLOGICAL SERV	4/21/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ICES	5931 STANLEY AVE	# 1	CARMICHAEL	CA	95608	3846	34	06067	38.622978	-121.326966	Sacramento County
151203	Fee-for-Service	1265864078	1265864078	1	1	WAL-MART STORE INC	6/12/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1266 E VALLEY PARKWAY	None	ESCONDIDO	CA	92027	2310	37	06073	33.13110643	-117.0658052	San Diego County
151291	Fee-for-Service	1639899669	1639899669	1	1	WEINZIMER CHIROPRACTIC INC	8/12/2024	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	ERVICES	535 H ST	None	CHULA VISTA	CA	91910	4301	37	06073	32.63175527	-117.0867242	San Diego County
151357	Fee-for-Service	1770506529	1770506529	1	1	WILSON, AUNDREA MD	12/16/2019	207P00000X	NA	Other	026	PHYSICIANS	60470	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 HEGENBERGER RD	STE 100	OAKLAND	CA	94621	1452	01	06001	37.7350428	-122.1976624	Alameda County
151364	Fee-for-Service	1346303096	1346303096	1	1	WHITE, LAURA L	2/14/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
151368	Fee-for-Service	1811993629	1811993629	1	2	WILSON, BARNARD G OD	1/1/1979	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1317 OAKDALE RD	STE 620	MODESTO	CA	95355	3365	50	06099	37.662489	-120.957588	Stanislaus County
151371	Fee-for-Service	1023270311	1023270311	1	1	WYHS, SARAH E MD	1/4/2023	207L00000X	NA	Other	026	PHYSICIANS	182687	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
151415	Fee-for-Service	1821172016	1821172016	1	1	WILBUR, JORDAN R MD INC	10/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	20501	40	Pediatrics	0	In state provider	None	2410 CLAY ST	None	SAN FRANCISCO	CA	94115	1809	38	06075	37.79095867	-122.4328001	San Francisco County
151420	Fee-for-Service	1295818862	1295818862	1	1	WOODLAND CENTERS	9/26/2014	261QM0801X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	2	Out of state provider	None	1125 6TH STREET SE	None	WILLMAR	MN	56201	4675	00	None	45.11115056	-95.03593533	Kandiyohi County
151424	Fee-for-Service	1447539747	1447539747	1	1	WESTSIDE SURGICAL CENTER	12/20/2018	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	9700 BRIMHALL RD	None	BAKERSFIELD	CA	93312	2777	15	06029	35.36875097	-119.1107379	Kern County
151432	Fee-for-Service	1700941739	1700941739	1	1	WATKINS, DONALD D LCSW	12/8/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
151457	Fee-for-Service	1962599340	1962599340	1	1	WANG, ERJUN MD	10/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84068	41	Internal Medicine	0	In state provider	None	780 E WASHINGTON BLVD	STE 202	CRESCENT CITY	CA	95531	8397	08	06015	41.775246	-124.194447	Del Norte County
151460	Fee-for-Service	1962558536	1962558536	1	1	WARNKE, ROGER A MD	1/1/1982	207ZP0102X	NA	Other	026	PHYSICIANS	23796	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
151463	Fee-for-Service	1649421785	1649421785	1	1	WATANABE, HISAKO RN	2/13/2009	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
151465	Fee-for-Service	1750418810	1750418810	1	1	WEST GASTROENTEROLOGY	4/18/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	GROUP	8110 AIRPORT BLVD	None	LOS ANGELES	CA	90045	3119	19	06037	33.96526302	-118.3852705	Los Angeles County
151492	Fee-for-Service	1679693170	1679693170	1	1	WASCO UNION SCHOOL DIST	7/22/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1102 FIFTH STREET	None	WASCO	CA	93280	1825	15	06029	35.59698742	-119.3384925	Kern County
151520	Fee-for-Service	1811157449	1811157449	1	1	WANG, STEVEN Y MD	9/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128715	30	Radiology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
151627	Fee-for-Service	1194232470	1194232470	1	1	WHALEY, LAMAR LMFT	3/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	440 E HUNTINGTON DR STE	None	ARCADIA	CA	91006	3775	19	06037	34.14014147	-118.0220265	Los Angeles County
151639	Fee-for-Service	1356429112	1356429112	1	1	WILKOF, LESLIE G MD	6/30/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	51049	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
151677	Fee-for-Service	1841511649	1841511649	1	1	WHITTLE-UTTER, JESSE R LMFT	1/24/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 SHATTUCK AVE	STE 200	BERKELEY	CA	94709	1601	01	06001	37.87811709	-122.2691431	Alameda County
151723	Fee-for-Service	1710388723	1710388723	1	1	WILLIAMS, BROOKE C LMFT	10/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
151735	Fee-for-Service	1275761249	1275761249	1	1	WEST HILLS EMERGENCY MEDICAL	6/24/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ASSOCIATES INC	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
151826	Fee-for-Service	1184730301	1184730301	1	1	WONG, JEAN Z MD	6/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	62840	41	Internal Medicine	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	6201	43	06085	37.37715796	-122.0651926	Santa Clara County
151852	Fee-for-Service	1801906136	1801906136	1	1	WELTER, STEPHEN E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37927	41	Internal Medicine	0	In state provider	None	165 ROWLAND WAY	STE 201	NOVATO	CA	94945	5055	21	06041	38.09824386	-122.559872	Marin County
151858	Fee-for-Service	1881627768	1881627768	1	1	WILEY, S JOHN SD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1305 N H ST	STE E	LOMPOC	CA	93436	3335	42	06083	34.65859479	-120.4576492	Santa Barbara County
151933	Fee-for-Service	1679679336	1679679336	1	1	WESP, CLYDE E JR MD	2/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45946	40	Pediatrics	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
151941	Fee-for-Service	1063792083	1063792083	1	1	WRIGHT, VANESSA CNM	8/30/2019	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
151947	Fee-for-Service	1356672398	1356672398	1	1	WONG, LYDIA A MD	9/23/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	151707	08	Family Practice	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
151969	Fee-for-Service	1740595313	1740595313	1	1	WONG, MELISSA S MD	8/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121495	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	99 N LA CIENEGA	None	BEVERLY HILLS	CA	90211	2222	19	06037	34.06736471	-118.3763201	Los Angeles County
152020	Fee-for-Service	1720016165	1720016165	1	1	WOODWARD, QUY-TRAN PHI	12/17/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	411 E HUNTINGTON DR	SUITE 121	ARCADIA	CA	91006	3788	19	06037	34.14020171	-118.0216631	Los Angeles County
152026	Fee-for-Service	1104844976	1104844976	1	1	WAL-MART STORES INC	1/31/2005	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 105162	27931 KELLY JOHNSON PKWY	None	SANTA CLARITA	CA	91355	0000	19	06037	34.44489925	-118.5763087	Los Angeles County
152028	Fee-for-Service	1376745356	1376745356	1	1	WIJERATINE, RANJITH MD	3/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	94092	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
152113	Fee-for-Service	1851737852	1851737852	1	1	WAL-MART STORES INC	7/19/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3112 SANTA RITA RD	None	PLEASANTON	CA	94566	8300	01	06001	37.6896785	-121.8781633	Alameda County
152122	Fee-for-Service	1346794872	1346794872	1	1	WISH U WELL HOME	12/7/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE	6501 FOOTHILL BLVD	SUITE 202A	TUJUNGA	CA	91042	2790	19	06037	34.24497265	-118.2734363	Los Angeles County
152148	Fee-for-Service	1326327933	1326327933	1	1	WAGMAN, LAWRENCE D MD	10/24/2014	208600000X	NA	General Surgery	026	PHYSICIANS	55578	02	General Surgery	0	In state provider	PROFESSIONAL CORPORATION	1010 W LA VETA	STE 470	ORANGE	CA	92868	4305	30	06059	33.78028244	-117.8635552	Orange County
152156	Fee-for-Service	1265140347	1265140347	1	1	WESTMONT CHULA VISTA	11/13/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	OPERATIONS, LP	2325 PROCTOR VALLEY RD	None	CHULA VISTA	CA	91914	2099	37	06073	32.66217681	-116.9704362	San Diego County
152187	Fee-for-Service	1184811952	1184811952	1	1	WOO, BENJAMIN K MD	10/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96701	36	Psychiatry	0	In state provider	None	3291 LOMA VISTA ROAD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
152208	Fee-for-Service	1780429373	1780429373	1	1	WELLS, BRIANNA C BIRTH DOULA	6/27/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	38	06075	0	0	None
152220	Fee-for-Service	1336291418	1336291418	1	1	WANG, HONG LAC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	18043 PIONEER BLVD	STE 200	ARTESIA	CA	90701	3904	19	06037	33.86672623	-118.0823551	Los Angeles County
152242	Fee-for-Service	1851658389	1851658389	1	1	WOODWARD, BRANDON J MD	3/13/2019	2086S0102X	NA	General Surgery	026	PHYSICIANS	131192	02	General Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
152275	Fee-for-Service	1023078235	1023078235	1	1	WANG, JOHN W MD	9/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73379	41	Internal Medicine	0	In state provider	CIRCLEMED HLTHCARE AMC	11160 WARNER AVE	STE 405	FOUNTAIN VALLEY	CA	92708	4056	30	06059	33.71630854	-117.934317	Orange County
152289	Fee-for-Service	1598025975	1598025975	1	1	WONG, SIU W MD INC	4/15/2013	207R00000X	NA	Other	026	PHYSICIANS	69408	41	Internal Medicine	0	In state provider	None	9324 GARVEY AVENUE	STE N	SOUTH EL MONTE	CA	91733	1090	19	06037	34.06269254	-118.065933	Los Angeles County
152297	Fee-for-Service	1588169353	1588169353	1	1	WU, DANIEL DPM	7/19/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	582 S SUNNYVALE AVE	None	SUNNYVALE	CA	94086	6215	43	06085	37.36886669	-122.0316101	Santa Clara County
152388	Fee-for-Service	1124373782	1124373782	1	1	WRIGHT, MITCHELL L PT	6/25/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7900 DISTRICT BLVD	C	BAKERSFIELD	CA	93313	4844	15	06029	35.31318383	-119.0908089	Kern County
152528	Fee-for-Service	1851658389	1851658389	1	1	WOODWARD, BRANDON J MD	3/13/2019	2086S0102X	NA	General Surgery	026	PHYSICIANS	131192	89	Surgery-Traumatic	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
152601	Fee-for-Service	1790989267	1790989267	1	2	WU, KONG-TAY MD INC	10/22/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	437 N CAMPUS AVE	None	ONTARIO	CA	91764	4229	36	06071	34.06797	-117.6415695	San Bernardino County
152624	Fee-for-Service	1942225362	1942225362	1	1	WRIGHT, PAUL C MD INC	8/1/1988	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	13144	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5682 ADELINE ST	None	OAKLAND	CA	94608	2804	01	06001	37.84149803	-122.2742749	Alameda County
152658	Fee-for-Service	1700461977	1700461977	1	1	WHITE ROSE HEALTH, INC	4/14/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7012 RESEDA BLVD	STE 201B	RESEDA	CA	91335	4219	19	06037	34.197975	-118.5360215	Los Angeles County
152660	Fee-for-Service	1841293305	1841293305	1	2	WEISSMAN, ROBERT J	10/22/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1334 COVINA	#205	SAN DIMAS	CA	91773	3211	19	06037	34.097067	-117.833751	Los Angeles County
152664	Fee-for-Service	1053372763	1053372763	1	1	WILLIAMS, LANCELOT L MD	5/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	46503	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
152671	Fee-for-Service	1760477475	1760477475	1	1	WOOLERY, WILLIAM G. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1712 S LAFAYETTE AVE	None	SEDALIA	MO	65301	7542	00	None	38.69623148	-93.22407694	Pettis County
152697	Fee-for-Service	1053412981	1053412981	1	1	WAHID, SHAHID MD	1/4/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	1	Border provider	None	2031 MCDANIEL ST	SUITE 140	NORTH LAS VEGAS	NV	89030	6303	00	None	36.19740597	-115.1207123	Clark County
152728	Fee-for-Service	1215990635	1215990635	1	1	WOLF, STEVEN L MD	10/3/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76717	08	Family Practice	0	In state provider	None	3536 MENDOCINO AVE	STE 300	SANTA ROSA	CA	95403	3634	49	06097	38.473326	-122.725935	Sonoma County
152738	Fee-for-Service	1386743698	1386743698	1	1	WARM SPRINGS ROAD CVS LLC	11/14/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	7190 W CRAIG RD	None	LAS VEGAS	NV	89129	6512	00	None	36.2405205	-115.25076	Clark County
152739	Fee-for-Service	1194835439	1194835439	1	1	WALMSLEY, JOAN LCSW	8/20/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	34112 CAMBRIDGE RD	None	DANA POINT	CA	92675	3207	30	06059	33.46747698	-117.6873154	Orange County
152757	Fee-for-Service	1649204397	1649204397	1	1	WANG, VICTOR S MD	6/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86616	10	Gastroenterology (M.D. only)	0	In state provider	None	1050 E YORBA LINDA BLVD	STE 103	PLACENTIA	CA	92870	3750	30	06059	33.88824259	-117.8446439	Orange County
152758	Fee-for-Service	1952334278	1952334278	2	1	WOLCOTT, SUSAN C LM	3/21/2016	No Taxonomy Provided	NA	None	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	703 S A ST	None	MT SHAST	CA	96067	2704	47	06093	41.30766573	-122.3096893	Siskiyou County
152766	Fee-for-Service	1598843278	1598843278	1	1	WANG, ERIC MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73004	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
152796	Fee-for-Service	1780897918	1780897918	1	1	WATERS, VERONICA LMFT	6/27/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
152797	Fee-for-Service	1013572015	1013572015	1	1	WANG, DOUGLAS MD	7/3/2023	208M00000X	NA	Other	026	PHYSICIANS	179449	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
152838	Fee-for-Service	1619928017	1619928017	1	1	WINCHESTER MEDICAL CENTER	10/31/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1840 AMHERST ST	None	WINCHESTER	VA	22601	2808	00	None	39.194406	-78.193485	Winchester city
152853	Fee-for-Service	1619943248	1619943248	1	1	WANG, BEVERLY Y MD	1/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134314	22	Pathology (M.D. only)	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
152858	Fee-for-Service	1235284225	1235284225	1	1	WILLIAMS, MARK I MD	6/1/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	60262	30	Radiology	0	In state provider	None	1817 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	5008	15	06029	35.37326659	-119.0227581	Kern County
152866	Fee-for-Service	1205142981	1205142981	1	1	WILLIAMS, ANGELA T LCSW	6/25/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2009 PALO VERDE AVE	SUITE A	LONG BEACH	CA	90815	3322	19	06037	33.792597	-118.1080155	Los Angeles County
152884	Fee-for-Service	1962716878	1962716878	1	1	WALGREEN CO	1/25/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	24790 VALLEY ST	None	SANTA CLARITA	CA	91321	2629	19	06037	34.3792796	-118.5405452	Los Angeles County
152918	Fee-for-Service	1225087190	1225087190	1	1	WHEATON ST FRANCIS HOSP	8/22/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3237 S 16TH ST	None	MILWAUKEE	WI	53215	4526	00	None	42.98553012	-87.93382656	Milwaukee County
152958	Fee-for-Service	1477618221	1477618221	1	1	WINTER, RANDY D MD	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	60601	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
152974	Fee-for-Service	1275513376	1275513376	1	1	WILSON, DONALD R MD	2/28/1994	208G00000X	NA	General Surgery	026	PHYSICIANS	24934	33	Thoracic Surgery	0	In state provider	None	660 SANITARIUM RD	STE 301	DEER PARK	CA	94576	9710	28	06055	38.54206023	-122.47561	Napa County
153028	Fee-for-Service	1073544904	1073544904	1	1	WEINSTEIN, DEBRA L MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67667	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 ALAMO PINTADO RD	None	SOLVANG	CA	93463	2269	42	06083	34.60203	-120.1262085	Santa Barbara County
153047	Fee-for-Service	1972671683	1972671683	1	1	WELCOME MED SUPPLIES INC	7/31/2001	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	9520 GARDEN GROVE BLVD	STE 15	GARDEN GROVE	CA	92844	1528	30	06059	33.77395138	-117.966418	Orange County
153107	Fee-for-Service	1760481352	1760481352	1	1	WHEELOCK, J PATRICK MD	5/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	78369	30	Radiology	0	In state provider	None	309 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
153152	Fee-for-Service	1770587511	1770587511	1	1	WESTERN PATHOLOGY CONSULTANT	8/15/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	1	Border provider	S LTD	1350 STARDUST ST	STE D	RENO	NV	89503	4264	00	None	39.52858204	-119.8347915	Washoe County
153207	Fee-for-Service	1659407963	1659407963	1	1	WILLSEY,DERRICK B MD	3/1/2001	174400000X	NA	Other	026	PHYSICIANS	86018	05	Anesthesiology	0	In state provider	None	425 W JUNIPERO ST	STE 3	SANTA BARBARA	CA	93105	4294	42	06083	34.42973253	-119.7249544	Santa Barbara County
153235	Fee-for-Service	1366523680	1366523680	1	1	WILLIAMS, STEVEN K MD	4/30/1989	207L00000X	NA	Other	026	PHYSICIANS	65420	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
153239	Fee-for-Service	1679573885	1679573885	1	1	WU, MICHAEL C MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	81748	36	Psychiatry	0	In state provider	None	3 POINTE DR	STE 305	BREA	CA	92821	6307	30	06059	33.92643348	-117.8771648	Orange County
153262	Fee-for-Service	1275513376	1275513376	1	1	WILSON, DONALD R MD	2/28/1994	208G00000X	NA	General Surgery	026	PHYSICIANS	24934	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	660 SANITARIUM RD	STE 301	DEER PARK	CA	94576	9710	28	06055	38.54206023	-122.47561	Napa County
153308	Fee-for-Service	1215327291	1215327291	1	1	WATERBROOK, STEPHEN K MD INC	2/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	94355	02	General Surgery	0	In state provider	None	150 CATHERINE LANE	SUITE J	GRASS VALLEY	CA	95945	5719	29	06057	39.22894557	-121.0489578	Nevada County
153326	Fee-for-Service	1538771837	1538771837	1	1	WESTERN HOME HEALTH INC	4/7/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2626 FOOTHILLS BLVD	STE 210	LA CRESCENTA	CA	91214	3574	19	06037	34.22187547	-118.2363189	Los Angeles County
153344	Fee-for-Service	1740560150	1740560150	1	1	WAHI, GAURAV DO	6/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14117	01	General Practice	0	In state provider	None	2430 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4356	52	06103	40.14832201	-122.2216203	Tehama County
153349	Fee-for-Service	1891085296	1891085296	1	1	WEINGARTEN, ILENE S LMFT	12/26/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6200 WILSHIRE BLVD	STE 1008	LOS ANGELES	CA	90048	5801	19	06037	34.06319291	-118.3636025	Los Angeles County
153420	Fee-for-Service	1932103843	1932103843	1	1	WITHERS, JUNE S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72572	41	Internal Medicine	0	In state provider	None	495 CASTRO ST	STE 102	MOUNTAIN VIEW	CA	94041	2086	43	06085	37.39017521	-122.0811089	Santa Clara County
153527	Fee-for-Service	1780635920	1780635920	1	1	WINOTO, JOHAN MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116149	45	Nephrology (Renal-Kidney)	0	In state provider	None	77 CADILLAC DRIVE	SUITE 130	SACRAMENTO	CA	95825	8337	34	06067	38.572551	-121.4181585	Sacramento County
153528	Fee-for-Service	1730312778	1730312778	1	1	WILSON, MARCIA H PSYD	11/22/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
153545	Fee-for-Service	1396123014	1396123014	1	1	WESTON, BRIAN MD	10/15/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	148412	30	Radiology	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
153555	Fee-for-Service	1316209968	1316209968	1	1	WHALEN, ANDREW D	6/5/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
153575	Fee-for-Service	1174775522	1174775522	1	1	WARNER, ROBIN M MD	12/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10616	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
153583	Fee-for-Service	1235526344	1235526344	1	1	WON, PAMELA J	7/13/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
153611	Fee-for-Service	1841205135	1841205135	1	1	WALGREEN CO	8/14/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	903 E HUNTINGTON DR	None	MONROVIA	CA	91016	3715	19	06037	34.13964081	-117.9858194	Los Angeles County
153629	Fee-for-Service	1083143820	1083143820	1	1	WANG, ERIC X MD	2/26/2021	207P00000X	NA	Other	026	PHYSICIANS	169424	None	None	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
153668	Fee-for-Service	1134437163	1134437163	1	1	WALIGORA, CHRISTINE M LCSW	12/28/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
153712	Fee-for-Service	1932103843	1932103843	1	1	WITHERS, JUNE S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72572	01	General Practice	0	In state provider	None	495 CASTRO ST	STE 102	MOUNTAIN VIEW	CA	94041	2086	43	06085	37.39017521	-122.0811089	Santa Clara County
153721	Fee-for-Service	1154718013	1154718013	1	1	WHITE, STACEY L MD	7/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145865	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
153734	Fee-for-Service	1801853114	1801853114	1	1	WAREHAM, JULIE G MD	1/31/1993	2084P0800X	NA	Psychiatry	026	PHYSICIANS	64072	01	General Practice	0	In state provider	None	770 MAGNOLIA AVE	SUITE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
153748	Fee-for-Service	1700881786	1700881786	1	1	WELSH, TERRY MICHAEL MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62839	22	Pathology (M.D. only)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
153761	Fee-for-Service	1124342720	1124342720	1	1	WEI, CHYI J MD	4/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	92868	4203	00	None	36.180999	-115.3174815	Clark County
153814	Fee-for-Service	1033313242	1033313242	1	1	WILLIAMS, SEAN M MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	97319	40	Pediatrics	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
153849	Fee-for-Service	1710054614	1710054614	1	1	WAKELEY, VICTORIA M MD	10/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86419	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
153873	Fee-for-Service	1578580809	1578580809	1	1	WAL-MART STORES, INC	11/22/1996	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1800 N MAIN ST	None	SALINAS	CA	93906	2804	27	06053	36.717723	-121.650489	Monterey County
153896	Fee-for-Service	1124097183	1124097183	1	1	WILKERSON, ILLYA L MD	3/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	52325	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
153920	Fee-for-Service	1760189138	1760189138	1	1	WOO, CHRISTOPHER NP	1/3/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2102 BUSINESS CENTER DR	STE 250	IRVINE	CA	92612	1001	30	06059	33.68027087	-117.855546	Orange County
153950	Fee-for-Service	1104017573	1104017573	1	1	WARDWELL, KERI S MD	6/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106345	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
153959	Fee-for-Service	1619982980	1619982980	1	1	WALGREEN CO	11/15/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14001 PALM DR	None	DESERT HOT SPRING	CA	92240	6845	33	06065	33.94673142	-116.5018116	Riverside County
153990	Fee-for-Service	1962567339	1962567339	1	1	WILLIAMSON, SCOTT M CRNA	3/16/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
153991	Fee-for-Service	1548345473	1548345473	1	1	WILLIAMS, NATHAN MD	5/24/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79720	08	Family Practice	0	In state provider	None	9390 HESPERIA RD	SUITE # 7	HESPERIA	CA	92345	3602	36	06071	34.4212584	-117.3021441	San Bernardino County
153995	Fee-for-Service	1710926381	1710926381	1	1	WU, TING MD	3/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88804	08	Family Practice	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
154008	Fee-for-Service	1346329471	1346329471	1	1	WANG, CHUNG C MD	9/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87067	36	Psychiatry	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
154012	Fee-for-Service	1972698769	1972698769	1	1	WANG, CLIFFORD MD	12/1/1995	207R00000X	NA	Other	026	PHYSICIANS	77903	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
154024	Fee-for-Service	1801853114	1801853114	1	1	WAREHAM, JULIE G MD	1/31/1993	2084P0800X	NA	Psychiatry	026	PHYSICIANS	64072	36	Psychiatry	0	In state provider	None	770 MAGNOLIA AVE	SUITE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
154031	Fee-for-Service	1508466210	1508466210	1	1	WESTLAKE OAKS HEALTHCARE,LLC	8/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	250 FAIRVIEW ROAD	None	THOUSAND OAKS	CA	91361	2456	56	06111	34.16528546	-118.8404629	Ventura County
154063	Fee-for-Service	1790833515	1790833515	1	1	WOJTOWICH, SCOTT C MD	4/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7858	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
154067	Fee-for-Service	1679704571	1679704571	1	1	WATERS, MICHELLE LMFT	12/21/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47449	-	NOT APPLICABLE	0	In state provider	None	1401 L ST	None	BAKERSFIELD	CA	93301	4522	15	06029	35.37071435	-119.0164657	Kern County
154119	Fee-for-Service	1417144817	1417144817	1	1	WILLIAMS, LATASHA N MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	96906	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
154158	Fee-for-Service	1619031259	1619031259	1	1	WASSERSTEIN, PHILIP H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40632	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
154216	Fee-for-Service	1063704237	1063704237	1	1	WOODS, JOHN P DO	11/16/2018	208600000X	NA	General Surgery	026	PHYSICIANS	15648	02	General Surgery	0	In state provider	None	26520 CACTUS AVE	STE 2021	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
154281	Fee-for-Service	1124199104	1124199104	1	1	WIN, KHINE K MD	10/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83164	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
154290	Fee-for-Service	1790724185	1790724185	1	1	WAHEED ZEHRI MD	1/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1225 HANCOCK RD	STE C	BULLHEAD CITY	AZ	86442	5961	00	None	35.108307	-114.6055365	Mohave County
154292	Fee-for-Service	1437579422	1437579422	1	1	WILLIAMSON, ANDREW T MD	8/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144673	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
154301	Fee-for-Service	1972698769	1972698769	1	1	WANG, CLIFFORD MD	12/1/1995	207R00000X	NA	Other	026	PHYSICIANS	77903	08	Family Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
154305	Fee-for-Service	1003436064	1003436064	1	36	WS AUDIOLOGY (CALIFORNIA), P	10/27/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	16914 SAN FERNANDO MISSI	None	GRANADA HILLS	CA	91344	4249	19	06037	34.27201353	-118.500093	Los Angeles County
154311	Fee-for-Service	1326363904	1326363904	1	1	WILCOX, AARON P MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132636	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
154315	Fee-for-Service	1922019637	1922019637	1	1	WONG, DIANA YUN-CHI MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	72281	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18460 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22071454	-118.5357375	Los Angeles County
154321	Fee-for-Service	1811933310	1811933310	1	1	WILLIAM A MIZE MD	2/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 CHICAGO AVE	None	MINNEAPOLIS	MN	55404	4518	00	None	44.95666589	-93.26255996	Hennepin County
154336	Fee-for-Service	1801807417	1801807417	1	1	WILLIAM H CHERRY MD INC	12/7/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	25109 JEFFERSON AVE	SUITE 100	MURRIETA	CA	92562	8116	33	06065	33.55410071	-117.2028115	Riverside County
154348	Fee-for-Service	1376754036	1376754036	1	1	WOODSON, ERIKA A	11/18/2022	207YX0901X	NA	ENT/Otolaryngology	026	PHYSICIANS	182845	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
154359	Fee-for-Service	1417633918	1417633918	1	1	WISSA, NEVEEN M LMFT	10/18/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4221 WILSHIRE BLVD	STE 230	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
154364	Fee-for-Service	1013410877	1013410877	1	1	WARING, KRISTOPHER R MD	7/14/2020	390200000X	NA	Other	026	PHYSICIANS	166393	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
154385	Fee-for-Service	1720469729	1720469729	1	1	WISECUP, KIMBERLY R DO	8/3/2022	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
154392	Fee-for-Service	1174604433	1174604433	1	1	WRIGHT, JEFFREY A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CHILDREN'S UNIV MED GRP	4500 SAND POINT WAY NE,	#100	SEATTLE	WA	98105	0000	00	None	47.66165594	-122.2864502	King County
154400	Fee-for-Service	1144271834	1144271834	1	1	WALTON PEDIATRICS	10/1/1998	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7237 E SOUTHGATE DR	STE A	SACRAMENTO	CA	95823	2631	34	06067	38.494629	-121.435686	Sacramento County
154405	Fee-for-Service	1750607180	1750607180	1	1	WANG, EMILY L MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131582	05	Anesthesiology	0	In state provider	None	3626 RUFFIN ROAD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
154414	Fee-for-Service	1457314551	1457314551	1	1	WHITE, PHILLIP J PT	2/25/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	180 ROSE LN	STE 1	YREKA	CA	96097	3371	47	06093	41.72221468	-122.6403662	Siskiyou County
154482	Fee-for-Service	1508941279	1508941279	1	1	WADHERA, AKHIL MD	11/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80112	07	Dermatology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
154498	Fee-for-Service	1225113442	1225113442	1	1	WILCOX MEMORIAL HOSPITAL	10/13/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3-3420 KUHIO HWY	None	LIHUE	HI	96766	1099	00	None	21.98560043	-159.3663628	Kauai County
154500	Fee-for-Service	1083293443	1083293443	1	1	WINNERS, BRET C DO	7/31/2024	207P00000X	NA	Other	026	PHYSICIANS	22545	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
154506	Fee-for-Service	1063704237	1063704237	1	1	WOODS, JOHN P DO	11/16/2018	208600000X	NA	General Surgery	026	PHYSICIANS	15648	89	Surgery-Traumatic	0	In state provider	None	26520 CACTUS AVE	STE 2021	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
154508	Fee-for-Service	1760440085	1760440085	1	1	WONG, SUSAN S MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66888	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
154513	Fee-for-Service	1497962492	1497962492	1	1	WU, JOSEPH MD	2/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99443	41	Internal Medicine	0	In state provider	None	4445 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
154538	Fee-for-Service	1467001883	1467001883	1	1	WARASHINA-MESSINA, CAMILE N	2/10/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	399 E HIGHLAND AVE	STE 401	SAN BERNARDINO	CA	92402	3862	36	06071	34.1358627	-117.2757898	San Bernardino County
154558	Fee-for-Service	1972632107	1972632107	1	1	WEIGLE, DAVID SCOTT M D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	325 9TH AVE	MS 359110 C/O UWP	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
154561	Fee-for-Service	1376558601	1376558601	1	1	WALGREEN CO	8/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	118 E BASE LINE RD	None	RIALTO	CA	92376	3607	36	06071	34.12138457	-117.3698386	San Bernardino County
154598	Fee-for-Service	1003436064	1003436064	1	36	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	16914 SAN FERNANDO MISSI	None	GRANADA HILLS	CA	91344	4249	19	06037	34.27201353	-118.500093	Los Angeles County
154599	Fee-for-Service	1467470252	1467470252	1	1	WAL-MART STORES INC	6/14/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHMCY #10-5192	5821 ANTELOPE NORTH RD	None	ANTELOPE	CA	95843	0000	34	06067	38.70491224	-121.3377694	Sacramento County
154602	Fee-for-Service	1003943341	1003943341	1	1	WESTERN YOUTH SERVICES	6/10/2024	261QM0855X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	23461 S POINTE DR	SUITE 220	LAGUNA HILLS	CA	92653	1547	30	06059	33.62535142	-117.7206568	Orange County
154633	Fee-for-Service	1942216692	1942216692	1	1	WALGREEN CO.	7/14/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	164 W JACKSON ST	None	HAYWARD	CA	94544	1810	01	06001	37.65311984	-122.0893016	Alameda County
154635	Fee-for-Service	1225055643	1225055643	1	1	WAL-MART STORES, INC	9/18/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101651	7011 N MAIN ST	None	AMERICAN CANYON	CA	94503	1169	28	06055	38.183022	-122.252643	Napa County
154671	Fee-for-Service	1194992842	1194992842	1	1	WEI, STEPHEN C MD	3/18/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	106515	30	Radiology	0	In state provider	None	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
154685	Fee-for-Service	1619039245	1619039245	1	1	WATSON, JOHN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	75 PRINGLE WAY	STE 606	RENO	NV	89502	1472	00	None	39.52621891	-119.7944075	Washoe County
154719	Fee-for-Service	1275829665	1275829665	1	1	WEBER, MATTHEW P MD	3/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124351	None	None	0	In state provider	None	27700 MEDICAL CENTER DR	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
154754	Fee-for-Service	1154353126	1154353126	1	1	WANG, JIN MD	1/25/1996	207RN0300X	NA	Nephrology	026	PHYSICIANS	49349	None	None	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
154786	Fee-for-Service	1578641387	1578641387	1	1	WEISS, STEFAN C MD	10/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80115	07	Dermatology	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
154789	Fee-for-Service	1225113442	1225113442	1	1	WILCOX MEMORIAL HOSPITAL	5/17/1999	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3-3420 KUHIO HWY	None	LIHUE	HI	96766	1099	00	None	21.98560043	-159.3663628	Kauai County
154793	Fee-for-Service	1083293443	1083293443	1	1	WINNERS, BRET C DO	7/31/2024	207P00000X	NA	Other	026	PHYSICIANS	22545	70	Clinic (mixed specialty)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
154827	Fee-for-Service	1366472649	1366472649	1	1	WONG, DOMINIC T NP	10/18/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10605 BALBOA BLVD	#330	GRANADA HILLS	CA	91344	6432	19	06037	34.263378	-118.5022965	Los Angeles County
154855	Fee-for-Service	1184027229	1184027229	1	1	WEISSBERGER, LAURA E LCSW	3/18/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
154903	Fee-for-Service	1881649549	1881649549	1	1	WALKER, DILYS M MD	12/31/1990	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	72210	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 POTRERO AVE	RM 6D	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
154923	Fee-for-Service	1083799738	1083799738	1	1	WONG, SHALE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13123 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742164	-104.8350375	Adams County
154975	Fee-for-Service	1619039245	1619039245	1	1	WATSON, JOHN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	1	Border provider	None	75 PRINGLE WAY	STE 606	RENO	NV	89502	1472	00	None	39.52621891	-119.7944075	Washoe County
154982	Fee-for-Service	1831593342	1831593342	1	1	WALGREEN CO	12/17/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1492 BLUE OAKS BLVD	None	ROSEVILLE	CA	95747	7143	31	06061	38.79553451	-121.3278885	Placer County
155065	Fee-for-Service	1164479473	1164479473	1	1	WOOD, FREDERICK MD	3/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	64336	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	25405 HANCOCK AVE	STE 216	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
155068	Fee-for-Service	1649568015	1649568015	1	1	WALTER, WILLIAM	6/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
155086	Fee-for-Service	1184825887	1184825887	1	1	WANG, RICK C OD	9/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
155087	Fee-for-Service	1184634859	1184634859	1	1	WILKIN, JOAN L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3500 W WHEATLAND RD	None	DALLAS	TX	75237	3460	00	None	32.64745255	-96.8764365	Dallas County
155236	Fee-for-Service	1104850932	1104850932	1	1	WAINBERG, ZEV MD	4/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82044	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 MED PLAZA	STE 120	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
155239	Fee-for-Service	1487115408	1487115408	1	1	WILLE, AARON J MD	8/19/2022	207P00000X	NA	Other	026	PHYSICIANS	180328	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
155263	Fee-for-Service	1619039245	1619039245	1	1	WATSON, JOHN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	75 PRINGLE WAY	STE 606	RENO	NV	89502	1472	00	None	39.52621891	-119.7944075	Washoe County
155287	Fee-for-Service	1396149555	1396149555	1	1	WILLICOMBE, JOAN LMFT	12/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	22 W MICHELTORENA ST	STE B	SANTA BARBARA	CA	93101	6525	42	06083	34.4255722	-119.7090178	Santa Barbara County
155343	Fee-for-Service	1235172446	1235172446	1	1	WONG, GORDON W MD	9/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102501	78	Neoplastic Diseases/Oncology	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
155376	Fee-for-Service	1083815518	1083815518	1	1	WEINSTEIN, DAVID MFT	9/29/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	30705	-	NOT APPLICABLE	0	In state provider	None	10850 MACARTHUR BLVD	STE 200	OAKLAND	CA	94605	5266	01	06001	37.7414325	-122.1498379	Alameda County
155380	Fee-for-Service	1992784755	1992784755	1	1	WEISENSEE, ANNE M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	166 4TH ST E	None	ST PAUL	MN	55101	1421	00	None	44.94748068	-93.08830943	Ramsey County
155388	Fee-for-Service	1851568067	1851568067	1	1	WALNUT CREEK ENDOSCOPY	5/2/2016	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	365 LENNON LANE	STE 100	WALNUT CREEK	CA	94598	5911	07	06013	37.92784983	-122.0301444	Contra Costa County
155396	Fee-for-Service	1740445279	1740445279	1	1	WONG, PATRICK DO MD	4/12/2018	207RP1001X	NA	Pulmonology	026	PHYSICIANS	15637	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
155418	Fee-for-Service	1407831639	1407831639	1	1	WHITTEN, LISA A	6/15/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
155437	Fee-for-Service	1649354630	1649354630	1	1	WEINSTEIN, ELYSE F MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	61699	36	Psychiatry	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
155445	Fee-for-Service	1992736367	1992736367	1	1	WILSON, BYRON E MD	10/31/1992	207RX0202X	NA	Oncology	026	PHYSICIANS	72444	41	Internal Medicine	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
155452	Fee-for-Service	1407082878	1407082878	1	1	WESTPHALN, KRISTI NP	7/14/2023	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
155466	Fee-for-Service	1134329022	1134329022	1	1	WOO, SANG H MD	8/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92419	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
155488	Fee-for-Service	1487648804	1487648804	1	1	WHITE PINE COUNTY HOSPITAL	7/3/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DISTRICT	1500 AVENUE H	None	ELY	NV	89301	2615	00	None	39.25616671	-114.8597172	White Pine County
155508	Fee-for-Service	1699779637	1699779637	1	1	WASLEY, JESSE MD	9/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	42184	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	17822 BEACH BLVD	STE 243	HUNTINGTON BEACH	CA	92647	7516	30	06059	33.70331388	-117.9890471	Orange County
155513	Fee-for-Service	1760914170	1760914170	1	1	WANG, CAROLINE MD	5/14/2020	390200000X	NA	Other	026	PHYSICIANS	157222	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
155515	Fee-for-Service	1104850932	1104850932	1	1	WAINBERG, ZEV MD	4/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82044	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	STE 120	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
155527	Fee-for-Service	1437350436	1437350436	1	1	WANG, YAN MD	2/11/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	97608	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
155529	Fee-for-Service	1689837742	1689837742	1	1	WONG, JENNY MD	6/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	96793	01	General Practice	0	In state provider	None	230 PROSPECT PLACE	SUITE 340-B	CORONADO	CA	92118	2309	37	06073	32.69468235	-117.1677128	San Diego County
155568	Fee-for-Service	1841217171	1841217171	1	1	WAL-MART STORES, INC	4/28/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102110	14501 LAKEWOOD BLVD	None	PARAMOUNT	CA	90723	3601	19	06037	33.902109	-118.145304	Los Angeles County
155588	Fee-for-Service	1750463014	1750463014	1	1	WHITTIER PEDIATRIC GROUP	4/4/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	8522 PAINTER AVE	None	WHITTIER	CA	90602	3335	19	06037	33.96065571	-118.0353275	Los Angeles County
155594	Fee-for-Service	1538924030	1538924030	1	1	WARGO, EMILEE PT	2/28/2024	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12411 POWAY RD	STE 202B	POWAY	CA	92064	4302	37	06073	32.95170468	-117.0621893	San Diego County
155595	Fee-for-Service	1558106328	1558106328	1	1	WATTS, CHASLYNN BIRTH DOULA	8/27/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	29	06057	0	0	None
155631	Fee-for-Service	1235172446	1235172446	1	1	WONG, GORDON W MD	9/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102501	30	Radiology	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
155634	Fee-for-Service	1134132129	1134132129	1	1	WALSH, CHRISTOPHER LMFT	12/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4909 MURPHY CANYON RD	300	SAN DIEGO	CA	92123	4349	37	06073	32.8287682	-117.1197549	San Diego County
155683	Fee-for-Service	1740445279	1740445279	1	1	WONG, PATRICK DO MD	4/12/2018	207RP1001X	NA	Pulmonology	026	PHYSICIANS	15637	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
155706	Fee-for-Service	1780751529	1780751529	1	1	WEN, KAREN C	5/5/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	9353 IMPERIAL HIGHWAY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
155718	Fee-for-Service	1801807417	1801807417	1	2	WILLIAM H CHERRY MD INC	12/1/2022	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	949 CALHOUN PL	SUITE G	HEMET	CA	92543	4403	33	06065	33.7502744	-116.9618423	Riverside County
155722	Fee-for-Service	1780727750	1780727750	1	1	WOODSON, JOHNNIE M MD	3/30/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	51198	None	None	0	In state provider	None	297 W. ARTESIA STREET	A	POMONA	CA	91768	1808	19	06037	34.07803547	-117.7555491	Los Angeles County
155730	Fee-for-Service	1811015639	1811015639	1	2	WILLIAMS, MARTHA F	1/9/2012	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	81 CERNON STREET	None	VACAVILLE	CA	95688	2803	48	06095	38.36102104	-121.9906107	Solano County
155776	Fee-for-Service	1487648804	1487648804	1	1	WHITE PINE COUNTY HOSPITAL	5/1/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DISTRICT	1500 AVENUE H	None	ELY	NV	89301	2615	00	None	39.25616671	-114.8597172	White Pine County
155815	Fee-for-Service	1952484255	1952484255	1	1	WALL, WILMAR O LMFT	5/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13006 PHILADELPHIA ST	STE 513	WHITTIER	CA	90601	4210	19	06037	33.97905852	-118.0370565	Los Angeles County
155818	Fee-for-Service	1104850932	1104850932	1	1	WAINBERG, ZEV MD	4/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82044	68	Hematology	0	In state provider	None	200 MED PLAZA	STE 120	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
155828	Fee-for-Service	1366947855	1366947855	1	1	WU, STEPHANIE J MD	12/17/2021	207R00000X	NA	Other	026	PHYSICIANS	164920	None	None	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
155839	Fee-for-Service	1659057313	1659057313	1	1	WALIA, AMBER NP	8/17/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95025668	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
155857	Fee-for-Service	1861571515	1861571515	1	1	WANG, MICHELLE J DO	2/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
155863	Fee-for-Service	1437125606	1437125606	1	1	WU, DAVID S MD	5/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	73250	66	Emergency Medicine (Urgent Care)	0	In state provider	None	531 W COLLEGE ST	None	LOS ANGELES	CA	90012	2315	19	06037	34.0645892	-118.2391033	Los Angeles County
155903	Fee-for-Service	1407507015	1407507015	1	1	WHOLESOME HOME HEALTH, INC	10/11/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14531 HAMLIN ST	STE 180	VAN NUYS	CA	91411	4125	19	06037	34.18870941	-118.449902	Los Angeles County
155919	Fee-for-Service	1487857116	1487857116	1	1	WONG, ANDREW C	5/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116067	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
155935	Fee-for-Service	1497320436	1497320436	1	1	WU, JINJIN MD	9/5/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
155977	Fee-for-Service	1730157504	1730157504	1	1	WONG, PINA K MD	1/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	52126	41	Internal Medicine	0	In state provider	None	201 N CHANDLER AVE	None	MONTEREY PARK	CA	91754	1503	19	06037	34.06373737	-118.1320838	Los Angeles County
156001	Fee-for-Service	1164835476	1164835476	1	1	WONG, ANGELA J OD	11/13/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1575 B STREET	None	HAYWARD	CA	94541	3017	01	06001	37.67905755	-122.072805	Alameda County
156002	Fee-for-Service	1083695605	1083695605	1	1	WHITNEY, REBECCA K MD	7/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83245	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
156152	Fee-for-Service	1437125606	1437125606	1	1	WU, DAVID S MD	5/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	73250	05	Anesthesiology	0	In state provider	None	531 W COLLEGE ST	None	LOS ANGELES	CA	90012	2315	19	06037	34.0645892	-118.2391033	Los Angeles County
156154	Fee-for-Service	1104985704	1104985704	1	1	WEST, LAURA R MD	11/30/1994	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72552	36	Psychiatry	0	In state provider	None	5575 LAKE PARK WAY	STE 211	LA MESA	CA	91942	1684	37	06073	32.78203256	-117.0342041	San Diego County
156157	Fee-for-Service	1902123656	1902123656	1	1	WOOD, JULIE A MD	10/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143804	36	Psychiatry	0	In state provider	None	2008 MORSE AVENUE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
156164	Fee-for-Service	1790768869	1790768869	1	1	WARD, LISA A MD	10/8/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80946	08	Family Practice	0	In state provider	None	751 LOMBARDI CT	STE B	SANTA ROSA	CA	95407	6793	49	06097	38.427804	-122.7493035	Sonoma County
156197	Fee-for-Service	1184020851	1184020851	1	1	WAL-MART STORES, INC	7/1/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4675 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5517	34	06067	38.649942	-121.385943	Sacramento County
156212	Fee-for-Service	1326380577	1326380577	1	1	WANG, KAIDI MD	6/19/2017	207W00000X	NA	Ophthalmology	026	PHYSICIANS	131447	18	Ophthalmology	0	In state provider	None	1001 POTRERO AVE	RM 4M31	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
156214	Fee-for-Service	1922021468	1922021468	1	1	WALKER, LOLA G PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5777 W CENTURY BLVD	STE 1645E	LOS ANGELES	CA	90045	5678	19	06037	33.94561146	-118.382661	Los Angeles County
156246	Fee-for-Service	1376693903	1376693903	1	1	WARNER, JEFFREY S	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
156265	Fee-for-Service	1730157504	1730157504	1	1	WONG, PINA K MD	1/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	52126	77	Infectious Disease	0	In state provider	None	201 N CHANDLER AVE	None	MONTEREY PARK	CA	91754	1503	19	06037	34.06373737	-118.1320838	Los Angeles County
156328	Fee-for-Service	1831519834	1831519834	1	1	WU, HENRY MD	6/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129669	40	Pediatrics	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
156340	Fee-for-Service	1205295243	1205295243	1	1	WATERS, JAMES A MD	12/5/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	138367	None	None	0	In state provider	None	4323 W RIVERSIDE DRIVE	None	BURBANK	CA	91505	4044	19	06037	34.15223748	-118.347426	Los Angeles County
156397	Fee-for-Service	1306164462	1306164462	1	1	WARIKOO, NISHA MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123598	36	Psychiatry	0	In state provider	None	101 THE CITY DRIVE SOUTH	BLDG 3	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
156430	Fee-for-Service	1831260686	1831260686	1	1	WILLERT, JENNIFER R MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	55446	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
156520	Fee-for-Service	1811356272	1811356272	1	1	WILLIAMS, JULIET J CRNA	9/5/2017	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
156556	Fee-for-Service	1588863260	1588863260	1	1	WOO, DENISE K MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112308	07	Dermatology	0	In state provider	None	910 MAPLE ST	None	REDWOOD CITY	CA	94063	2034	41	06081	37.48867968	-122.2222351	San Mateo County
156588	Fee-for-Service	1801811955	1801811955	1	1	WONG, JAMES W MD INC	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	22857	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	500 N GARFIELD AVE	STE 209	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
156589	Fee-for-Service	1780021378	1780021378	1	1	WANG, ZHIPENG	8/26/2016	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	2000 HARBOR BLVD	STE A110	COSTA MESA	CA	92627	2601	30	06059	33.647283	-117.919003	Orange County
156618	Fee-for-Service	1134289598	1134289598	1	1	WEST COAST NURSING VENTURA	11/19/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	2955 E HILLCREST DR	STE 121	THOUSAND OAKS	CA	91362	3177	56	06111	34.17313733	-118.8347453	Ventura County
156626	Fee-for-Service	1760960660	1760960660	1	1	WHITE, BERNARD L RCP	8/27/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
156690	Fee-for-Service	1366850331	1366850331	1	1	WANG, YE E	6/23/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	138519	None	None	0	In state provider	None	665 CAMINO DE LOS MARES	STE 102	SAN CLEMENTE	CA	92673	2840	30	06059	33.45730192	-117.6483252	Orange County
156702	Fee-for-Service	1407953102	1407953102	1	1	WU, JASHIN J MD	9/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86962	07	Dermatology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
156791	Fee-for-Service	1144292186	1144292186	1	1	WELLBOUND OF MENLO PARK	10/29/2003	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	39510 PASEO PADRE PARKWY	STE 100	FREMONT	CA	94538	4707	01	06001	37.55006025	-121.9740719	Alameda County
156792	Fee-for-Service	1134426208	1134426208	1	1	WARREN, HEATHER F MD	6/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113292	None	None	0	In state provider	None	2656 EDITH AVE	STE B	REDDING	CA	96001	3030	45	06089	40.57073094	-122.3974088	Shasta County
156837	Fee-for-Service	1639875990	1639875990	1	1	WINSTON, FAITH T CNM	11/6/2023	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
156845	Fee-for-Service	1063579613	1063579613	1	2	WYNN, VERONICA M LMFT	9/26/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES	383 CONNORS COURT	SUITE G	CHICO	CA	95926	1178	04	06007	39.75880794	-121.8558587	Butte County
156851	Fee-for-Service	1386833135	1386833135	2	1	WADEKAMPER, MICHAEL J	1/24/2008	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	1245 32ND ST	None	SACRAMENTO	CA	95816	5210	34	06067	38.569851	-121.464099	Sacramento County
156934	Fee-for-Service	1124160080	1124160080	1	1	WESTERN PACIFIC MED-CORP	3/1/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	4838 LAUREL CANYON BLVD	None	NORTH HOLLYWOOD	CA	91607	3717	19	06037	34.158726	-118.3964605	Los Angeles County
156939	Fee-for-Service	1467559724	1467559724	1	1	WHITTIER ADULT DAY	5/18/1998	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER	14268 TELEGRAPH RD	None	WHITTIER	CA	90604	2901	19	06037	33.92686258	-118.0273096	Los Angeles County
156946	Fee-for-Service	1932437969	1932437969	1	1	WEST, HALYNA Y MD	9/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114276	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
156992	Fee-for-Service	1902402506	1902402506	1	1	WATERS, TONYA J NP	2/27/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	29955 TECHNOLOGY DR	SUITE 111	MURRIETA	CA	92563	2637	33	06065	33.56063993	-117.1379703	Riverside County
157027	Fee-for-Service	1326350257	1326350257	1	1	WU, EDWIN J OD	2/2/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	911 N GRAND AVE	None	COVINA	CA	91724	2046	19	06037	34.09685628	-117.8727243	Los Angeles County
157055	Fee-for-Service	1063537934	1063537934	1	1	WONG, GLENN D DO	12/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10095	68	Hematology	0	In state provider	None	2850 COMMERCIAL CROSSING	None	SANTA CRUZ	CA	95065	1816	44	06087	36.98796413	-121.9825327	Santa Cruz County
157116	Fee-for-Service	1063519023	1063519023	1	1	WE KARE MED EQUIPMENT	7/25/2000	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	3738 W CENTURY BLVD	STE 3	INGLEWOOD	CA	90303	1178	19	06037	33.94542853	-118.338795	Los Angeles County
157132	Fee-for-Service	1588648877	1588648877	1	1	WRIGHT, DEBRA D MD	9/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48889	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
157133	Fee-for-Service	1447332036	1447332036	1	8	WELLSPACE HEALTH	2/9/2018	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4150 TRUXEL ROAD	SUITE C	SACRAMENTO	CA	95834	3761	34	06067	38.645658	-121.508397	Sacramento County
157138	Fee-for-Service	1538253802	1538253802	1	1	WANG, MICHAEL D MD	10/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70345	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	0000	30	06059	33.78674051	-117.8888713	Orange County
157141	Fee-for-Service	1871568659	1871568659	1	1	WINKLER,MARK R MD	12/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	67756	41	Internal Medicine	0	In state provider	None	8833 RESEDA BLVD	STE B	NORTHRIDGE	CA	91324	5355	19	06037	34.231743	-118.5361195	Los Angeles County
157173	Fee-for-Service	1811468788	1811468788	1	1	WOOLLEY, PAULINA LMFT	2/27/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE STE 130	None	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
157179	Fee-for-Service	1679589329	1679589329	1	1	WADHWA, MANISH K MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84648	None	None	0	In state provider	None	4060 4TH AVE	STE 206	SAN DIEGO	CA	92103	2120	37	06073	32.75053673	-117.1616539	San Diego County
157198	Fee-for-Service	1538764105	1538764105	1	1	WAGNER, NATALIA M NP	9/13/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
157220	Fee-for-Service	1124160080	1124160080	1	1	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4838 LAUREL CANYON BLVD	None	NORTH HOLLYWOOD	CA	91607	3717	19	06037	34.158726	-118.3964605	Los Angeles County
157227	Fee-for-Service	1326280389	1326280389	1	1	WEBB, NICOLE E MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115834	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
157334	Fee-for-Service	1366411639	1366411639	1	1	WEST, EILEEN C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	825 NE 10TH ST	None	OKLAHOMA CITY	OK	73104	5417	00	None	35.47832172	-97.49755294	Oklahoma County
157367	Fee-for-Service	1346203817	1346203817	1	1	WINANS, BRADFORD A MD	2/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	83073	30	Radiology	0	In state provider	None	372 WEST CYPRESS AVENUE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
157404	Fee-for-Service	1770865016	1770865016	1	1	WATKINS, AUBREE J NP	1/23/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
157415	Fee-for-Service	1790852515	1790852515	1	1	WULUR, ARLAINE H MD	9/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86879	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
157421	Fee-for-Service	1447332036	1447332036	1	8	WELLSPACE HEALTH	2/9/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4150 TRUXEL ROAD	SUITE C	SACRAMENTO	CA	95834	3761	34	06067	38.645658	-121.508397	Sacramento County
157433	Fee-for-Service	1437404266	1437404266	1	1	WALGREEN CO	11/14/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	22456 BARTON RD	None	GRAND TERRACE	CA	92313	5009	36	06071	34.0339605	-117.3146175	San Bernardino County
157482	Fee-for-Service	1801863535	1801863535	1	1	W. LAWRENCE GREIF, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8401 DATAPOINT DR	STE 600	SAN ANTONIO	TX	78229	5907	00	None	29.51741764	-98.56930692	Bexar County
157494	Fee-for-Service	1992012736	1992012736	1	1	WALDRON, CHRISTINE M LMFT	1/16/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	22777 LYONS AVE,	#213D	NEWHALL	CA	91321	5777	19	06037	34.38063512	-118.5316765	Los Angeles County
157504	Fee-for-Service	1982838579	1982838579	1	1	WOO, BRIAN M MD INC	1/14/2010	204E00000X	NA	Dental Provider	026	PHYSICIANS	107428	02	General Surgery	0	In state provider	None	290 N WAYTE LANE	None	FRESNO	CA	93701	1324	10	06019	36.74643429	-119.7837416	Fresno County
157551	Fee-for-Service	1528066164	1528066164	1	1	WONG, JULIE MD	4/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71422	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
157651	Fee-for-Service	1619185535	1619185535	1	1	WAL-MART STORE, INC	10/23/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-4238	2761 JENSON AVE	None	SANGER	CA	93657	9797	10	06019	36.70667969	-119.5768746	Fresno County
157676	Fee-for-Service	1568406130	1568406130	1	1	WALTZ, JOHN S. MD	5/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 S EAGLE RD	None	MERIDIAN	ID	83642	6351	00	None	43.600527	-116.3518425	Ada County
157683	Fee-for-Service	1972173128	1972173128	1	1	WESTMED HOME HEALTH INC	8/11/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5924 E LOS ANGELES AVE	STE P	SIMI VALLEY	CA	93063	5526	56	06111	34.27171481	-118.6755673	Ventura County
157736	Fee-for-Service	1831455807	1831455807	1	1	WARE, KIRSTEN A MD	1/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	12296	01	General Practice	0	In state provider	None	191 S BUENA VISTA	STE 150	BURBANK	CA	91505	4522	19	06037	34.15872557	-118.3283863	Los Angeles County
157749	Fee-for-Service	1538328539	1538328539	1	1	WALLSH, IAN K	7/8/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2040 PACIFIC COAST HWY	None	LOMITA	CA	90717	2660	19	06037	33.78948351	-118.316493	Los Angeles County
157759	Fee-for-Service	1578611836	1578611836	1	1	WAYNE GULSTON	5/18/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	234 E 149TH ST	None	BRONX	NY	10451	5504	00	None	40.817538	-73.9240965	Bronx County
157768	Fee-for-Service	1720034846	1720034846	1	1	WALLS, CRAIG A MD	8/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95891	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
157782	Fee-for-Service	1740712694	1740712694	1	1	WU, HUIMIN PT	2/17/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	888 S HILL ROAD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
157820	Fee-for-Service	1447580691	1447580691	1	1	WENDT, JACQUELINE Y MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110706	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
157900	Fee-for-Service	1417962747	1417962747	1	1	WALGREEN CO	1/3/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5224 COLDWATER CANYON AV	None	VAN NUYS	CA	91401	6146	19	06037	34.165512	-118.4137725	Los Angeles County
157903	Fee-for-Service	1790790707	1790790707	1	1	WALGREEN CO	2/22/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8766 NAVAJO RD	None	SAN DIEGO	CA	92119	2722	37	06073	32.8030677	-117.0089304	San Diego County
157912	Fee-for-Service	1821123134	1821123134	1	1	WILSON, BRENDA A LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	79107	-	NOT APPLICABLE	0	In state provider	None	370 S CRENSHAW BLVD	SUITE E-100	TORRANCE	CA	90503	1727	19	06037	33.84549	-118.3287415	Los Angeles County
157915	Fee-for-Service	1629169107	1629169107	1	1	WARD, SALLY L DAVIDSON	7/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	41338	85	Surgery-Pediatric	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
157949	Fee-for-Service	1366478992	1366478992	1	1	WESTLAKE MEDICAL MANAGEMENT	8/13/1997	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	529 S ALVARADO ST	None	LOS ANGELES	CA	90057	2903	19	06037	34.06009726	-118.2745484	Los Angeles County
157953	Fee-for-Service	1861526808	1861526808	1	1	WALTER, ROBIN L LCSW	12/3/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	16766	-	NOT APPLICABLE	0	In state provider	None	3150 LOS ANGELES AVENUE	None	SIMI VALLEY	CA	93065	3940	56	06111	34.2716367	-118.7360247	Ventura County
157958	Fee-for-Service	1033642871	1033642871	1	1	WANG, EILEEN MD	2/24/2023	207L00000X	NA	Other	026	PHYSICIANS	172748	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
158006	Fee-for-Service	1548660350	1548660350	1	1	WEST HOLLYWOOD HEALTHCARE &	10/11/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTRE, LP	855 N FAIRFAX AVE	None	LOS ANGELES	CA	90046	7207	19	06037	34.08672117	-118.3616072	Los Angeles County
158048	Fee-for-Service	1548931413	1548931413	1	1	WALSH, AMANDA J OD	10/11/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	36330 HIDDEN SPRINGS RD.	SUITE A	WILDOMAR	CA	92595	5804	33	06065	33.59339735	-117.2454691	Riverside County
158102	Fee-for-Service	1346333010	1346333010	1	1	WARD, ANDRETTE T MD	1/17/1996	2080P0205X	NA	Endocrinology	026	PHYSICIANS	55556	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
158207	Fee-for-Service	1629169107	1629169107	1	1	WARD, SALLY L DAVIDSON	7/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	41338	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
158228	Fee-for-Service	1508156407	1508156407	1	1	WERTH, HEATHER J DO	7/23/2019	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
158260	Fee-for-Service	1578673901	1578673901	1	1	WINEY, TANYA SUE MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70651	01	General Practice	0	In state provider	None	15025 INNOVATION DR	None	SAN DIEGO	CA	92128	3409	37	06073	32.98956795	-117.0767228	San Diego County
158305	Fee-for-Service	1679721609	1679721609	1	1	WIGGINS, KENDRA L MD	4/2/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	126601	08	Family Practice	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
158322	Fee-for-Service	1114944469	1114944469	1	1	WAL-MART PHARM #10-1760	3/15/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1018 RILEY ST	None	FOLSOM	CA	95630	3268	34	06067	38.66841	-121.16754	Sacramento County
158329	Fee-for-Service	1518395771	1518395771	1	1	WOLF, STEFANIE	9/11/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	555 SOQUEL AVE	STE 260	SANTA CRUZ	CA	95062	2340	44	06087	36.97623386	-122.0170137	Santa Cruz County
158358	Fee-for-Service	1750471520	1750471520	1	1	WU, YIPING MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	62128	05	Anesthesiology	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
158362	Fee-for-Service	1003436064	1003436064	1	37	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	454 ORANGE STREET	4H	REDLANDS	CA	92374	0000	36	06071	34.059429	-117.1825505	San Bernardino County
158419	Fee-for-Service	1225343130	1225343130	1	1	WU, GLORIA MD A PROFESSIONAL	5/19/2014	207W00000X	NA	Ophthalmology	026	PHYSICIANS	59994	18	Ophthalmology	0	In state provider	None	2550 SAMARITAN DRIVE	STE C	SAN JOSE	CA	95124	4104	43	06085	37.25247449	-121.9502479	Santa Clara County
158433	Fee-for-Service	1780835611	1780835611	1	1	WINDSOR TERRACE HEALTHCARE	9/1/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	7447 SEPULVEDA BLVD	None	VAN NUYS	CA	91405	1631	19	06037	34.206246	-118.466238	Los Angeles County
158455	Fee-for-Service	1205855053	1205855053	1	1	WALTERS, ELIZABETH L MD	12/31/1995	207P00000X	NA	Other	026	PHYSICIANS	55399	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	STE A108	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
158481	Fee-for-Service	1174509723	1174509723	1	1	WONG, ELLEN Y MD	10/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	37201	41	Internal Medicine	0	In state provider	None	2950 SYCAMORE DR	STE 300	SIMI VALLEY	CA	93065	1210	56	06111	34.28932056	-118.7438673	Ventura County
158485	Fee-for-Service	1083032023	1083032023	1	1	WU, SHENGYANG MD	5/12/2023	2085R0001X	NA	Other	026	PHYSICIANS	186136	None	None	0	In state provider	None	301 W HUNTINGTON DR	STE 419	ARCADIA	CA	91007	1507	19	06037	34.13481053	-118.0425638	Los Angeles County
158517	Fee-for-Service	1205464872	1205464872	1	1	WORTHINGTON, EMMA K MD	10/23/2023	208600000X	NA	General Surgery	026	PHYSICIANS	186477	None	None	0	In state provider	None	20790 MADRONA AVE	None	TORRANCE	CA	90503	3777	19	06037	33.84145481	-118.344603	Los Angeles County
158533	Fee-for-Service	1295723294	1295723294	1	1	WEIDHAAS, JOANNE B MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138412	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 MEDICAL PLAZA	STE B365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
158643	Fee-for-Service	1659389419	1659389419	1	1	WEI-SHATZEL, JULIE R DO	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	7681	08	Family Practice	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
158650	Fee-for-Service	1003436064	1003436064	1	37	WS AUDIOLOGY (CALIFORNIA), P	4/16/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	454 ORANGE STREET	4H	REDLANDS	CA	92374	0000	36	06071	34.059429	-117.1825505	San Bernardino County
158690	Fee-for-Service	1871722611	1871722611	1	1	WU, YICHEN E MD	8/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121923	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
158713	Fee-for-Service	1639165483	1639165483	1	1	WEBER, PETER B MD	3/17/2010	207T00000X	NA	General Surgery	026	PHYSICIANS	53445	14	Neurological Surgery	0	In state provider	None	2100 WEBSTER ST	STE 521	SAN FRANCISCO	CA	94115	2382	38	06075	37.7904826	-122.4324477	San Francisco County
158747	Fee-for-Service	1750693891	1750693891	1	1	WAGNER, ALEXEI MD	8/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125137	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
158759	Fee-for-Service	1801068747	1801068747	1	1	WOZNIAK, LAURA J MD	4/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99297	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
158813	Fee-for-Service	1407863459	1407863459	1	1	WELLS, STANLEY D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS NE	None	ALBUQUERQUE	NM	87131	0001	00	None	35.08771808	-106.6192188	Bernalillo County
158815	Fee-for-Service	1295723294	1295723294	1	1	WEIDHAAS, JOANNE B MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138412	30	Radiology	0	In state provider	None	200 MEDICAL PLAZA	STE B365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
158818	Fee-for-Service	1508945254	1508945254	1	1	WONG, MITCHELL J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	48673	83	Rheumatology	0	In state provider	None	1500 SOUTHGATE AVE	None	DALY CITY	CA	94015	2259	41	06081	37.67558248	-122.4750825	San Mateo County
158879	Fee-for-Service	1104141217	1104141217	1	1	WOO, IRENE MD	4/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130687	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
158883	Fee-for-Service	1285662825	1285662825	1	1	WOODMAN, STEPHAN K. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
158915	Fee-for-Service	1548448053	1548448053	1	1	WAREHAM, RACHELLE E MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	94413	40	Pediatrics	0	In state provider	None	11370 ANDERSON STREET	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
158918	Fee-for-Service	1003436064	1003436064	1	11	WS AUDIOLOGY (CALIFORNIA), P	3/24/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	7602 E CHAPMAN AVE	None	ORANGE	CA	92869	4505	30	06059	33.79541811	-117.7723847	Orange County
158921	Fee-for-Service	1376743955	1376743955	1	1	WEI, JAMES C MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64653	13	Neurology (M.D. only)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
158961	Fee-for-Service	1609028042	1609028042	1	1	WALSH, STEVEN D MD	2/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	54622	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
159004	Fee-for-Service	1306972930	1306972930	1	1	WILLIAMSON, CHRISTINE L LMFT	9/9/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39159 PASEO PADRE PKWY	STE 121	FREMONT	CA	94538	1600	01	06001	37.5531875	-121.9805141	Alameda County
159023	Fee-for-Service	1669487948	1669487948	1	1	WALGREEN CO	7/1/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #5501	3999 FOOTHILLS BLVD	None	ROSEVILLE	CA	95747	7256	31	06061	38.75127171	-121.3093622	Placer County
159039	Fee-for-Service	1306409974	1306409974	1	1	WONG, MICHAEL MD	8/28/2023	207L00000X	NA	Other	026	PHYSICIANS	187772	None	None	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
159055	Fee-for-Service	1538574108	1538574108	1	1	WOLFE, YANIKA MD	6/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154271	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
159071	Fee-for-Service	1386253821	1386253821	1	1	WOO, DARLENE LMFT	2/16/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10113 ALTA SIERRA DR	SUITE 101	GRASS VALLEY	CA	95949	6896	29	06057	39.14030863	-121.0695823	Nevada County
159091	Fee-for-Service	1144256009	1144256009	1	1	WU, AGNES Y MD	11/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50093	22	Pathology (M.D. only)	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
159100	Fee-for-Service	1992248918	1992248918	1	1	WEST COAST SURGERY INC	8/26/2020	207X00000X	NA	Orthopedic Surgery	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	36915 COOK STREET	SUITE 103 B	PALM DESERT	CA	92211	6067	33	06065	33.77987071	-116.3558569	Riverside County
159101	Fee-for-Service	1790933067	1790933067	1	1	WEISCOVITZ, GENEVIEVE A PHD	3/5/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
159103	Fee-for-Service	1295051779	1295051779	1	1	WESTERN UNIVERSITY OF HEALTH	12/5/2018	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	SCIENCES	795 EAST SECOND	SUITE 1	POMONA	CA	91766	2007	19	06037	34.05845654	-117.7423951	Los Angeles County
159150	Fee-for-Service	1285866061	1285866061	1	1	WALGREEN CO	10/28/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1186 CALIMESA BLVD	None	CALIMESA	CA	92320	1509	33	06065	33.99496056	-117.0579751	Riverside County
159171	Fee-for-Service	1609095322	1609095322	1	1	WOODLAND HEARING AID	1/14/2003	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1837 E GIBSON RD	SUITE K	WOODLAND	CA	95776	5182	57	06113	38.6628248	-121.7417034	Yolo County
159202	Fee-for-Service	1548448053	1548448053	1	1	WAREHAM, RACHELLE E MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	94413	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	11370 ANDERSON STREET	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
159205	Fee-for-Service	1003436064	1003436064	1	11	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7602 E CHAPMAN AVE	None	ORANGE	CA	92869	4505	30	06059	33.79541811	-117.7723847	Orange County
159217	Fee-for-Service	1194773549	1194773549	1	1	WILLIAMS, LANCE MD	7/20/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	179148	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
159230	Fee-for-Service	1770619983	1770619983	1	1	WHEELER, MORIYA R LMFT	5/16/2020	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1789 W YOSEMITE AVE	None	MANTECA	CA	95337	5160	39	06077	37.79964	-121.246425	San Joaquin County
159275	Fee-for-Service	1629264098	1629264098	1	1	WANG, VICTORIA E MD	12/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116118	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
159277	Fee-for-Service	1881609162	1881609162	1	1	WALGREEN CO	8/4/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	75 N HAM LN	None	LODI	CA	95242	2700	39	06077	38.1357851	-121.2884423	San Joaquin County
159389	Fee-for-Service	1427634393	1427634393	1	1	WANG, CHRISTINA K MD	8/2/2024	207R00000X	NA	Other	026	PHYSICIANS	189491	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
159457	Fee-for-Service	1972560688	1972560688	3	1	WALGREENS SPECIALTY PHARMACY	4/1/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	130 ENTERPRISE DR	None	PITTSBURGH	PA	15275	1213	00	None	40.46263888	-80.19914499	Allegheny County
159470	Fee-for-Service	1346679362	1346679362	1	1	WILLIAMSON, CONRAD S MD	11/17/2019	207P00000X	NA	Other	026	PHYSICIANS	160991	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
159472	Fee-for-Service	1013236439	1013236439	1	1	WOODALL, ALLISON M MD	10/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136747	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
159475	Fee-for-Service	1760730758	1760730758	1	1	WESTERMANN, MELISSA L MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130149	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
159477	Fee-for-Service	1639150139	1639150139	1	1	WALTON, ANITA A MD	9/22/1994	207R00000X	NA	Other	026	PHYSICIANS	57217	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
159564	Fee-for-Service	1447339197	1447339197	1	1	WONG, WILLIAM T MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	77529	36	Psychiatry	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
159573	Fee-for-Service	1205853629	1205853629	1	1	WAL-MART STORES, INC	5/7/1996	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102253	13487 CAMINO CANADA	None	EL CAJON	CA	92021	8811	37	06073	32.82264	-116.90181	San Diego County
159592	Fee-for-Service	1902893969	1902893969	1	1	WITHERS, JOHN MD	5/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3200 PROVIDENCE DR	None	ANCHORAGE	AK	99508	4615	00	None	61.188354	-149.8187475	Municipality of Anchorage
159609	Fee-for-Service	1902833320	1902833320	1	1	WANG, MELINDA MD	9/2/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180860	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
159611	Fee-for-Service	1326583279	1326583279	1	2	WAVES OF PEACE, AN INDIVIDUA	9/24/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	5855 E. NAPLES PLAZA	209	LONG BEACH	CA	90803	5080	19	06037	33.75591002	-118.119711	Los Angeles County
159629	Fee-for-Service	1053322453	1053322453	1	1	WONG, ROBERTA L MD	4/2/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	71404	30	Radiology	0	In state provider	None	1101 LAS TABLAS RD	STE L	TEMPLETON	CA	93465	9733	40	06079	35.55437551	-120.718593	San Luis Obispo County
159721	Fee-for-Service	1306287172	1306287172	1	1	WU, NATALIE L MD	1/7/2022	2080P0207X	NA	Hematology	026	PHYSICIANS	174618	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
159750	Fee-for-Service	1902219801	1902219801	1	1	WEINTRAUB, MICHAEL D MD	6/22/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172832	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
159799	Fee-for-Service	1407914088	1407914088	1	1	WILBUR, ERIKA PT	5/12/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1044 MANGROVE AVE	None	CHICO	CA	95926	3509	04	06007	39.74053676	-121.8373879	Butte County
159847	Fee-for-Service	1386306611	1386306611	1	1	WOUND AND BURN CENTERS OF AM	1/22/2023	261Q00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	ERICA, P.C.	8631 W 3RD ST	STE 1110E	LOS ANGELES	CA	90048	5914	19	06037	34.07361928	-118.3803143	Los Angeles County
159855	Fee-for-Service	1437334232	1437334232	1	1	WONG, MICHELINE J MD	9/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	89341	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
159866	Fee-for-Service	1770547465	1770547465	1	1	WALOFF, RONALD I MD	8/14/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	87858	None	None	0	In state provider	None	1083 LOS PALOS DR	None	SALINAS	CA	93901	3916	27	06053	36.65821658	-121.6450795	Monterey County
159873	Fee-for-Service	1033240791	1033240791	1	1	WINDELL, VERNON W LMFT	1/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28494 WESTINGHOUSE PL	SUITE 213	VALENCIA	CA	91355	0930	19	06037	34.44221561	-118.5989564	Los Angeles County
159876	Fee-for-Service	1275678591	1275678591	1	1	WEERASINGHE, SUNJEEVE P NP	5/2/2022	363LN0005X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
159929	Fee-for-Service	1760417323	1760417323	1	1	WESCO MEDICAL SUPPLY	5/30/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	& EQUIPMENT CO	1359 MT VERNON AVENUE	None	COLTON	CA	92324	2561	36	06071	34.082406	-117.313876	San Bernardino County
159961	Fee-for-Service	1881872034	1881872034	1	1	WALLIN, THOMAS R MD	4/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94866	66	Emergency Medicine (Urgent Care)	0	In state provider	None	301 EAST 13TH STREET	None	MERCED	CA	95340	6211	24	06047	37.29248035	-120.4730619	Merced County
159965	Fee-for-Service	1548013097	1548013097	1	1	WHOLLY WOMB LLC	5/16/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	40	06079	0	0	None
159985	Fee-for-Service	1013113737	1013113737	1	1	WARDWELL. BRIAN N MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104983	36	Psychiatry	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
159997	Fee-for-Service	1417980723	1417980723	1	1	WACHS, DEBORAH S MD	9/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77813	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
160004	Fee-for-Service	1518205012	1518205012	1	1	WEINGARTEN, NAFTOLI H DPM	7/31/2019	213ES0103X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	901 E SAN ANTONIO DR	None	LONG BEACH	CA	90807	2211	19	06037	33.83829601	-118.1824972	Los Angeles County
160055	Fee-for-Service	1356381990	1356381990	1	1	WEN, STEPHEN Y MD	5/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	70996	05	Anesthesiology	0	In state provider	None	CLAY AND BUCHANNAN ST	None	SAN FRANCISCO	CA	94115	0000	38	06075	37.791126	-122.4309105	San Francisco County
160057	Fee-for-Service	1073162541	1073162541	1	1	WARD, LUISA R LCSW	7/19/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
160117	Fee-for-Service	1659565398	1659565398	1	3	WALIA, MANJIT PSYD	6/16/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	25050 AVENUE KEARNY	114	VALENCIA	CA	91355	1255	19	06037	34.43517857	-118.5722781	Los Angeles County
160128	Fee-for-Service	1215004155	1215004155	1	1	WIRIOSUPARTO, SONY S MD	3/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76071	22	Pathology (M.D. only)	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
160176	Fee-for-Service	1427306489	1427306489	1	1	WAL-MART STORES, INC	12/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8810 GROSSMONT BLVD	None	LA MESA	CA	91942	9027	37	06073	32.77392338	-117.0076062	San Diego County
160185	Fee-for-Service	1356952881	1356952881	1	1	WAKELING, EMILY LMFT	12/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6904 VILLAGE PARKWAY	None	DUBLIN	CA	94568	2406	01	06001	37.70726135	-121.9248393	Alameda County
160200	Fee-for-Service	1609909191	1609909191	1	1	WROBEL, MICHAEL D	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8950 VILLA LA JOLLA DR	STE 1241	LA JOLLA	CA	92037	1708	37	06073	32.870934	-117.2338765	San Diego County
160216	Fee-for-Service	1730788423	1730788423	1	1	WANYOIKE, ESTHER W	3/16/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2078 S MOUNTAIN AVE	None	ONTARIO	CA	91762	6120	36	06071	34.03566	-117.6706485	San Bernardino County
160251	Fee-for-Service	1336269687	1336269687	1	1	WILLIS, JENNIFER M LMFT	5/25/2020	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
160278	Fee-for-Service	1194255091	1194255091	1	1	WANG, DAVID LAC	10/30/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	4125 BLACKFORD AVE	215	SAN JOSE	CA	95117	1701	43	06085	37.31436259	-121.9754443	Santa Clara County
160289	Fee-for-Service	1518360601	1518360601	1	1	WILLIAMS, HANNAH LCSW	2/11/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 N PALM CANYON DR	215	PALM SPRINGS	CA	92262	5658	33	06065	33.827652	-116.5468485	Riverside County
160324	Fee-for-Service	1346256567	1346256567	1	1	WILLIAMS, HOLLY L MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80966	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90074	0001	19	06037	34.06373445	-118.443537	Los Angeles County
160331	Fee-for-Service	1063400604	1063400604	1	1	WU, ROGER LI-CHUNG OD	4/19/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	18575 GALE AVE	STE 168	CITY OF INDUSTRY	CA	91748	1384	19	06037	33.99497471	-117.8986874	Los Angeles County
160351	Fee-for-Service	1396311338	1396311338	1	1	WIAFE, ADWOA O MD	1/13/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	44	Public Health	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
160369	Fee-for-Service	1194037754	1194037754	1	1	WAITE, KENNETH B DO	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 SOUTH AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
160398	Fee-for-Service	1013924612	1013924612	1	1	WOOD, HARRISON W JR MD	7/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134878	41	Internal Medicine	0	In state provider	None	2710 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78449066	-124.1414748	Humboldt County
160422	Fee-for-Service	1467727479	1467727479	1	1	WAL-MART STORES INC	2/22/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3750 S MOONEY BLVD	None	VISALIA	CA	93277	8021	54	06107	36.296658	-119.310633	Tulare County
160449	Fee-for-Service	1396984118	1396984118	1	1	WONG, JORDAN J PA	12/5/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	20219	-	NOT APPLICABLE	0	In state provider	None	1155 THIRD AVE	None	CHULA VISTA	CA	91911	3136	37	06073	32.61178172	-117.068313	San Diego County
160463	Fee-for-Service	1760981732	1760981732	1	1	WAKIM, GRACE A PSYD	3/8/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
160479	Fee-for-Service	1033447339	1033447339	1	1	WHITMORE, ALINA C PSYD	10/30/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
160491	Fee-for-Service	1033640800	1033640800	1	1	WANG, YANJUN MD	9/24/2020	207R00000X	NA	Other	026	PHYSICIANS	169496	41	Internal Medicine	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
160501	Fee-for-Service	1417367467	1417367467	1	1	WONG, KATHERINE MD	8/17/2023	163WG0100X	NA	Other	026	PHYSICIANS	148786	None	None	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
160504	Fee-for-Service	1730788423	1730788423	1	1	WANYOIKE, ESTHER W	3/16/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2078 S MOUNTAIN AVE	None	ONTARIO	CA	91762	6120	36	06071	34.03566	-117.6706485	San Bernardino County
160564	Fee-for-Service	1134150758	1134150758	1	1	WILLIAM WHEELER	1/9/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 N 3RD AVE	None	SANDPOINT	ID	83864	1507	00	None	48.27786153	-116.5503511	Bonner County
160595	Fee-for-Service	1083848428	1083848428	1	1	WINTRODE, LINDA ANN RN	3/22/2006	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	382 WEST DR	None	FELTON	CA	95018	8925	44	06087	37.10506694	-122.0543225	Santa Cruz County
160640	Fee-for-Service	1396311338	1396311338	1	1	WIAFE, ADWOA O MD	1/13/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
160662	Fee-for-Service	1770859571	1770859571	1	1	WALLS, ANTHONY S MD	2/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129564	01	General Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
160668	Fee-for-Service	1609881994	1609881994	1	1	WALGREEN CO.	2/19/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	707 N BROADWAY	None	SANTA MARIA	CA	93454	3753	42	06083	34.95981863	-120.4357596	Santa Barbara County
160696	Fee-for-Service	1760432751	1760432751	1	1	WESTCOTT,KELLI MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10123 SE MARKET STREET	None	PORTLAND	OR	97216	2599	00	None	45.51158947	-122.5586205	Multnomah County
160710	Fee-for-Service	1770165573	1770165573	1	1	WONG, LELAND H DO	9/17/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21038	08	Family Practice	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
160711	Fee-for-Service	1619152147	1619152147	1	1	WEST COAST DIALYSIS CTR, LLC	12/17/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3780 KILROY AIRPORT WAY	STE 110	LONG BEACH	CA	90806	2458	19	06037	33.80733529	-118.1450095	Los Angeles County
160752	Fee-for-Service	1366848301	1366848301	1	1	WONG, SPENCER B MD	4/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144035	01	General Practice	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
160775	Fee-for-Service	1427466473	1427466473	1	1	WYRICK, CYNTHIA	7/15/2016	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1806 HUMMINGBIRD DR	None	COSTA MESA	CA	92626	4836	30	06059	33.67165651	-117.931977	Orange County
160778	Fee-for-Service	1952489031	1952489031	1	1	WEINGARTEN, ROBERT J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40635	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
160823	Fee-for-Service	1093703530	1093703530	1	1	WOODMANSEE,JAMES A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2230 N UNIVERSITY	PARKWAY 1-A	PROVO	UT	84604	0000	00	None	40.26176913	-111.6656173	Utah County
160860	Fee-for-Service	1467758714	1467758714	1	1	WHITE, DANA K LMFT	6/13/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15082 ROSECRANS AVE	None	LA MIRADA	CA	90638	4741	19	06037	33.89843387	-118.009518	Los Angeles County
160882	Fee-for-Service	1083848428	1083848428	1	1	WINTRODE, LINDA ANN RN	3/22/2006	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	382 WEST DR	None	FELTON	CA	95018	8925	44	06087	37.10506694	-122.0543225	Santa Cruz County
160907	Fee-for-Service	1447425913	1447425913	1	2	WATERHOUSE, GARET LCSW	5/29/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3438 MENDOCINO AVE	STE B	SANTA ROSA	CA	95403	2275	49	06097	38.472282	-122.723991	Sonoma County
160909	Fee-for-Service	1114984168	1114984168	1	1	WEITZ, MICHAEL MD	12/16/1988	193400000X	NA	Other	026	PHYSICIANS	57330	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1217 N LA BREA AVE	None	LOS ANGELES	CA	90038	1023	19	06037	34.0931283	-118.3441607	Los Angeles County
160911	Fee-for-Service	1841222536	1841222536	1	1	WOO, BONNIE BT MD	3/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110075	18	Ophthalmology	0	In state provider	None	18575 GALE AVE	SUITE 168	CITY OF INDUSTRY	CA	91748	1384	19	06037	33.99497471	-117.8986874	Los Angeles County
160927	Fee-for-Service	1396311338	1396311338	1	1	WIAFE, ADWOA O MD	1/13/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	39	Preventive (M.D. only)	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
160947	Fee-for-Service	1770859571	1770859571	1	1	WALLS, ANTHONY S MD	2/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129564	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
160954	Fee-for-Service	1205980729	1205980729	1	1	WEINSTEIN, FREDDIE S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73362	36	Psychiatry	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
160986	Fee-for-Service	1598320103	1598320103	1	1	WAIGHT, ABAGAIL R LPCC	10/2/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
160989	Fee-for-Service	1508291402	1508291402	1	1	WARD, DAWN C MD	1/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111774	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	RM B186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
161007	Fee-for-Service	1780638650	1780638650	1	1	WONG, JAMES G MD	10/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81827	None	None	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
161008	Fee-for-Service	1447332036	1447332036	1	10	WELLSPACE HEALTH	1/29/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	151 N SUNRISE AVE	SUITE 1309	ROSEVILLE	CA	95661	2933	31	06061	38.74746043	-121.2655348	Placer County
161026	Fee-for-Service	1861571598	1861571598	1	1	WANG, JERRY MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60840	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
161029	Fee-for-Service	1891982658	1891982658	1	1	WALGREEN CO	1/7/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4616 DE LONGPRE AVE	None	LOS ANGELES	CA	90027	6076	19	06037	34.0969945	-118.2901545	Los Angeles County
161031	Fee-for-Service	1275553679	1275553679	1	1	WILEN, LILLY L MD	6/1/1998	207R00000X	NA	Other	026	PHYSICIANS	61876	01	General Practice	0	In state provider	None	17075 DEVONSHIRE ST	STE 306	NORTHRIDGE	CA	91325	5417	19	06037	34.25755945	-118.50471	Los Angeles County
161056	Fee-for-Service	1861404782	1861404782	1	1	WELLISCH, DAVID	6/4/1998	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
161063	Fee-for-Service	1427466473	1427466473	1	1	WYRICK, CYNTHIA	7/15/2016	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1806 HUMMINGBIRD DR	None	COSTA MESA	CA	92626	4836	30	06059	33.67165651	-117.931977	Orange County
161090	Fee-for-Service	1346221819	1346221819	1	1	WASHINGTON ENTERPRISES	8/1/1999	311500000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	III LLC	2300 W WASHINGTON BLVD	None	LOS ANGELES	CA	90018	1445	19	06037	34.03989193	-118.3118359	Los Angeles County
161092	Fee-for-Service	1386148302	1386148302	1	1	WU, MENGYOU MD	9/10/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	166175	None	None	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
161114	Fee-for-Service	1801478250	1801478250	1	1	WHITELEY, ADAM MD	7/23/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2050 VIBORG RD	None	SOLVANG	CA	93463	2220	42	06083	34.60246267	-120.1261332	Santa Barbara County
161155	Fee-for-Service	1417005364	1417005364	1	1	WONG, PATTY C MD	12/6/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	88714	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
161157	Fee-for-Service	1780658070	1780658070	1	1	WOLIN, EDWARD M MD	1/25/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	30317	78	Neoplastic Diseases/Oncology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
161168	Fee-for-Service	1902964315	1902964315	1	1	WILLIAM T. HOLLANDER, M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1813 W HARVARD AVE	STE 436	ROSEBURG	OR	97471	8705	00	None	43.21375497	-123.3719215	Douglas County
161177	Fee-for-Service	1316093990	1316093990	2	1	WEITZEL, NATHAEN S MD	11/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
161216	Fee-for-Service	1093098212	1093098212	1	1	WALGREEN CO	3/13/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2321 HAWTHORNE BLVD	None	REDONDO BEACH	CA	90278	3400	19	06037	33.873318	-118.352726	Los Angeles County
161218	Fee-for-Service	1275386617	1275386617	1	1	WEBSTER, ALISON C LCSW	4/26/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
161240	Fee-for-Service	1619982907	1619982907	1	1	WALGREEN CO	1/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9550 HAGEMAN RD	None	BAKERSFIELD	CA	93312	3956	15	06029	35.39819227	-119.1084347	Kern County
161291	Fee-for-Service	1275171704	1275171704	1	1	WYLIE, LEAH PT	2/2/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
161294	Fee-for-Service	1447332036	1447332036	1	10	WELLSPACE HEALTH	1/29/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	151 N SUNRISE AVE	SUITE 1309	ROSEVILLE	CA	95661	2933	31	06061	38.74746043	-121.2655348	Placer County
161302	Fee-for-Service	1396750626	1396750626	1	1	WALGREEN CO	8/14/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10992 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3045	33	06065	33.90464034	-117.4738995	Riverside County
161329	Fee-for-Service	1366457640	1366457640	1	1	WALGREEN CO	5/11/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #05743	7560 TOPANGA CANYON BLVD	None	CANOGA PARK	CA	91303	1213	19	06037	34.207596	-118.605942	Los Angeles County
161332	Fee-for-Service	1679273551	1679273551	1	1	WILLIS, JAHMAAL NP	10/26/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18092 WIKA ROAD	SUITE 220	APPLE VALLEY	CA	92307	2132	36	06071	34.54070062	-117.2694542	San Bernardino County
161365	Fee-for-Service	1578818209	1578818209	1	1	WAL-MART STORES, INC	12/28/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13401 MAIN ST	None	HESPERIA	CA	92345	9123	36	06071	34.424199	-117.3700485	San Bernardino County
161392	Fee-for-Service	1588260319	1588260319	1	1	WALLFLOWERS BLOOM THERAPY, I	12/9/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NC.	25000 AVENUE STANFORD	STE 240	VALENCIA	CA	91355	4598	19	06037	34.43847322	-118.5729968	Los Angeles County
161412	Fee-for-Service	1508805011	1508805011	1	1	WONG, VIVIAN W Y MD	11/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	67528	40	Pediatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
161425	Fee-for-Service	1346930237	1346930237	1	1	WEEKS, CHELSEA LP	2/28/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10055 WINECREST RD	None	SAN DIEGO	CA	92127	3725	37	06073	33.00024734	-117.1167379	San Diego County
161439	Fee-for-Service	1972695112	1972695112	1	1	WOOD, MICHAEL K MD	11/24/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	43607	-	NOT APPLICABLE	0	In state provider	None	6127 FAIR OAKS BLVD	None	CARMICHAEL	CA	95608	4818	34	06067	38.61252	-121.329387	Sacramento County
161450	Fee-for-Service	1780126771	1780126771	2	1	WELLCARE HEALTHCARE PHARMACY	10/20/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9493 GARFIELD ST	None	RIVERSIDE	CA	92503	3765	33	06065	33.92369582	-117.4488769	Riverside County
161485	Fee-for-Service	1598921272	1598921272	1	1	WU, DARRELL MD	9/28/2021	208600000X	NA	General Surgery	026	PHYSICIANS	167955	None	None	0	In state provider	None	5555 GROSSMONT CENTER	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
161487	Fee-for-Service	1932159431	1932159431	1	1	WONG, LESTER K MD	4/30/1995	207ZP0102X	NA	Other	026	PHYSICIANS	45801	22	Pathology (M.D. only)	0	In state provider	None	1600 THE ESPLANADE	STE A	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
161540	Fee-for-Service	1649657768	1649657768	1	1	WONG, RAYMOND W PT	1/22/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
161546	Fee-for-Service	1912269788	1912269788	1	1	WONG, JANICE C Y MD	9/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149217	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
161554	Fee-for-Service	1730284092	1730284092	1	1	WHITNEY, JOHN MD	1/23/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	73247	40	Pediatrics	0	In state provider	A MEDICAL CORPORATION	777 KNOWLES DR	STE 3	LOS GATOS	CA	95032	1417	43	06085	37.26160688	-121.9683379	Santa Clara County
161559	Fee-for-Service	1144220369	1144220369	1	1	WILLIAMS, JOHN P DO	11/30/1992	207R00000X	NA	Other	026	PHYSICIANS	6027	41	Internal Medicine	0	In state provider	None	1772 SO MAIN ST	None	WILLITS	CA	95490	4435	23	06045	39.38887418	-123.3459815	Mendocino County
161579	Fee-for-Service	1235321969	1235321969	1	1	WOLARIDGE, KAREN N CRNA	9/1/2000	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
161582	Fee-for-Service	1073687190	1073687190	1	1	WHITE, SUNNY LAC	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	BOHWA SUNNY ACUPUNTURE	143 S BEACH BLVD	None	LA HABRA	CA	90631	6972	30	06059	33.93145497	-117.9680161	Orange County
161583	Fee-for-Service	1447332036	1447332036	1	10	WELLSPACE HEALTH	5/25/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	151 N SUNRISE AVE	SUITE 1309	ROSEVILLE	CA	95661	2933	31	06061	38.74746043	-121.2655348	Placer County
161614	Fee-for-Service	1992355655	1992355655	1	1	WEI LEON, JUAN I CRNA	12/21/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
161620	Fee-for-Service	1841359460	1841359460	1	1	WEISS, STACY A MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69965	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	655 EUCLID AVE	STE 409	NATIONAL CITY	CA	91950	2981	37	06073	32.68353398	-117.082625	San Diego County
161674	Fee-for-Service	1689680241	1689680241	1	1	WALGREEN CO.	1/7/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 STANDIFORD AVE	STE 4	MODESTO	CA	95350	6506	50	06099	37.68943266	-121.0238421	Stanislaus County
161677	Fee-for-Service	1164023867	1164023867	1	1	WATSON, SANCHEZ, & NAVARRO P	3/25/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SYCHOLOGICAL GROUP INC	270 E. 7TH STREET	SUITE 1C	UPLAND	CA	91786	6602	36	06071	34.08880656	-117.6475309	San Bernardino County
161707	Fee-for-Service	1518427756	1518427756	1	1	WANIS, MORCOS MD	4/13/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
161754	Fee-for-Service	1770756389	1770756389	1	1	WONG, JASMINE M MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109119	02	General Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
161756	Fee-for-Service	1760641310	1760641310	1	1	WEI, JANET MD	4/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	107662	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
161822	Fee-for-Service	1457471500	1457471500	1	1	WEST OAKLAND HEALTH COUNCIL	7/1/1993	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	1890 ALCATRAZ AVE	None	BERKELEY	CA	94703	2715	01	06001	37.84893892	-122.2696251	Alameda County
161847	Fee-for-Service	1700841269	1700841269	1	1	WANG, TUNG-HO MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	52426	13	Neurology (M.D. only)	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
161909	Fee-for-Service	1194769059	1194769059	1	1	WELLER, MARC L MD	12/31/1986	207L00000X	NA	Other	026	PHYSICIANS	45304	05	Anesthesiology	0	In state provider	None	12440 FIRESTONE BLVD	STE 101	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
161930	Fee-for-Service	1710054671	1710054671	1	1	WADHWANI, RESHAM A MD	9/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78250	18	Ophthalmology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
161961	Fee-for-Service	1669550729	1669550729	1	1	WOO, KEVIN S MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	45109	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1100 PACIFIC COAST HWY	None	HARBOR CITY	CA	90710	3511	19	06037	33.7899001	-118.2974971	Los Angeles County
161963	Fee-for-Service	1366520025	1366520025	1	1	WINARDI, RICKY MD	12/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79505	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
161969	Fee-for-Service	1689869547	1689869547	1	1	WARAICH, BHUPINDER S MD	9/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	53968	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
161993	Fee-for-Service	1801875141	1801875141	1	1	WEINSTEIN, STEFANIE MD	7/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76069	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
162043	Fee-for-Service	1760641310	1760641310	1	1	WEI, JANET MD	4/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	107662	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
162092	Fee-for-Service	1437413952	1437413952	1	1	WOO, JEAN J NP	3/12/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18522 US HIGHWAY 18 STE	None	APPLE VALLEY	CA	92307	2321	36	06071	34.53944358	-117.2599885	San Bernardino County
162105	Fee-for-Service	1063660660	1063660660	1	1	WU, ELLIN Y OD	9/15/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
162111	Fee-for-Service	1457471500	1457471500	1	1	WEST OAKLAND HEALTH COUNCIL	7/1/1993	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	1890 ALCATRAZ AVE	None	BERKELEY	CA	94703	2715	01	06001	37.84893892	-122.2696251	Alameda County
162136	Fee-for-Service	1417443219	1417443219	1	1	WEI, JASON J DO	3/23/2021	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	17011	None	None	0	In state provider	None	1131 WILSHIRE BLVD	100	SANTA MONICA	CA	90401	2072	19	06037	34.02509887	-118.4909994	Los Angeles County
162137	Fee-for-Service	1700841269	1700841269	1	1	WANG, TUNG-HO MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	52426	40	Pediatrics	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
162165	Fee-for-Service	1043453657	1043453657	1	1	WANG, DA MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117060	05	Anesthesiology	0	In state provider	None	1100 W STEWART DRIVE	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
162178	Fee-for-Service	1740577881	1740577881	1	1	WADE, YVETTE D LCSW	10/11/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LN	325	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
162196	Fee-for-Service	1629285382	1629285382	1	1	WALGREEN CO	8/29/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3752 MISSION AVE	None	OCEANSIDE	CA	92058	1417	37	06073	33.22514029	-117.3318383	San Diego County
162200	Fee-for-Service	1922621432	1922621432	1	1	WARREN, LATASHA T NP	8/18/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15030 7TH ST.	None	VICTORVILLE	CA	92395	3811	36	06071	34.52471945	-117.3042336	San Bernardino County
162301	Fee-for-Service	1053054296	1053054296	1	1	WEAVERVILLE PHARMACY INC	11/15/2022	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	60 S. MINER ST.	STE. C	WEAVERVILLE	CA	96093	0000	53	06105	40.73303357	-122.9420529	Trinity County
162333	Fee-for-Service	1518937085	1518937085	1	1	WALL, DEREK B MD	8/1/1998	208600000X	NA	General Surgery	026	PHYSICIANS	64368	01	General Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
162337	Fee-for-Service	1407842230	1407842230	1	1	WIMER, CAREY DO	12/8/2023	208M00000X	NA	Other	026	PHYSICIANS	20707	None	None	0	In state provider	None	ONE MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
162399	Fee-for-Service	1619459187	1619459187	1	1	WAUGH, BRANDON D LCSW	11/29/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
162414	Fee-for-Service	1922699149	1922699149	1	1	WELLS, KARI E NP	1/24/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	24329 CRENSHAW BLVD	STE. A	TORRANCE	CA	90505	5334	19	06037	33.804612	-118.327997	Los Angeles County
162418	Fee-for-Service	1215034905	1215034905	1	1	WONG, SAMMMUEL J DO	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	5983	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3012 SUMMIT ST	None	OAKLAND	CA	94609	3480	01	06001	37.81947101	-122.264516	Alameda County
162422	Fee-for-Service	1700841269	1700841269	1	1	WANG, TUNG-HO MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	52426	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
162426	Fee-for-Service	1477583714	1477583714	1	1	WOOSLEY, MATHEW M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	250 E DUNLAP AVE	None	PHOENIX	AZ	85020	2825	00	None	33.568947	-112.0712985	Maricopa County
162458	Fee-for-Service	1114946464	1114946464	1	1	WELLS, MICHAEL V MD	7/29/1974	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	30292	22	Pathology (M.D. only)	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
162464	Fee-for-Service	1225186174	1225186174	1	1	WEBB, KELLY T NP	11/4/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3955 BONITA RD	None	BONITA	CA	91902	1230	37	06073	32.65714827	-117.042186	San Diego County
162501	Fee-for-Service	1396811154	1396811154	1	1	WRIGHT, JAMES C OD	2/20/2025	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2213 SHATTUCK AVE	None	BERKELEY	CA	94704	1415	01	06001	37.86917066	-122.2677712	Alameda County
162509	Fee-for-Service	1811061773	1811061773	1	1	WELLS, J DARRICK MD INC	12/1/1993	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	78059	01	General Practice	0	In state provider	None	1201 ROSE AVE	None	SELMA	CA	93662	3227	10	06019	36.56881154	-119.5998255	Fresno County
162513	Fee-for-Service	1114305612	1114305612	1	1	WOHLFORD, ERIC M MD	6/22/2021	2080P0201X	NA	Neurology	026	PHYSICIANS	147882	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
162543	Fee-for-Service	1407582513	1407582513	1	1	WHITE, LINDSEY PSYD	10/16/2023	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
162570	Fee-for-Service	1700810330	1700810330	1	1	WINKLE, ROGER A MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	35385	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
162594	Fee-for-Service	1396928347	1396928347	1	1	WALGREEN CO	2/8/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7850 WEST LANE	None	STOCKTON	CA	95210	3314	39	06077	38.01971854	-121.294716	San Joaquin County
162640	Fee-for-Service	1215953211	1215953211	1	1	WONG, DONNA LYNN DO	12/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6755	08	Family Practice	0	In state provider	None	10800 PARAMOUNT BLVD	STE 402	DOWNEY	CA	90241	3334	19	06037	33.94604301	-118.1354831	Los Angeles County
162676	Fee-for-Service	1326583279	1326583279	1	1	WAVES OF PEACE, AN INDIVIDUA	4/14/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	18837 BROOKHURST ST	SUITE 102	FOUNTAIN VALLEY	CA	92708	7301	30	06059	33.68919119	-117.9542204	Orange County
162705	Fee-for-Service	1215034905	1215034905	1	1	WONG, SAMMMUEL J DO	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	5983	45	Nephrology (Renal-Kidney)	0	In state provider	None	3012 SUMMIT ST	None	OAKLAND	CA	94609	3480	01	06001	37.81947101	-122.264516	Alameda County
162746	Fee-for-Service	1912144379	1912144379	1	1	WARD, MICHAEL E MD	6/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107334	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
162748	Fee-for-Service	1114946464	1114946464	1	1	WELLS, MICHAEL V MD	7/29/1974	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	30292	30	Radiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
162758	Fee-for-Service	1003436064	1003436064	1	47	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	936 N WESTERN AVENUE	SUITE 270	SAN PEDRO	CA	90732	2427	19	06037	33.75111361	-118.3090432	Los Angeles County
162787	Fee-for-Service	1730628728	1730628728	1	1	WALMART INC.	2/16/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	5210 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9223	00	None	35.005743	-114.595461	Mohave County
162809	Fee-for-Service	1275895997	1275895997	1	1	WONG, BENJAMIN MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	1524 PINTO LANE	3RD FLOOR	LAS VEGAS	NV	89106	4195	00	None	36.1643883	-115.162182	Clark County
162828	Fee-for-Service	1770683526	1770683526	1	1	WHITE, WILLIAM F MD	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	50759	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.64575895	-118.9638914	Mono County
162869	Fee-for-Service	1316138886	1316138886	1	1	WESTIN, ANDRE MD	8/19/2008	207R00000X	NA	Other	026	PHYSICIANS	101015	41	Internal Medicine	0	In state provider	None	2030 SUTTER PL	None	DAVIS	CA	95616	6215	57	06113	38.56292466	-121.7715423	Yolo County
162885	Fee-for-Service	1184686255	1184686255	1	1	WITTER, DEBRA DENISE	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	56606	40	Pediatrics	0	In state provider	None	6170 THORNTON AVE	STE A	NEWARK	CA	94560	3700	01	06001	37.5360754	-122.0311695	Alameda County
162893	Fee-for-Service	1164576708	1164576708	1	1	WANG, KAIDONG	8/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54585	None	None	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
162919	Fee-for-Service	1013020973	1013020973	1	1	WEST-STALLARD, TRACY LEE	1/25/2019	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.64575895	-118.9638914	Mono County
162934	Fee-for-Service	1053706267	1053706267	1	1	WONG, BRIAN MD	1/27/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	134904	None	None	0	In state provider	None	630 S RAYMOND AVE	STE 310	PASADENA	CA	91105	3278	19	06037	34.13505223	-118.1487761	Los Angeles County
162952	Fee-for-Service	1295936136	1295936136	1	1	WILHITE, ALLYSON E LMFT	7/17/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3209 ESPLANADE	STE 130	CHICO	CA	95973	0154	04	06007	39.77079925	-121.8755055	Butte County
162959	Fee-for-Service	1326583279	1326583279	1	1	WAVES OF PEACE, AN INDIVIDUA	1/4/2024	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	RVICES	18837 BROOKHURST ST	SUITE 102	FOUNTAIN VALLEY	CA	92708	7301	30	06059	33.68919119	-117.9542204	Orange County
163039	Fee-for-Service	1588169353	1588169353	1	2	WU, DANIEL DPM	8/16/2022	213ES0103X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
163063	Fee-for-Service	1720484207	1720484207	1	1	WEST COAST HOME HEALTH LLC	10/21/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	29222 RANCHO VIEJO RD	SUITE 201	SAN JUAN CAPISTR	CA	92675	1045	30	06059	33.53905045	-117.6736364	Orange County
163066	Fee-for-Service	1265634992	1265634992	1	1	WONG, TINA MD	10/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102178	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
163125	Fee-for-Service	1154497725	1154497725	1	1	WALKER, WILLIAM B MD	7/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	25175	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
163187	Fee-for-Service	1184068348	1184068348	1	1	WANG, PHILLIP C MD	5/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126889	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
163202	Fee-for-Service	1245434042	1245434042	1	1	WEBB-PEREZ, ALLISON S MD	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117867	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	220 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	43	06085	37.26914953	-121.9566285	Santa Clara County
163233	Fee-for-Service	1609233600	1609233600	1	1	WILLIAMS, ERIKA S LCSW	3/17/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	126172	-	NOT APPLICABLE	0	In state provider	None	200 W SANTA ANA BLVD	100 & 175	SANTA ANA	CA	92701	4134	30	06059	33.74970951	-117.8691975	Orange County
163302	Fee-for-Service	1487707097	1487707097	1	1	WEST HILLS DERMATOLOGY GROUP	12/10/2018	207NS0135X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	7320 WOODLAKE AVE.	SUITE 340	WEST HILLS	CA	91307	7320	19	06037	34.20245266	-118.6321273	Los Angeles County
163305	Fee-for-Service	1609956465	1609956465	1	1	WILLIAMS, MICHAEL J MD	3/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	49905	30	Radiology	0	In state provider	None	652 PETALUMA AVE	STE I	SEBASTOPOL	CA	95472	4266	49	06097	38.39662494	-122.8201368	Sonoma County
163359	Fee-for-Service	1679980882	1679980882	1	1	WEI, GUI MD	5/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138872	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
163410	Fee-for-Service	1326033614	1326033614	1	1	WAGNER, STEVEN D DO	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	5398	08	Family Practice	0	In state provider	None	114 MISSION RANCH BLVD	STE 10	CHICO	CA	95926	2186	04	06007	39.75356438	-121.8600403	Butte County
163429	Fee-for-Service	1225292949	1225292949	1	1	WILKINSON, JEREMY M MD	9/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105191	36	Psychiatry	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
163465	Fee-for-Service	1659391548	1659391548	1	1	WOOD, MICHAEL MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	48744	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1060 E FOOTHILL BLVD	STE 201	UPLAND	CA	91786	4070	36	06071	34.1070235	-117.6371235	San Bernardino County
163470	Fee-for-Service	1124045448	1124045448	1	2	WALMART INC.	2/4/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3960 MITCHELL RD	None	CERES	CA	95307	9420	50	06099	37.582641	-120.938767	Stanislaus County
163485	Fee-for-Service	1295034056	1295034056	1	1	WISE, AUDRA C MD	4/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114312	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
163503	Fee-for-Service	1447332036	1447332036	1	14	WELLSPACE HEALTH	7/28/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7601 HOSPITAL DR	SUITE 220	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
163536	Fee-for-Service	1003436064	1003436064	1	67	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	12209 HESPERIA	SUITE D	VICTORVILLE	CA	92395	5855	36	06071	34.47275368	-117.2917026	San Bernardino County
163580	Fee-for-Service	1457448789	1457448789	1	1	WIELER & SEIN MED GRP	10/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1720 TERMINO AVE	None	LONG BEACH	CA	90804	2104	19	06037	33.78889871	-118.1458784	Los Angeles County
163593	Fee-for-Service	1528179330	1528179330	1	1	WHEELER, CARRIE L DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	5705 MARCONI AVE	STE B	CARMICHAEL	CA	95608	4470	34	06067	38.617533	-121.3315335	Sacramento County
163595	Fee-for-Service	1669527594	1669527594	1	1	WASEEM, MOHIUDDIN MD	1/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52567	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
163609	Fee-for-Service	1053338475	1053338475	1	1	WAL-MART STORES, INC	10/13/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 ROSEWOOD DR	None	PLEASANTON	CA	94588	3079	01	06001	37.698336	-121.8873465	Alameda County
163611	Fee-for-Service	1114086394	1114086394	1	1	WEINSTEIN, ELLIOT S MD	7/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38238	40	Pediatrics	0	In state provider	None	8283 GROVE AVE	STE 203	RANCHO CUCAMONGA	CA	91730	3140	36	06071	34.10380433	-117.6285116	San Bernardino County
163621	Fee-for-Service	1851497002	1851497002	1	1	WHITE MEMORIAL PEDIATRIC	7/17/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GROUP	1701 CESAR E CHAVEZ AV	STE 456 & 532	LOS ANGELES	CA	90033	2464	19	06037	34.05112725	-118.2173921	Los Angeles County
163627	Fee-for-Service	1437281219	1437281219	1	1	WIKE, BEVERLY OT	4/5/2018	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1017 S FAIR OAKS AVE	None	PASADENA	CA	91105	2621	19	06037	34.12830178	-118.1503497	Los Angeles County
163667	Fee-for-Service	1265857585	1265857585	1	1	WAL-MART STORES INC	6/12/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	512 NORTH VENTU PARK RD	None	THOUSAND OAKS	CA	91320	4649	56	06111	34.18679486	-118.9109997	Ventura County
163674	Fee-for-Service	1861710469	1861710469	1	1	WANG, SAMBIN DO	5/3/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	11738	36	Psychiatry	0	In state provider	None	415 W ROUTE 66	SUITE 202	GLENDORA	CA	91740	4335	19	06037	34.12883848	-117.869958	Los Angeles County
163699	Fee-for-Service	1326033614	1326033614	1	1	WAGNER, STEVEN D DO	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	5398	01	General Practice	0	In state provider	None	114 MISSION RANCH BLVD	STE 10	CHICO	CA	95926	2186	04	06007	39.75356438	-121.8600403	Butte County
163723	Fee-for-Service	1023093770	1023093770	1	1	WONG, WILLIAM J MD	6/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	87670	30	Radiology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
163728	Fee-for-Service	1134707680	1134707680	1	1	WEI, PETER C DO	12/7/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22170	None	None	0	In state provider	None	264 N HIGHLAND SPRINGS A	D	BANNING	CA	92220	3082	33	06065	33.93063	-116.946864	Riverside County
163746	Fee-for-Service	1568621803	1568621803	1	1	WILKINSON, JOHN B MD	1/16/2020	2085R0001X	NA	Other	026	PHYSICIANS	156310	32	Radiation Therapy (D.O. only)	0	In state provider	None	1213 E OCEAN AVE	100	LOMPOC	CA	93436	7047	42	06083	34.6388755	-120.442995	Santa Barbara County
163790	Fee-for-Service	1447332036	1447332036	1	14	WELLSPACE HEALTH	5/25/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7601 HOSPITAL DR	SUITE 220	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
163822	Fee-for-Service	1407891351	1407891351	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15480 MAIN ST	None	HESPERIA	CA	92345	3318	36	06071	34.42530462	-117.3256052	San Bernardino County
163825	Fee-for-Service	1003436064	1003436064	1	67	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	12209 HESPERIA	SUITE D	VICTORVILLE	CA	92395	5855	36	06071	34.47275368	-117.2917026	San Bernardino County
163840	Fee-for-Service	1851605208	1851605208	1	1	WERNEID, KRISTIAN F MD	10/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134900	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
163854	Fee-for-Service	1184656860	1184656860	1	1	WALLACE, DANIEL G MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71835	41	Internal Medicine	0	In state provider	None	12509 POWAY RD	None	POWAY	CA	92064	4304	37	06073	32.95198061	-117.0600875	San Diego County
163862	Fee-for-Service	1275611006	1275611006	1	1	WELCH, RICHARD B MD	2/1/1971	No Taxonomy Provided	NA	None	026	PHYSICIANS	31486	01	General Practice	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
163878	Fee-for-Service	1679563498	1679563498	1	1	WONG, DARYL S Y DO	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	8805	05	Anesthesiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
163889	Fee-for-Service	1225443997	1225443997	1	1	WANG, JAY C	11/15/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	174746	None	None	0	In state provider	None	2485 HOSPITAL DR	STE 200	MOUNTAIN VIEW	CA	94040	4123	43	06085	37.368918	-122.081761	Santa Clara County
163919	Fee-for-Service	1962513135	1962513135	1	1	WESTEREN, ALAN C MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79738	18	Ophthalmology	0	In state provider	None	15725 POMERADO RD	STE 203	POWAY	CA	92064	2058	37	06073	33.00037882	-117.0580735	San Diego County
163930	Fee-for-Service	1457341497	1457341497	1	1	WETTERAU, LAWRENCE A MD	7/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	62927	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
163998	Fee-for-Service	1740392984	1740392984	1	1	WU, JEANNE I	7/1/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	477 E COLORADO BLVD	None	PASADENA	CA	91101	2024	19	06037	34.14587948	-118.140561	Los Angeles County
164000	Fee-for-Service	1508141359	1508141359	1	1	WEINSTEIN, STACEY E MD	1/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121633	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
164043	Fee-for-Service	1487671913	1487671913	1	1	WANG, HANLIN MD	7/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52688	22	Pathology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
164052	Fee-for-Service	1356808091	1356808091	1	1	WEST COAST MEDICAL TRANSPORT	3/23/2020	341600000X	NA	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	100 COOMBS ST	None	NAPA	CA	94559	3941	28	06055	38.28783106	-122.2868912	Napa County
164064	Fee-for-Service	1669425062	1669425062	1	1	WONG, RODNEY Z MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	56838	20	Orthopedic Surgery	0	In state provider	None	515 SOUTH DR	STE 16	MOUNTAIN VIEW	CA	94040	4209	43	06085	37.36725925	-122.0837256	Santa Clara County
164069	Fee-for-Service	1538397997	1538397997	1	1	WASSON, NICHOLAS R MD	7/22/2020	207LP3000X	NA	Other	026	PHYSICIANS	166214	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
164077	Fee-for-Service	1447332036	1447332036	1	14	WELLSPACE HEALTH	7/28/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7601 HOSPITAL DR	SUITE 220	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
164134	Fee-for-Service	1124153481	1124153481	1	1	WASSERMAN, LESLIE A LCSW	5/13/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
164141	Fee-for-Service	1609847821	1609847821	1	1	WHITAKER, DUANE C MD	6/26/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	45899	07	Dermatology	0	In state provider	None	5530 AVENUE DE LOS ROBLE	None	VISALIA	CA	93291	5174	54	06107	36.328365	-119.3525775	Tulare County
164149	Fee-for-Service	1770042103	1770042103	1	1	WESTERN HEALTH RESOURCES	3/24/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	800 S LOWER SACRAMENTO	None	LODI	CA	95242	3635	39	06077	38.12374272	-121.3065139	San Joaquin County
164180	Fee-for-Service	1558974824	1558974824	1	1	WILLIAMS, MELODY D PHD	9/9/2020	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1255 W COLTON AVE STE 58	None	REDLANDS	CA	92374	2861	36	06071	34.06285254	-117.20178	San Bernardino County
164204	Fee-for-Service	1760526743	1760526743	1	1	WILLIAMS, CHARLES R CA	9/14/2022	207LP2900X	NA	Other	026	PHYSICIANS	51191	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
164206	Fee-for-Service	1669738175	1669738175	1	1	WINGERT, THEODORA E MD	12/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127839	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
164208	Fee-for-Service	1962513135	1962513135	1	1	WESTEREN, ALAN C MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79738	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15725 POMERADO RD	STE 203	POWAY	CA	92064	2058	37	06073	33.00037882	-117.0580735	San Diego County
164214	Fee-for-Service	1649478801	1649478801	1	1	WARTAK, SIDDHARTH A MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148625	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
164217	Fee-for-Service	1457341497	1457341497	1	1	WETTERAU, LAWRENCE A MD	7/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	62927	57	Unknown	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
164220	Fee-for-Service	1922013218	1922013218	1	1	WALGREENS CO	7/14/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10 W MAIN ST	None	WOODLAND	CA	95695	3016	57	06113	38.67755849	-121.784616	Yolo County
164252	Fee-for-Service	1558771246	1558771246	1	1	WILLIAM GILLESPIE AND	12/19/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ASSOCIATES INC	510 S GRAND AVENUE	SUITE 200	GLENDORA	CA	91741	4291	19	06037	34.13034587	-117.8725246	Los Angeles County
164307	Fee-for-Service	1508141359	1508141359	1	1	WEINSTEIN, STACEY E MD	1/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121633	40	Pediatrics	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
164319	Fee-for-Service	1235422197	1235422197	1	1	WHANG, EMILY MD	6/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124692	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVENUE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
164366	Fee-for-Service	1447332036	1447332036	1	14	WELLSPACE HEALTH	7/28/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7601 HOSPITAL DR	SUITE 220	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
164367	Fee-for-Service	1750189684	1750189684	1	1	WYNGLARZ, ALEXA CCC-SLP	4/9/2025	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
164394	Fee-for-Service	1851468672	1851468672	1	1	WAKE, WILLIAM T MD	5/4/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	47814	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
164404	Fee-for-Service	1629542923	1629542923	1	1	WALSH, JASON P NP	10/31/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
164437	Fee-for-Service	1972531838	1972531838	1	1	WHITING, CLAYTON B MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73293	None	None	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
164438	Fee-for-Service	1780788919	1780788919	1	1	WEISS, CHARLES S MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	48539	01	General Practice	0	In state provider	None	1001 SNEATH LN	STE 104	SAN BRUNO	CA	94066	2349	41	06081	37.63462925	-122.4259247	San Mateo County
164439	Fee-for-Service	1477590016	1477590016	1	1	WASBIN, STANLEY A MD	3/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	59158	01	General Practice	0	In state provider	None	27871 MEDICAL CENTER RD	SUITE 200	MISSION VIEJO	CA	92691	6406	30	06059	33.558534	-117.6641255	Orange County
164485	Fee-for-Service	1851623029	1851623029	1	1	WALTER R OBRIEN MD INC A MED	4/25/2019	207QS0010X	NA	Adult Primary Care	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	ICAL CORPORATION	11710 WILSHIRE BLVD	None	LOS ANGELES	CA	90025	1503	19	06037	34.04917484	-118.4611352	Los Angeles County
164502	Fee-for-Service	1457341497	1457341497	1	1	WETTERAU, LAWRENCE A MD	7/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	62927	67	Endocrinology	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
164517	Fee-for-Service	1851707343	1851707343	1	1	WANG, SUNNIE MD	8/2/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	141145	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
164532	Fee-for-Service	1417435991	1417435991	1	1	WESTERN HEALTH RESOURCES	5/17/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1601 NEW STINE ROAD	SUITE 103	BAKERSFIELD	CA	93309	3698	15	06029	35.34050144	-119.0612558	Kern County
164591	Fee-for-Service	1942625132	1942625132	1	1	WELDON DIALYSIS LLC	12/5/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1836 SIERRA GARDENS DR	STE 150	ROSEVILLE	CA	95661	2943	31	06061	38.74701375	-121.2601009	Placer County
164604	Fee-for-Service	1295099042	1295099042	1	1	WAN, XIAO C MD	6/20/2022	207K00000X	NA	Other	026	PHYSICIANS	135680	None	None	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
164605	Fee-for-Service	1235422197	1235422197	1	1	WHANG, EMILY MD	6/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124692	10	Gastroenterology (M.D. only)	0	In state provider	None	10833 LE CONTE AVENUE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
164612	Fee-for-Service	1457855454	1457855454	1	1	WEISS, JOSHUA E MD	6/18/2021	390200000X	NA	Other	026	PHYSICIANS	164888	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
164655	Fee-for-Service	1619366341	1619366341	1	1	WAL-MART STORES, INC.	6/15/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1560 W 6TH ST	None	CORONA	CA	92882	2730	33	06065	33.87852387	-117.5960156	Riverside County
164658	Fee-for-Service	1841468105	1841468105	1	1	WALGREEN CO.	5/19/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#12694	10990 WARNER AVE.	SUITE A	FOUNTAIN VALLEY	CA	92708	3849	30	06059	33.7162557	-117.9373439	Orange County
164664	Fee-for-Service	1508871831	1508871831	1	1	WALGREEN CO	1/31/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4351 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2318	19	06037	33.93079627	-118.1842645	Los Angeles County
164666	Fee-for-Service	1518061100	1518061100	1	1	WAFFARN, FEIZAL A MD	12/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	29638	40	Pediatrics	0	In state provider	MEDICAL CTR OF LA MIRADA	14900 IMPERIAL HWY	None	LA MIRADA	CA	90638	2172	19	06037	33.91710433	-118.0132986	Los Angeles County
164669	Fee-for-Service	1114565439	1114565439	1	1	WOLDER, JUDITH R LMFT	12/21/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	OACHING	24351 MOULTON PKWY	None	LAGUNA WOODS	CA	92637	0201	30	06059	33.60856058	-117.7241714	Orange County
164681	Fee-for-Service	1598384695	1598384695	1	1	WEN, NANCY K MD	9/5/2023	208M00000X	NA	Other	026	PHYSICIANS	187480	None	None	0	In state provider	None	8120 TIMBERLAKE WAY	SUITE 107	SACRAMENTO	CA	95823	5413	34	06067	38.461023	-121.41414	Sacramento County
164703	Fee-for-Service	1346451028	1346451028	1	1	WEST SONOMA CO UHSD	3/11/2002	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	462 JOHNSON ST	None	SEBASTOPOL	CA	95472	3431	49	06097	38.40623345	-122.8224661	Sonoma County
164772	Fee-for-Service	1942227269	1942227269	1	1	WAL-MART STORES, INC	9/14/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102025	3010 W GRANT LINE RD	None	TRACY	CA	95304	9402	39	06077	37.751661	-121.4717085	San Joaquin County
164782	Fee-for-Service	1346681517	1346681517	1	1	WONG, GEORGE DO	9/23/2021	207R00000X	NA	Other	026	PHYSICIANS	18680	None	None	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
164785	Fee-for-Service	1750537437	1750537437	1	3	WEST COUNTY MEDICAL CORPORAT	11/6/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ION	2272 PACIFIC AVENUE	A	LONG BEACH	CA	90806	4312	19	06037	33.798582	-118.193644	Los Angeles County
164789	Fee-for-Service	1932640190	1932640190	1	1	WANG, LIZ B MD	6/19/2023	208800000X	NA	Other	026	PHYSICIANS	178087	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
164826	Fee-for-Service	1417435991	1417435991	1	1	WESTERN HEALTH RESOURCES	5/17/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1601 NEW STINE ROAD	SUITE 103	BAKERSFIELD	CA	93309	3698	15	06029	35.34050144	-119.0612558	Kern County
164834	Fee-for-Service	1346270816	1346270816	1	1	WATSON, DEBORAH MD	12/19/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	79374	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
164848	Fee-for-Service	1962769497	1962769497	1	1	WANG, ZHONG MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121787	02	General Surgery	0	In state provider	None	880 E TUOLUMNE RD	STE 201	TURLOCK	CA	95382	1549	50	06099	37.51459247	-120.837519	Stanislaus County
164869	Fee-for-Service	1184065930	1184065930	1	1	WALL, JESSICA L MD	5/8/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	145258	08	Family Practice	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
164872	Fee-for-Service	1124504204	1124504204	1	1	WONG, KRISTA Y OD	9/17/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3525 PACIFIC COAST HWY	STE E	TORRANCE	CA	90505	6656	19	06037	33.80337655	-118.3474795	Los Angeles County
164976	Fee-for-Service	1356356638	1356356638	1	1	WALGREEN CO	8/8/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11800 ARTESIA BLVD	None	ARTESIA	CA	90701	4003	19	06037	33.87293272	-118.0818003	Los Angeles County
165003	Fee-for-Service	1295804201	1295804201	1	1	WU, JOHN C MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93845	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
165007	Fee-for-Service	1487673935	1487673935	1	1	WINDROW, MATHEW J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3200 AVE E E	None	HONDO	TX	78861	3525	00	None	29.33417989	-99.13348669	Medina County
165039	Fee-for-Service	1396108536	1396108536	1	1	WINTERS, LEIGHA MD	7/1/2019	207P00000X	NA	Other	026	PHYSICIANS	152959	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
165100	Fee-for-Service	1881665818	1881665818	1	1	WOOLF, ANTHONY M MD	7/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	81648	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
165111	Fee-for-Service	1356765465	1356765465	1	1	WEILAND, JOSEPH M DO	9/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13170	01	General Practice	0	In state provider	None	510 SUPERIOR AVE	SUITE 200B	NEWPORT BEACH	CA	92663	3663	30	06059	33.63019271	-117.9294795	Orange County
165114	Fee-for-Service	1326664384	1326664384	1	1	WONG, DANIEL G MD	3/11/2025	208800000X	NA	Other	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
165115	Fee-for-Service	1720002512	1720002512	1	1	WANG, SANDRA J MD	1/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54749	41	Internal Medicine	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
165219	Fee-for-Service	1366784373	1366784373	1	1	WYNN, CHRISTINA E CNM	11/19/2021	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
165221	Fee-for-Service	1568993350	1568993350	1	1	WU, TARA MD	7/27/2023	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	160978	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
165231	Fee-for-Service	1588157549	1588157549	1	1	WADOOD, ZERGHONA MD	9/19/2023	207L00000X	NA	Other	026	PHYSICIANS	176499	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
165239	Fee-for-Service	1902966484	1902966484	1	1	WRIGHT, PAIGE L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	LINDA DRINKWATER	4500 SAND POINT WAY NE	None	SEATTLE	WA	98105	3900	00	None	47.66165594	-122.2864502	King County
165264	Fee-for-Service	1154701662	1154701662	1	1	WESTSIDE MEDICAL PHARMACY CO	3/30/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11968 WILSHIRE BLVD	B	LOS ANGELES	CA	90025	6665	19	06037	34.04543291	-118.465761	Los Angeles County
165284	Fee-for-Service	1194840660	1194840660	1	1	WEISSBEINMACKEN, CYNTHIA L	7/5/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	14465	-	NOT APPLICABLE	0	In state provider	PSY	5900 STATE FARM DRIVE	SUITE 200	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
165292	Fee-for-Service	1003436064	1003436064	1	29	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7040 AVENIDA ENCINAS	SUITE 103	CARLSBAD	CA	92011	4652	37	06073	33.10198968	-117.3129408	San Diego County
165324	Fee-for-Service	1114311909	1114311909	1	1	WAL-MART STORES, INC.	6/15/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5037 E BRUNDAGE LN	None	BAKERSFIELD	CA	93307	9676	15	06029	35.35419839	-118.9479323	Kern County
165330	Fee-for-Service	1427685031	1427685031	1	1	WEISER, JEREMY MD	3/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
165337	Fee-for-Service	1841293305	1841293305	1	1	WEISSMAN, ROBERT J	2/8/2015	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	WESTERN AUDIOLOGY	50 ALESSANDRO PL	STE 230	PASADENA	CA	91105	4003	19	06037	34.13101049	-118.151532	Los Angeles County
165353	Fee-for-Service	1104180264	1104180264	1	1	WILSHIRE CENTER FOR	12/1/2014	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	DERMATOLOGY APC	5757 WILSHIRE BLVD	PROMENADE 2	LOS ANGELES	CA	90036	5810	19	06037	34.0624504	-118.3534253	Los Angeles County
165359	Fee-for-Service	1639228919	1639228919	1	1	WANG, PAUL Y MD	3/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74393	45	Nephrology (Renal-Kidney)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
165379	Fee-for-Service	1275889545	1275889545	1	1	WILLIAMS, MATTHEW S MD	1/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1380 E MEDICAL CENTER DR	None	ST GEORGE	UT	84790	2123	04	06007	37.097622	-113.553828	Washington County
165441	Fee-for-Service	1467909473	1467909473	1	1	WILSTEIN, LAUREN M NP	9/10/2018	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
165443	Fee-for-Service	1548490543	1548490543	1	1	WOOD, MEGHAN B MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114278	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
165449	Fee-for-Service	1508847971	1508847971	1	1	WOLF, MELANIE S DO	11/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8332	41	Internal Medicine	0	In state provider	None	15 MAREBLU	STE 100	ALISO VIEJO	CA	92656	3046	30	06059	33.5729913	-117.703431	Orange County
165452	Fee-for-Service	1528088960	1528088960	1	1	WALLACE, WILLIAM C MD	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	66100	02	General Surgery	0	In state provider	None	24411 HEALTH CENTER DR	SUITE 350	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
165481	Fee-for-Service	1659430981	1659430981	1	1	WOLFF, ANDREA L. MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	475 S DOBSON RD	None	CHANDLER	AZ	85224	5605	00	None	33.29768043	-111.8761089	Maricopa County
165524	Fee-for-Service	1023418878	1023418878	1	1	WAH, THINN T MD	6/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134453	41	Internal Medicine	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
165541	Fee-for-Service	1790989267	1790989267	1	1	WU, KONG-TAY MD INC	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	30553	40	Pediatrics	0	In state provider	None	1818 N ORANGE GROVE AVE	STE 200	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
165559	Fee-for-Service	1245493808	1245493808	1	1	WISER, JESSICA L MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110768	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
165570	Fee-for-Service	1013922343	1013922343	1	1	WALGREEN CO	3/7/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2120 POLK ST	None	SAN FRANCISCO	CA	94109	2507	38	06075	37.79633377	-122.4218183	San Francisco County
165581	Fee-for-Service	1003436064	1003436064	1	29	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	7040 AVENIDA ENCINAS	SUITE 103	CARLSBAD	CA	92011	4652	37	06073	33.10198968	-117.3129408	San Diego County
165584	Fee-for-Service	1417920380	1417920380	1	1	WHANG, CATHERINE C MD	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84695	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
165610	Fee-for-Service	1497106348	1497106348	1	1	WILD, ANGELA	9/17/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
165627	Fee-for-Service	1215163217	1215163217	1	1	WALKER, ANGELA K MD	8/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108158	07	Dermatology	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
165637	Fee-for-Service	1558567826	1558567826	1	1	WU, WILLIAM C MD	4/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	10610	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
165663	Fee-for-Service	1003183617	1003183617	1	1	WANG, JACKSON MD	11/3/2018	207RN0300X	NA	Nephrology	026	PHYSICIANS	119259	45	Nephrology (Renal-Kidney)	0	In state provider	None	151 N SUNRISE AVE	STE 1205	ROSEVILLE	CA	95661	2926	31	06061	38.74746043	-121.2655348	Placer County
165666	Fee-for-Service	1306264007	1306264007	1	1	WILSON-HARRIS, BRITTANEY M M	11/1/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163597	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	D	1800 N. WESTERN AVE	SUITE 204	SAN BERNARDINO	CA	92411	1353	36	06071	34.1315778	-117.3182453	San Bernardino County
165750	Fee-for-Service	1235197898	1235197898	1	1	WU, DANNY MD	12/31/1989	174400000X	NA	Other	026	PHYSICIANS	67822	None	None	0	In state provider	None	1330 CUTTING BLVD	None	RICHMOND	CA	94804	2555	07	06013	37.92518651	-122.3564715	Contra Costa County
165760	Fee-for-Service	1528444023	1528444023	1	1	WOOD, LANDON DO	8/24/2020	207P00000X	NA	Other	026	PHYSICIANS	18204	66	Emergency Medicine (Urgent Care)	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
165767	Fee-for-Service	1578650990	1578650990	2	1	WRIGHT, KENNETH W MD	10/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	37720	None	None	0	In state provider	None	520 S SAN VICENTE BLVD	None	LOS ANGELES	CA	90048	4616	19	06037	34.06814789	-118.3742916	Los Angeles County
165769	Fee-for-Service	1366406381	1366406381	1	1	WU, DAISY T DPM	9/28/2006	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	4646 BROCKTON AVE	STE 202	RIVERSIDE	CA	92506	0102	33	06065	33.9760171	-117.3860626	Riverside County
165784	Fee-for-Service	1902149321	1902149321	1	1	WU, NING MD	12/8/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	154542	13	Neurology (M.D. only)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
165786	Fee-for-Service	1699840231	1699840231	1	1	WILLOW PASS HEALTHCARE	11/1/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	3318 WILLOW PASS RD	None	CONCORD	CA	94519	2316	07	06013	37.98252102	-122.0171819	Contra Costa County
165789	Fee-for-Service	1083679997	1083679997	1	1	WEISS. ALAN M MD	3/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54750	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
165793	Fee-for-Service	1104933290	1104933290	1	1	WALTER, DOROTHY J	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO STREET	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
165848	Fee-for-Service	1245405356	1245405356	1	1	WILLIAMS, EVAN A	4/14/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	99034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
165909	Fee-for-Service	1124308382	1124308382	1	1	WALGREEN CO	12/18/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1435 HIGH ST	None	DELANO	CA	93215	1714	15	06029	35.77502393	-119.2484146	Kern County
165931	Fee-for-Service	1306023742	1306023742	1	1	WITT, SCOTT A MD	10/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113708	None	None	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95404	1707	49	06097	38.469537	-122.707314	Sonoma County
165967	Fee-for-Service	1376060764	1376060764	1	1	WETHERBY HOSPICE CARE INC	6/23/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	167 N 3RD AVE	STE E	UPLAND	CA	91786	6052	36	06071	34.095618	-117.647108	San Bernardino County
165976	Fee-for-Service	1124168018	1124168018	1	1	WOOD, JOHN D	12/31/1985	207P00000X	NA	Other	026	PHYSICIANS	4550	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4747 ENGLE RD	None	CARMICHAEL	CA	95608	2223	34	06067	38.6320173	-121.3545928	Sacramento County
165996	Fee-for-Service	1710240635	1710240635	1	1	WALLACE, ANN E OT	12/4/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
166033	Fee-for-Service	1992007439	1992007439	1	1	WILKINS, TREVER L DO	1/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
166069	Fee-for-Service	1023034733	1023034733	1	1	WEINER, KEITH M MD	10/1/2000	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	53493	40	Pediatrics	0	In state provider	None	1310 W STEWART DR	STE 601	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
166093	Fee-for-Service	1184666091	1184666091	1	1	WILSON, MARK W MD	2/28/1995	2085R0204X	NA	Other	026	PHYSICIANS	74073	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
166159	Fee-for-Service	1831147792	1831147792	1	1	WEIGEL, ANNA G PSYD	10/21/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	700 E ST	STE 203	SAN RAFAEL	CA	94901	2782	21	06041	37.97112293	-122.533553	Marin County
166172	Fee-for-Service	1588923023	1588923023	1	1	WANG, XIAO B MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129757	40	Pediatrics	0	In state provider	None	18210 YORBA LINDA BLVD	STE 404	YORBA LINDA	CA	92886	4060	30	06059	33.8883981	-117.8154098	Orange County
166179	Fee-for-Service	1457666455	1457666455	1	1	WORKMAN, LAURA J	8/1/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12801 CROSSROADS PRKWY	None	CITY OF INDUSTRY	CA	91746	3402	19	06037	34.0289395	-118.024533	Los Angeles County
166188	Fee-for-Service	1760530653	1760530653	1	1	WAHN, UDO MD	1/1/1982	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	42268	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7060 HOLLYWOOD BLVD	STE 414	LOS ANGELES	CA	90028	6017	19	06037	34.10150448	-118.3437315	Los Angeles County
166210	Fee-for-Service	1629094560	1629094560	1	1	WOON, SARAH E MD	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	98029	45	Nephrology (Renal-Kidney)	0	In state provider	None	365 LENNON LANE	SUITE 250	WALNUT CREEK	CA	94598	5915	07	06013	37.92784983	-122.0301444	Contra Costa County
166218	Fee-for-Service	1003436064	1003436064	1	73	WS AUDIOLOGY (CALIFORNIA), P	8/28/2024	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	21787 VENTURA BLVD	None	WOODLAND HILLS	CA	91364	1835	19	06037	34.16845346	-118.602765	Los Angeles County
166250	Fee-for-Service	1518461730	1518461730	1	1	WONG, SANDY M	5/1/2018	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	416 W LAS TUNAS DR	STE 101	SAN GABRIEL	CA	91776	1237	19	06037	34.10243845	-118.1046106	Los Angeles County
166257	Fee-for-Service	1457448789	1457448789	1	3	WIELER & SEIN MED GRP	4/1/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	30	06059	33.77450951	-117.913014	Orange County
166258	Fee-for-Service	1376060764	1376060764	1	1	WETHERBY HOSPICE CARE INC	6/23/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	167 N 3RD AVE	STE E	UPLAND	CA	91786	6052	36	06071	34.095618	-117.647108	San Bernardino County
166262	Fee-for-Service	1386171080	1386171080	1	1	WALL, LUCY PSYD	7/24/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
166295	Fee-for-Service	1417920216	1417920216	1	1	WANG, LAWRENCE T MD	7/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90624	07	Dermatology	0	In state provider	None	15025 INNOVATION DR	None	SAN DIEGO	CA	92128	3409	37	06073	32.98956795	-117.0767228	San Diego County
166299	Fee-for-Service	1194763169	1194763169	1	1	WARHAFT, VAL MD	4/30/1988	207P00000X	NA	Other	026	PHYSICIANS	32512	66	Emergency Medicine (Urgent Care)	0	In state provider	None	910 S FAIRFAX AVE	None	LOS ANGELES	CA	90036	4419	19	06037	34.0597882	-118.3630234	Los Angeles County
166319	Fee-for-Service	1255346524	1255346524	1	1	WALGREEN CO	9/8/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1830 W 11TH ST	None	TRACY	CA	95376	3736	39	06077	37.73923552	-121.4505495	San Joaquin County
166376	Fee-for-Service	1568725562	1568725562	1	1	WU, YU-TAI OD	1/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
166413	Fee-for-Service	1982847836	1982847836	1	2	WANG, MIKE Y P MD	1/9/2017	207L00000X	NA	Other	026	PHYSICIANS	115004	05	Anesthesiology	0	In state provider	None	309 WEST BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
166489	Fee-for-Service	1285719955	1285719955	1	1	WANG, CHI-HUA MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73425	40	Pediatrics	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
166499	Fee-for-Service	1487090973	1487090973	1	1	WHEELER, MICHAEL G DPM	11/8/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
166501	Fee-for-Service	1871551564	1871551564	1	1	WETTSTEIN, WENDELL MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	31737	08	Family Practice	0	In state provider	None	12370 HESPERIA RD	STE 15	VICTORVILLE	CA	92395	5808	36	06071	34.47625382	-117.2913208	San Bernardino County
166507	Fee-for-Service	1174663975	1174663975	1	1	WRIGHT ELEMENTARY SD	3/11/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	4385 PRICE AVE	None	SANTA ROSA	CA	95407	6550	49	06097	38.419713	-122.7722445	Sonoma County
166611	Fee-for-Service	1396783668	1396783668	1	1	WEEKER, ELLIS MD	6/30/1988	207P00000X	NA	Other	026	PHYSICIANS	33463	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15891 LOS GATOS ALMADEN	None	LOS GATOS	CA	95032	3742	43	06085	37.24361275	-121.9477516	Santa Clara County
166632	Fee-for-Service	1366073975	1366073975	1	1	WU, MONICA PHD	3/13/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
166641	Fee-for-Service	1679569933	1679569933	1	1	WOESNER, RANDALL E MD	11/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44111	18	Ophthalmology	0	In state provider	None	248 HOSPITAL DR	None	UKIAH	CA	95482	4555	23	06045	39.15280713	-123.2037723	Mendocino County
166650	Fee-for-Service	1962768317	1962768317	1	1	WU, NATALIE B MD	11/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126427	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
166695	Fee-for-Service	1346433091	1346433091	1	1	WANG, ALEX K	6/22/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	405 KAINS AVE	102	ALBANY	CA	94706	1271	01	06001	37.89775845	-122.3005042	Alameda County
166701	Fee-for-Service	1396771960	1396771960	1	2	WONG, JAIR MD INC	7/30/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75543	41	Internal Medicine	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
166737	Fee-for-Service	1548707615	1548707615	1	1	WYANT, BILLIE J LCSW	5/21/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	681 LESLIE ST	None	UKIAH	CA	95482	3941	23	06045	39.1446949	-123.2010262	Mendocino County
166759	Fee-for-Service	1811224413	1811224413	1	1	WINDSOR CHEVIOT HILLS LLC	2/23/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3533 MOTOR AVENUE	None	LOS ANGELES	CA	90034	4806	19	06037	34.02588491	-118.4081613	Los Angeles County
166794	Fee-for-Service	1962420158	1962420158	1	1	WISS, DONALD A MD	6/1/2009	207K00000X	NA	Other	026	PHYSICIANS	30824	20	Orthopedic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
166800	Fee-for-Service	1760450845	1760450845	2	1	WING, J GERALD OD	11/5/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1901 MITCHELL RD	STE C	CERES	CA	95307	2400	50	06099	37.60176287	-120.9387462	Stanislaus County
166809	Fee-for-Service	1245455104	1245455104	1	1	WINN, THEODORA	4/10/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
166815	Fee-for-Service	1861842809	1861842809	1	1	WEINBAUM, KAREN MD MPH	1/10/2018	390200000X	NA	Other	026	PHYSICIANS	150760	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2664	07	06013	38.00771973	-122.1331484	Contra Costa County
166818	Fee-for-Service	1518941772	1518941772	1	1	WONG, GAIL A MD	8/31/1992	207RE0101X	NA	Endocrinology	026	PHYSICIANS	69666	41	Internal Medicine	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
166852	Fee-for-Service	1902984701	1902984701	1	1	WEBSTER, STEVEN F MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30231	02	General Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
166911	Fee-for-Service	1245308907	1245308907	1	1	WATERBROOK, ANNA L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N. CAMPBELL	None	PHOENIX	AZ	85724	0000	00	None	32.240493	-110.9460825	Pima County
166931	Fee-for-Service	1982788253	1982788253	1	1	WILLIAM, WINIFRED MD APC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	70389	41	Internal Medicine	0	In state provider	None	803 E ROSECRANS AVE	None	E RNCHO DMNGZ	CA	90221	2145	19	06037	33.9035073	-118.2153406	Los Angeles County
166939	Fee-for-Service	1558420281	1558420281	1	1	WALSH, DAVID J OD	12/16/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12815 HEACOCK ST	None	MORENO VALLEY	CA	92553	3116	33	06065	33.934842	-117.2438195	Riverside County
166994	Fee-for-Service	1063647238	1063647238	1	1	WALGREEN CO	8/11/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2795 FLORAL AVE	None	SELMA	CA	93662	2603	10	06019	36.57639181	-119.6264901	Fresno County
167020	Fee-for-Service	1750523478	1750523478	1	1	WU, MICHAEL C MD	1/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112396	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
167033	Fee-for-Service	1700133725	1700133725	1	1	WHELAN, KRISTIN CP	12/9/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4909 MURPHY CANYON RD	300	SAN DIEGO	CA	92123	4349	37	06073	32.8287682	-117.1197549	San Diego County
167095	Fee-for-Service	1841662038	1841662038	1	1	WHITE OAK CONGREGATE LLC	2/10/2016	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9301 WHITE OAK AVE	None	NORTHRIDGE	CA	91325	2336	19	06037	34.23924335	-118.520026	Los Angeles County
167126	Fee-for-Service	1184661837	1184661837	1	1	WU, CHUANG-KUO MD	5/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74302	13	Neurology (M.D. only)	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
167160	Fee-for-Service	1235220187	1235220187	1	1	WALKER, JONATHAN R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N. CAMPBELL AVE	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
167166	Fee-for-Service	1154495885	1154495885	1	1	WILSON, WILLIAM L	1/8/2003	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	WILSONS ABBEY MEDICAB	160 NORTH E ST	None	EXETER	CA	93221	1731	54	06107	36.29733818	-119.141451	Tulare County
167203	Fee-for-Service	1609881614	1609881614	1	1	WALGREEN CO	4/6/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7015 N WEST AVE	None	FRESNO	CA	93711	0461	10	06019	36.83777613	-119.8264816	Fresno County
167209	Fee-for-Service	1417070822	1417070822	1	1	WEISZ, IGOR MD	2/22/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	53529	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
167212	Fee-for-Service	1790788347	1790788347	1	1	WOODARD, JOSEPH P JR MD	6/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53334	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2722	38	06075	37.76332993	-122.4582988	San Francisco County
167218	Fee-for-Service	1982788253	1982788253	1	1	WILLIAM, WINIFRED MD APC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	70389	40	Pediatrics	0	In state provider	None	803 E ROSECRANS AVE	None	E RNCHO DMNGZ	CA	90221	2145	19	06037	33.9035073	-118.2153406	Los Angeles County
167246	Fee-for-Service	1518498179	1518498179	1	1	WU, HAO-HUA MD	10/7/2023	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	159767	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
167276	Fee-for-Service	1295800548	1295800548	1	1	WANG, JONATHAN C MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111287	30	Radiology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92193	2410	37	06073	32.7537975	-117.1658298	San Diego County
167301	Fee-for-Service	1770500092	1770500092	1	1	WAL-MART STORES INC	1/26/2000	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102526	19821 RINALDI ST	None	PORTER RANCH	CA	91326	4145	19	06037	34.277139	-118.566819	Los Angeles County
167345	Fee-for-Service	1972980340	1972980340	1	1	WATSON, LARONNA E LCSW	5/29/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	3220 SACRAMENTO ST	None	BERKELEY	CA	94702	2726	01	06001	37.84916151	-122.2781457	Alameda County
167380	Fee-for-Service	1306121116	1306121116	1	1	WALGREEN CO	3/5/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#15190	1399 ROXBURY DR	None	LOS ANGELES	CA	90035	4709	19	06037	34.05424495	-118.4023816	Los Angeles County
167406	Fee-for-Service	1811064769	1811064769	1	1	WU, JUSTIN S MD	1/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86044	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
167420	Fee-for-Service	1639625544	1639625544	1	1	WHITEFORD, SARAH A	11/14/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
167461	Fee-for-Service	1538584693	1538584693	1	2	WILBUR, KATHRYN C LCSW	12/10/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	74612	-	NOT APPLICABLE	0	In state provider	None	2445 W WHITESBRIDGE AVEN	None	FRESNO	CA	93706	1225	10	06019	36.73569321	-119.8393299	Fresno County
167499	Fee-for-Service	1023043304	1023043304	1	1	WEE, CHOONG Y MD	4/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	39800	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2690 PACIFIC AVE	STE 250A	LONG BEACH	CA	90806	2657	19	06037	33.805854	-118.1936805	Los Angeles County
167500	Fee-for-Service	1790788347	1790788347	1	1	WOODARD, JOSEPH P JR MD	6/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53334	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2722	38	06075	37.76332993	-122.4582988	San Francisco County
167523	Fee-for-Service	1205149390	1205149390	1	1	WOLSKY, SAMANTHA J LMFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
167550	Fee-for-Service	1164523247	1164523247	1	1	WILBORN, SONALI M MD	9/1/2020	207R00000X	NA	Other	026	PHYSICIANS	169738	41	Internal Medicine	0	In state provider	None	19929 GREENLEY RD	None	SONORA	CA	95370	5996	55	06109	37.9837971	-120.366851	Tuolumne County
167555	Fee-for-Service	1942617360	1942617360	1	1	WELEBIR, MORGAN MD	4/13/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	155810	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	1689	19	06037	34.15729818	-118.3277073	Los Angeles County
167559	Fee-for-Service	1508093923	1508093923	1	1	WAN, SHEILA T MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122116	66	Emergency Medicine (Urgent Care)	0	In state provider	None	309 WEST BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
167565	Fee-for-Service	1184144677	1184144677	1	1	WINTER, AMY E MD	1/5/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169874	None	None	0	In state provider	None	260 SAN JOSE ST	None	SALINAS	CA	93901	3901	27	06053	36.65808446	-121.6456618	Monterey County
167594	Fee-for-Service	1669029971	1669029971	1	1	WOLPERN, ELIZABETH A PSYD	10/29/2019	103TH0100X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
167600	Fee-for-Service	1104992502	1104992502	1	1	WALKER, KIMBERLY D	2/8/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	528 LAURA ANN CT	None	BAY POINT	CA	94565	1519	07	06013	38.03066774	-121.9592366	Contra Costa County
167643	Fee-for-Service	1184787962	1184787962	1	1	WAGNER, RITA R CNM	1/17/2007	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
167652	Fee-for-Service	1700111887	1700111887	1	1	WHITAKER, AMANDA T MD	10/11/2021	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	114996	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
167663	Fee-for-Service	1689610552	1689610552	1	1	WIELER, MARTIN W MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	30123	30	Radiology	0	In state provider	None	1720 TERMINO AVE	None	LONG BEACH	CA	90804	2104	19	06037	33.78889871	-118.1458784	Los Angeles County
167672	Fee-for-Service	1043263403	1043263403	1	1	WANG, QING MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75209	05	Anesthesiology	0	In state provider	None	725 E SANTA CLARA ST	STE 101	SAN JOSE	CA	95112	1936	43	06085	37.34328626	-121.8756374	Santa Clara County
167715	Fee-for-Service	1447597380	1447597380	1	1	WEAVER, SAGE K	1/30/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
167735	Fee-for-Service	1639188535	1639188535	1	1	WARRINGTON, JOHN PHD	12/9/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	931 BUENA VISTA ST	STE 307	DUARTE	CA	91010	1724	19	06037	34.141635	-117.9775755	Los Angeles County
167750	Fee-for-Service	1750396842	1750396842	1	1	WALGREEN COMPANY	6/28/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4495 MACK RD	None	SACRAMENTO	CA	95823	4545	34	06067	38.474874	-121.451292	Sacramento County
167781	Fee-for-Service	1598818197	1598818197	1	1	WONG, ALAN MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	66018	40	Pediatrics	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
167795	Fee-for-Service	1326525189	1326525189	1	1	WOOD, LINZIE PT	6/10/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2301 S MELROSE DR	None	VISTA	CA	92081	8788	37	06073	33.14409946	-117.2417711	San Diego County
167800	Fee-for-Service	1538367487	1538367487	1	1	WATERS, EDWARD P CRNA	8/24/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
167809	Fee-for-Service	1831278365	1831278365	1	1	WADHWANI, RESHMA A MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	48824	40	Pediatrics	0	In state provider	None	2185 WEST GRANT LINE RD	None	TRACY	CA	95377	7309	39	06077	37.75425686	-121.4567805	San Joaquin County
167818	Fee-for-Service	1992050215	1992050215	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2700 MARCONI AVE	None	SACRAMENTO	CA	95821	4914	34	06067	38.617002	-121.3990425	Sacramento County
167875	Fee-for-Service	1083732754	1083732754	1	1	WEIBELL, NICHOLAI J DO	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	9457	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	888 N ALTA AVENUE	None	DINUBA	CA	93618	3089	54	06107	36.552825	-119.395071	Tulare County
167883	Fee-for-Service	1255383451	1255383451	1	1	WOLFE, FREDERICK F MD	4/30/1985	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	18966	30	Radiology	0	In state provider	None	15243 VANOWEN ST	None	VAN NUYS	CA	91405	3605	19	06037	34.19394848	-118.4654115	Los Angeles County
167969	Fee-for-Service	1487038170	1487038170	1	1	WHITENACK, NICHOLAS A MD	8/28/2020	208600000X	NA	General Surgery	026	PHYSICIANS	168827	02	General Surgery	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
167970	Fee-for-Service	1649343591	1649343591	1	1	WILBUR, BRUCE G MD	2/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	18447	02	General Surgery	0	In state provider	None	2505 SAMARITAN DRIVE	SUITE 601	SAN JOSE	CA	95124	4014	43	06085	37.25111447	-121.9483395	Santa Clara County
168031	Fee-for-Service	1336436500	1336436500	1	1	WONG, JOHN K MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122357	41	Internal Medicine	0	In state provider	None	11370 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
168051	Fee-for-Service	1598024515	1598024515	1	1	WAY, CHRISTOPHER Y DO	3/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13317	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
168073	Fee-for-Service	1235161498	1235161498	1	1	WILLIAM CASE MD	9/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6701 AIRPORT BLVD	STE D430	MOBILE	AL	36608	6759	00	None	30.677742	-88.1977995	Mobile County
168088	Fee-for-Service	1093476905	1093476905	1	1	WELL TREVI CARLOTTA SNF LLC	12/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	41405 CARLOTTA DRIVE	None	PALM DESERT	CA	92211	3279	33	06065	33.74783409	-116.3438194	Riverside County
168095	Fee-for-Service	1184706152	1184706152	1	1	WYTHE CO COMM HOSP LLC	1/10/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	600 W RIDGE RD	None	WYTHEVILLE	VA	24382	1044	00	None	36.95307905	-81.09648302	Wythe County
168181	Fee-for-Service	1780765255	1780765255	1	1	WEBER, JAN B MD	6/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	83860	26	Psychiatry (child)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
168211	Fee-for-Service	1043204712	1043204712	1	1	WICKRAMASINGHE, KUMARI	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61111	22	Pathology (M.D. only)	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
168216	Fee-for-Service	1043305394	1043305394	1	1	WHANG, SEON H MD INC	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38291	41	Internal Medicine	0	In state provider	None	3663 W 6TH ST	STE 100	LOS ANGELES	CA	90020	3047	19	06037	34.06360557	-118.30199	Los Angeles County
168246	Fee-for-Service	1932130648	1932130648	1	1	WESLING, PAUL J OD	3/1/2000	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7850 BROADWAY	None	LEMON GROVE	CA	91945	1801	37	06073	32.7428152	-117.0294346	San Diego County
168262	Fee-for-Service	1154300754	1154300754	1	1	WEXLER, REBECCA S MD	9/20/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67073	None	None	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
168318	Fee-for-Service	1336436500	1336436500	1	1	WONG, JOHN K MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122357	68	Hematology	0	In state provider	None	11370 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
168383	Fee-for-Service	1184706152	1184706152	1	1	WYTHE CO COMM HOSP LLC	1/10/2007	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	600 W RIDGE RD	None	WYTHEVILLE	VA	24382	1044	00	None	36.95307905	-81.09648302	Wythe County
168388	Fee-for-Service	1700993524	1700993524	1	1	WLODARCZYK, DANIEL M MD	12/31/1985	207R00000X	NA	Other	026	PHYSICIANS	42994	41	Internal Medicine	0	In state provider	None	2401 KEITH ST	None	SAN FRANCISCO	CA	94124	3231	38	06075	37.72600973	-122.3923769	San Francisco County
168442	Fee-for-Service	1669905600	1669905600	1	1	WHITE, ANGELA B MD	6/29/2020	207P00000X	NA	Other	026	PHYSICIANS	159782	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95242	3635	39	06077	38.12188356	-121.285872	San Joaquin County
168455	Fee-for-Service	1548604721	1548604721	1	1	WONG, DARRIN J	4/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132965	41	Internal Medicine	0	In state provider	None	354 SANTA FE	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
168460	Fee-for-Service	1588811509	1588811509	1	1	WENDER, JON D MD	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94184	18	Ophthalmology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
168486	Fee-for-Service	1508437013	1508437013	1	1	WING, SYDNEY PSYD	3/11/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1307 W 6TH ST	108	CORONA	CA	92882	3294	33	06065	33.87790309	-117.589666	Riverside County
168506	Fee-for-Service	1588743223	1588743223	1	1	WONG, MARTIN K MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	50255	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
168510	Fee-for-Service	1043305394	1043305394	1	1	WHANG, SEON H MD INC	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38291	83	Rheumatology	0	In state provider	None	3663 W 6TH ST	STE 100	LOS ANGELES	CA	90020	3047	19	06037	34.06360557	-118.30199	Los Angeles County
168511	Fee-for-Service	1487748752	1487748752	1	1	WONG, BRIAN J MD	9/30/1995	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	50734	84	Surgery-Head and Neck	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
168561	Fee-for-Service	1346243516	1346243516	1	1	WADE,TERRY DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	255 S GRAND MESA DR	None	CEDAREDGE	CO	81413	3822	00	None	38.89863713	-107.9244902	Delta County
168564	Fee-for-Service	1295753069	1295753069	1	1	WAL-MART STORES, INC	10/29/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHAR 10-2708	32225 US HIGHWAY 79 S	None	TEMECULA	CA	92592	6811	33	06065	33.48162232	-117.0958985	Riverside County
168576	Fee-for-Service	1417330218	1417330218	1	1	WONG, IRIS G OD	9/21/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10906 VALLEY MALL	None	EL MONTE	CA	91731	2616	19	06037	34.07569098	-118.0370272	Los Angeles County
168584	Fee-for-Service	1366974859	1366974859	1	1	WANG, LIN	2/23/2023	207RN0300X	NA	Nephrology	026	PHYSICIANS	18540	None	None	0	In state provider	None	1400 S GRAND AVE	STE 800	LOS ANGELES	CA	90015	3048	19	06037	34.03692236	-118.2655238	Los Angeles County
168606	Fee-for-Service	1336436500	1336436500	1	1	WONG, JOHN K MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122357	78	Neoplastic Diseases/Oncology	0	In state provider	None	11370 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
168636	Fee-for-Service	1790790079	1790790079	1	1	WALGREENS CO	5/17/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #13000	860 EAST AVE	None	CHICO	CA	95926	1220	04	06007	39.76088587	-121.8450071	Butte County
168662	Fee-for-Service	1205499647	1205499647	1	1	WU, YUFAN MD	10/26/2024	2085R0001X	NA	Other	026	PHYSICIANS	181188	32	Radiation Therapy (D.O. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
168672	Fee-for-Service	1447332036	1447332036	1	1	WELLSPACE HEALTH	2/9/2010	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	8233 E STOCKTON BLVD	SUITE D	SACRAMENTO	CA	95828	8203	34	06067	38.459628	-121.4095815	Sacramento County
168710	Fee-for-Service	1225474273	1225474273	1	1	WHITE, GENEVA A	11/18/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152526	None	None	0	In state provider	None	2210 DEL PASO RD	None	SACRAMENTO	CA	95834	9671	34	06067	38.655189	-121.5091575	Sacramento County
168717	Fee-for-Service	1154472058	1154472058	1	1	WASHINGTON HOSPITAL	12/1/1977	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1746	01	06001	37.55769729	-121.9808861	Alameda County
168730	Fee-for-Service	1124040209	1124040209	1	1	WIN, PETER H MD	3/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85277	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	#1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
168750	Fee-for-Service	1750649414	1750649414	1	1	WECSLER, JULIE S MD	10/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120901	02	General Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
168784	Fee-for-Service	1902044951	1902044951	1	1	WONG, DEBORAH J MD	5/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101243	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
168792	Fee-for-Service	1851663470	1851663470	1	1	WELL BEING Q ACUPUNCTURIST	8/24/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	INC	680 WILSHIRE PL	STE 311, 312	LOS ANGELES	CA	90005	3950	19	06037	34.060581	-118.2877945	Los Angeles County
168810	Fee-for-Service	1427198027	1427198027	1	1	WESTCARE CALIFORNIA, INC	12/11/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2901 SOUTH H STREET	None	BAKERSFIELD	CA	93304	5602	15	06029	35.328573	-119.021358	Kern County
168825	Fee-for-Service	1063838894	1063838894	1	1	WALTON DIALYSIS LLC	4/21/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1405 W VALLEY BLVD	SUITE 100	COLTON	CA	92324	1910	36	06071	34.06940659	-117.3490124	San Bernardino County
168851	Fee-for-Service	1033780192	1033780192	1	1	WASLOSKI, EDWARD CRNA	3/4/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	4809	19	06037	34.158213	-118.328112	Los Angeles County
168857	Fee-for-Service	1982271490	1982271490	1	1	WHITE STAR HOME HEALTH INC	6/28/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4444 W RIVERSIDE DR	STE 204A	BURBANK	CA	91505	4048	19	06037	34.15216892	-118.348791	Los Angeles County
168903	Fee-for-Service	1710183512	1710183512	1	1	WU, SAMUEL WENDONG MD	6/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	74074	41	Internal Medicine	0	In state provider	None	7880 WREN AVE	STE D143	GILROY	CA	95020	7802	43	06085	37.00983795	-121.5870382	Santa Clara County
168908	Fee-for-Service	1255497459	1255497459	1	1	WADLE, DAWN M MD	1/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	69776	None	None	0	In state provider	None	3555 ARMY ST	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.7479947	-122.4209132	San Francisco County
168912	Fee-for-Service	1881995587	1881995587	1	1	WHITING, BONNIE JO PT	4/16/2020	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7737 MEANY AVE	B5-7	BAKERSFIELD	CA	93308	5266	15	06029	35.39423549	-119.0882835	Kern County
168960	Fee-for-Service	1447332036	1447332036	1	1	WELLSPACE HEALTH	2/9/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	8233 E STOCKTON BLVD	SUITE D	SACRAMENTO	CA	95828	8203	34	06067	38.459628	-121.4095815	Sacramento County
169005	Fee-for-Service	1154472058	1154472058	1	1	WASHINGTON HOSPITAL	3/1/1966	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1746	01	06001	37.55769729	-121.9808861	Alameda County
169009	Fee-for-Service	1417241472	1417241472	1	1	WILLIAMS, ROSAURA A MD	12/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	71252	22	Pathology (M.D. only)	0	In state provider	None	17821 PIONEER BLVD	None	ARTESIA	CA	90701	3901	19	06037	33.8691791	-118.0823685	Los Angeles County
169153	Fee-for-Service	1164174579	1164174579	1	1	WHEATLAND SCHOOL DISTRICT	7/1/2022	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	111 MAIN ST	None	WHEATLAND	CA	95692	9277	58	06115	39.01324588	-121.4196858	Yuba County
169199	Fee-for-Service	1417017906	1417017906	1	1	WOLFISH, JEFFREY S CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
169208	Fee-for-Service	1487764379	1487764379	1	1	WADA, JERRY K MD	1/1/1982	207R00000X	NA	Other	026	PHYSICIANS	22808	01	General Practice	0	In state provider	None	540 N CENTRAL AVE	STE 30	GLENDALE	CA	91203	1916	19	06037	34.15437	-118.257912	Los Angeles County
169225	Fee-for-Service	1285157362	1285157362	1	1	WHITE, BREANA LMFT	6/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
169248	Fee-for-Service	1447332036	1447332036	1	1	WELLSPACE HEALTH	2/9/2010	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	8233 E STOCKTON BLVD	SUITE D	SACRAMENTO	CA	95828	8203	34	06067	38.459628	-121.4095815	Sacramento County
169304	Fee-for-Service	1386707990	1386707990	2	1	WILLIAMS, CHRISTINE L LCSW	8/29/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 N MOUNTAIN AVE	219	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
169341	Fee-for-Service	1023649530	1023649530	1	1	WELL-BEING HOME HEALTH	10/28/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	224 E OLIVE AVE	STE 218	BURBANK	CA	91502	1234	19	06037	34.18109046	-118.3084839	Los Angeles County
169367	Fee-for-Service	1083047955	1083047955	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	4050 BARRANCA PARKWAY	STE 160	IRVINE	CA	92604	4785	30	06059	33.68293726	-117.8067799	Orange County
169386	Fee-for-Service	1699120592	1699120592	1	1	WANG, PENGCHENG MD	10/4/2022	2086S0105X	NA	General Surgery	026	PHYSICIANS	154166	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
169404	Fee-for-Service	1972565018	1972565018	1	1	WOLFE,TIMOTHY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3580 WEST 9000 SOUTH	None	WEST JORDAN	UT	84088	8812	00	None	40.590153	-111.974634	Salt Lake County
169410	Fee-for-Service	1295746345	1295746345	1	1	WONG, CONNIE L DPM	11/15/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	915 REDONDO AVE	None	LONG BEACH	CA	90804	5132	19	06037	33.77838734	-118.1524544	Los Angeles County
169451	Fee-for-Service	1528252178	1528252178	1	1	WALGREEN CO.	11/14/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	78218 VARNER ROAD	None	PALM DESERT	CA	92211	4134	33	06065	33.76159388	-116.2990734	Riverside County
169458	Fee-for-Service	1609190404	1609190404	1	1	WIEDERHOLD, BENJAMIN D MD	8/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109950	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5306	01	06001	37.698264	-122.090112	Alameda County
169474	Fee-for-Service	1689668048	1689668048	1	1	WEISSMAN, DIANE E MD	1/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	72337	08	Family Practice	0	In state provider	None	181 ANDRIEUX ST	STE 201	SONOMA	CA	95476	6920	49	06097	38.28809911	-122.4613026	Sonoma County
169485	Fee-for-Service	1528263308	1528263308	1	1	WALGREEN CO	8/29/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16020 PERRIS BLVD	None	MORENO VALLEY	CA	92551	4618	33	06065	33.887844	-117.2261435	Riverside County
169487	Fee-for-Service	1881633501	1881633501	1	1	WADA, JON GORDON OD	10/1/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2405 FOREST AVE	None	SAN JOSE	CA	95128	1500	43	06085	37.32698648	-121.9464315	Santa Clara County
169494	Fee-for-Service	1487764379	1487764379	1	1	WADA, JERRY K MD	1/1/1982	207R00000X	NA	Other	026	PHYSICIANS	22808	68	Hematology	0	In state provider	None	540 N CENTRAL AVE	STE 30	GLENDALE	CA	91203	1916	19	06037	34.15437	-118.257912	Los Angeles County
169522	Fee-for-Service	1417068800	1417068800	1	1	WEINMAN, DAVID STEVEN MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	69123	01	General Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
169536	Fee-for-Service	1811620693	1811620693	1	1	WONG, ELTON K OD	11/11/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	117 PELTON CENTER WAY	None	SAN LEANDRO	CA	94577	4815	01	06001	37.72269703	-122.1538905	Alameda County
169546	Fee-for-Service	1487764312	1487764312	1	1	WOOD, CHRISTINE M MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51022	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
169565	Fee-for-Service	1487066064	1487066064	1	1	WAGE, KATHRYN J CCC-SLP	12/21/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2505 W SHAW AVE	STE. 101	FRESNO	CA	93711	3334	10	06019	36.80619423	-119.8359004	Fresno County
169596	Fee-for-Service	1457375230	1457375230	1	1	WAT, LINDA I MD	12/31/1986	207L00000X	NA	Other	026	PHYSICIANS	50504	05	Anesthesiology	0	In state provider	None	12440 FIRESTONE BLVD	STE 101	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
169651	Fee-for-Service	1326518770	1326518770	1	1	WALKER, LESLIE E CCC-SLP	12/6/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1055 E COLORADO BLVD	STE 500	PASADENA	CA	91106	2380	19	06037	34.14595648	-118.1287575	Los Angeles County
169667	Fee-for-Service	1881741080	1881741080	1	1	WISEBURN ELEM SD	1/22/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	201 NORTH DOUGLAS ST	None	EL SEGUNDO	CA	90245	4637	19	06037	33.918876	-118.383247	Los Angeles County
169678	Fee-for-Service	1194898726	1194898726	1	1	WELLNESS CARE MEDICAL GROUP	9/30/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A PROFESSIONAL CORP	416 16TH AVE	None	SAN FRANCISCO	CA	94118	2812	38	06075	37.78011652	-122.4750458	San Francisco County
169685	Fee-for-Service	1003134180	1003134180	1	1	WON, SARA M MD	11/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143465	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
169686	Fee-for-Service	1053326322	1053326322	1	1	WALGREEN CO	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	615 BROADWAY	None	MILLBRAE	CA	94030	1909	41	06081	37.60368974	-122.3954957	San Mateo County
169690	Fee-for-Service	1003436064	1003436064	1	56	WS AUDIOLOGY (CALIFORNIA), P	11/23/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3920 GRAND	SUITE E	CHINO	CA	91710	5484	36	06071	33.99859228	-117.7190491	San Bernardino County
169715	Fee-for-Service	1679520464	1679520464	1	1	WILBER AND ASSOCIATES	11/1/2000	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	DEPT OF PATHOLOGY	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
169755	Fee-for-Service	1114075173	1114075173	1	1	WILKES, MADALYNNE MD	8/31/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77437	08	Family Practice	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
169765	Fee-for-Service	1295983252	1295983252	1	1	WALGREEN CO	1/16/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	26531 ALISO CREEK RD	None	ALISO VIEJO	CA	92656	2882	30	06059	33.57711083	-117.7232234	Orange County
169773	Fee-for-Service	1871906669	1871906669	1	1	WOOD, SCHUYLER J MD	8/7/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	137932	08	Family Practice	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
169790	Fee-for-Service	1134374705	1134374705	1	1	WISEMAN, CORI L NP	5/4/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	517 S MYRTLE AVE	SUITE 101	MONROVIA	CA	91016	6100	19	06037	34.14639513	-118.0009744	Los Angeles County
169834	Fee-for-Service	1487764312	1487764312	1	1	WOOD, CHRISTINE M MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51022	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
169874	Fee-for-Service	1689436511	1689436511	1	1	WILDER, SORAYA Q LPCC	4/4/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
169903	Fee-for-Service	1871942219	1871942219	1	1	WHITEMAN, ONNA S NP	6/25/2018	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
169948	Fee-for-Service	1346955846	1346955846	1	1	WALKER, LEEARTRIC TOLABOR C	5/21/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
169991	Fee-for-Service	1962499616	1962499616	1	1	WANG, GEORGE H	1/1/2002	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	73256	None	None	0	In state provider	OB/GYN MEDICAL CORP	2211 S ATLANTIC BLVD	STE B	MONTEREY PARK	CA	91754	6833	19	06037	34.03836069	-118.1451882	Los Angeles County
170004	Fee-for-Service	1679520464	1679520464	1	1	WILBER AND ASSOCIATES	11/1/2000	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	DEPT OF PATHOLOGY	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
170019	Fee-for-Service	1689014086	1689014086	1	1	WEINBERGER, ANDREW MD	10/10/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	168316	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
170024	Fee-for-Service	1760118459	1760118459	1	1	WHITE AND BLUE WELLNESS, INC	5/30/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3340 W BALL RD	SUITE B	ANAHEIM	CA	92804	3729	30	06059	33.81726795	-118.0068541	Orange County
170054	Fee-for-Service	1558371229	1558371229	1	1	WALKER, JENNIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73644	66	Emergency Medicine (Urgent Care)	0	In state provider	None	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.64575895	-118.9638914	Mono County
170063	Fee-for-Service	1902880867	1902880867	1	1	WESTEREN, ALAN C MD INC	5/19/2004	207W00000X	NA	Ophthalmology	026	PHYSICIANS	79738	18	Ophthalmology	0	In state provider	EXPERT VISION CARE MED	6529 LA JOLLA BLVD	None	LA JOLLA	CA	92037	6016	37	06073	32.82725176	-117.2768784	San Diego County
170139	Fee-for-Service	1508246703	1508246703	1	1	WEI, JUSTIN M MD	5/7/2021	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	169469	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
170167	Fee-for-Service	1609656917	1609656917	1	1	W ENTERPRISING LLC	10/3/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	255 WASHINGTON RD	423	CHOWCHILLA	CA	93610	1912	20	06039	37.11273153	-120.277683	Madera County
170290	Fee-for-Service	1306870605	1306870605	1	1	WHIPKEY-OLSON, ELIZABETH J	3/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9232	08	Family Practice	0	In state provider	DO	830 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
170305	Fee-for-Service	1568401255	1568401255	1	1	WELSH, WILLIAM DO	11/28/1985	207QG0300X	NA	Adult Primary Care	026	PHYSICIANS	4272	01	General Practice	0	In state provider	#105	16315 WHITTIER BLVD	None	WHITTIER	CA	90603	2908	19	06037	33.94033146	-117.9827221	Los Angeles County
170353	Fee-for-Service	1902880867	1902880867	1	1	WESTEREN, ALAN C MD INC	5/19/2004	207W00000X	NA	Ophthalmology	026	PHYSICIANS	79738	66	Emergency Medicine (Urgent Care)	0	In state provider	EXPERT VISION CARE MED	6529 LA JOLLA BLVD	None	LA JOLLA	CA	92037	6016	37	06073	32.82725176	-117.2768784	San Diego County
170365	Fee-for-Service	1134516602	1134516602	1	1	WANG, JOSEPH MD	11/2/2023	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	186289	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
170373	Fee-for-Service	1114554888	1114554888	1	1	WINKEL, MAIA MD	5/18/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
170376	Fee-for-Service	1114395134	1114395134	1	1	WESTCARE CALIFORNIA INC	4/29/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1045 BETHEL AVE	RMS 206,303,404	FRESNO	CA	93657	2985	10	06019	36.701289	-119.5744255	Fresno
170381	Fee-for-Service	1396857850	1396857850	1	1	WILLIAMS, ROBERT C DPM	10/31/1985	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	425 W BONITA AVE	STE 110	SAN DIMAS	CA	91773	2543	19	06037	34.10669347	-117.814932	Los Angeles County
170389	Fee-for-Service	1851362933	1851362933	1	1	WESSMAN, DYLAN E MD	4/12/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	108828	None	None	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
170418	Fee-for-Service	1316964729	1316964729	1	1	WAL-MART PHARMACY 101574	12/11/1990	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2300 WHITE LN	None	BAKERSFIELD	CA	93304	6917	15	06029	35.319744	-119.028834	Kern County
170421	Fee-for-Service	1932272887	1932272887	1	1	WHITEHILL, CHARLES C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79429	08	Family Practice	0	In state provider	None	768 MOUNTAIN RANCH RD	None	SAN ANDREAS	CA	95249	9707	05	06009	38.19058212	-120.6709481	Calaveras County
170468	Fee-for-Service	1568818227	1568818227	1	1	WONG, MEAGAN DO	5/15/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16538	None	None	0	In state provider	None	4560 ADMIRALTY WAY	STE 100	MARINA DEL REY	CA	90292	5424	19	06037	33.98364904	-118.4449069	Los Angeles County
170549	Fee-for-Service	1528073533	1528073533	1	1	WALGREEN CO	1/14/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	115 LAKE BLVD E	None	REDDING	CA	96003	2913	45	06089	40.61032419	-122.3732707	Shasta County
170559	Fee-for-Service	1821015173	1821015173	1	1	WAL-MART STORES INC	10/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM #10-2948	13310 TELEGRAPH RD	None	SANTA FE SPRINGS	CA	90670	4016	19	06037	33.94178249	-118.049787	Los Angeles County
170581	Fee-for-Service	1841520277	1841520277	1	1	WHITNEY, RYAN MD	9/1/2020	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
170597	Fee-for-Service	1255538773	1255538773	1	1	WHITTIER PULMONARY AND	12/19/2007	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CRITICAL CARE MEDICAL GR	12462 PUTMAN STREET	SUITE 208	WHITTIER	CA	90602	1049	19	06037	0	0	None
170792	Fee-for-Service	1134387335	1134387335	1	1	WANG, ANDREW S DO	9/17/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18767	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
170801	Fee-for-Service	1992880025	1992880025	1	1	WHITE, JACQUELINE A DPM	7/1/1987	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2617 E CHAPMAN AVE	STE 101	ORANGE	CA	92869	3251	30	06059	33.7878445	-117.8254845	Orange County
170841	Fee-for-Service	1801034293	1801034293	1	1	WASHINGTON, TIANA	8/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
170846	Fee-for-Service	1134182348	1134182348	1	1	WILLETT, MICHAEL W MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	56481	08	Family Practice	0	In state provider	None	2607 HARRIS ST	None	EUREKA	CA	95503	4806	12	06023	40.78053517	-124.1380509	Humboldt County
170856	Fee-for-Service	1710555420	1710555420	1	1	WHEELER, BRETT LMFT	1/24/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 SHATTUCK AVE	STE 200	BERKELEY	CA	94709	1601	01	06001	37.87811709	-122.2691431	Alameda County
170875	Fee-for-Service	1528130853	1528130853	1	1	WANG, WILLIAM D MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55780	05	Anesthesiology	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
170891	Fee-for-Service	1487944724	1487944724	1	1	WARD, BRIAN MD	10/5/2023	208600000X	NA	General Surgery	026	PHYSICIANS	-	None	None	1	Border provider	None	1707 W CHARLESTON BLVD	SUITE 160	LAS VEGAS	NV	89102	2354	00	None	36.15879353	-115.1643015	Clark County
170901	Fee-for-Service	1891855995	1891855995	1	1	WU, LI-CHYM NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7825 ATLANTIC AVE	None	CUDAHY	CA	90201	5022	19	06037	33.96396181	-118.1866866	Los Angeles County
171028	Fee-for-Service	1346520897	1346520897	1	1	WEISS, RICHARD C MD	10/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	51247	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVENUE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
171085	Fee-for-Service	1851499370	1851499370	1	1	WILSON, JOSEPH W JR MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	50443	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1201 W LA VETA AVE	STE 600	ORANGE	CA	92868	4211	30	06059	33.78034779	-117.8655767	Orange County
171100	Fee-for-Service	1518197284	1518197284	1	1	WRIGHT, LISA M PHD	1/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
171103	Fee-for-Service	1528480613	1528480613	1	1	WAL-MART STORES INC	3/14/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 N 2ND ST	None	EL CAJON	CA	92021	6444	37	06073	32.798439	-116.9358975	San Diego County
171104	Fee-for-Service	1902973738	1902973738	1	1	WANG, JENNIFER C MD	11/30/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	89476	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
171128	Fee-for-Service	1548362577	1548362577	1	1	WITTENBERG, MARTHA E MD	4/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	90355	08	Family Practice	0	In state provider	None	1250 BELLFLOWER BLVD	None	LONG BEACH	CA	90840	0201	19	06037	33.783174	-118.119528	Los Angeles County
171151	Fee-for-Service	1508026766	1508026766	1	1	WAYNE, EDGAR M II MD	11/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103826	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
171248	Fee-for-Service	1003983842	1003983842	1	1	WATSON, TERRE J OD	1/13/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
171299	Fee-for-Service	1316119969	1316119969	1	1	WASHINGTON, PATRICK NP	2/20/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
171300	Fee-for-Service	1043237712	1043237712	1	1	WAKIL, ADIL S MD	1/1/1994	207RI0008X	NA	Gastroenterology	026	PHYSICIANS	50595	10	Gastroenterology (M.D. only)	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
171320	Fee-for-Service	1215942594	1215942594	1	1	WALGREEN CO	3/17/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1424 BROADWAY ST	None	EUREKA	CA	95501	0134	12	06023	40.7935752	-124.1772614	Humboldt County
171343	Fee-for-Service	1740981711	1740981711	1	1	WILSON, CHARLES CCC-SLP	4/9/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
171346	Fee-for-Service	1073725768	1073725768	1	1	WONG, HANSON P MD	7/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	10230 ARTESIA BLVD	# 201	BELLFLOWER	CA	90706	2564	19	06037	33.8728276	-118.1160403	Los Angeles County
171350	Fee-for-Service	1679861157	1679861157	1	1	WILLIAM BETZ	12/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	950 S 500 W	None	BRIGHAM CITY	UT	84302	4724	00	None	41.49156616	-112.0242085	Box Elder County
171365	Fee-for-Service	1861159154	1861159154	1	1	WADE, MARY-CATHERINE LMFT	5/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	687 UPLAND RD	None	REDWOOD CITY	CA	94062	2828	41	06081	37.47213818	-122.2520257	San Mateo County
171373	Fee-for-Service	1851499370	1851499370	1	1	WILSON, JOSEPH W JR MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	50443	33	Thoracic Surgery	0	In state provider	None	1201 W LA VETA AVE	STE 600	ORANGE	CA	92868	4211	30	06059	33.78034779	-117.8655767	Orange County
171419	Fee-for-Service	1124139589	1124139589	1	1	WU, MICHAEL P MD	8/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103179	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
171454	Fee-for-Service	1316380694	1316380694	1	1	WAGNER, MEREDITH W MD	3/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146514	07	Dermatology	0	In state provider	None	3629 VISTA WAY	None	OCEANSIDE	CA	92056	4522	37	06073	33.1814285	-117.3093613	San Diego County
171473	Fee-for-Service	1841390051	1841390051	1	1	WRONSKI, CRAIG J DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	5560	36	Psychiatry	0	In state provider	None	18811 HUNTINGTON ST	STE 200	HUNTINGTON BEACH	CA	92648	6003	30	06059	33.68962104	-117.9954102	Orange County
171482	Fee-for-Service	1912943168	1912943168	1	1	WILSON, JAMES M MD	11/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75466	45	Nephrology (Renal-Kidney)	0	In state provider	None	200 MED PLAZA #365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
171507	Fee-for-Service	1285830430	1285830430	1	1	WONG-SEFIDAN, IDA C MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108162	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
171588	Fee-for-Service	1043237712	1043237712	1	1	WAKIL, ADIL S MD	1/1/1994	207RI0008X	NA	Gastroenterology	026	PHYSICIANS	50595	41	Internal Medicine	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
171591	Fee-for-Service	1376629899	1376629899	1	1	WON, DANA C MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74339	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
171632	Fee-for-Service	1073725768	1073725768	1	1	WONG, HANSON P MD	7/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	10230 ARTESIA BLVD	# 201	BELLFLOWER	CA	90706	2564	19	06037	33.8728276	-118.1160403	Los Angeles County
171643	Fee-for-Service	1336238781	1336238781	1	1	WILMS, DALE J MD	12/31/1988	207RP1001X	NA	Pulmonology	026	PHYSICIANS	31430	41	Internal Medicine	0	In state provider	None	130 INDEPENDENCE CIR	None	CHICO	CA	95973	4918	04	06007	39.77157762	-121.8747816	Butte County
171676	Fee-for-Service	1457366734	1457366734	1	1	WALGREEN CO	3/12/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	626 S CLOVIS AVE	None	FRESNO	CA	93727	4511	10	06019	36.73652674	-119.7002129	Fresno County
171681	Fee-for-Service	1245419829	1245419829	1	1	WELLNESS P.T. & REHAB, INC	6/18/2021	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1010 N GLENDALE AVE	STE 2	GLENDALE	CA	91206	2157	19	06037	34.16066484	-118.2372103	Los Angeles County
171682	Fee-for-Service	1245435791	1245435791	1	1	WHITE, ROBERT A MD	10/31/1985	208600000X	NA	General Surgery	026	PHYSICIANS	41035	02	General Surgery	0	In state provider	None	3434 VILLA LN	STE 260	NAPA	CA	94558	6415	28	06055	38.32515937	-122.2938358	Napa County
171683	Fee-for-Service	1437680725	1437680725	1	2	WINTER, WILLIAM K MD	4/13/2020	208M00000X	NA	Other	026	PHYSICIANS	157635	41	Internal Medicine	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
171686	Fee-for-Service	1619458791	1619458791	1	1	WANG, XIAOJUAN RCP	9/18/2018	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
171732	Fee-for-Service	1710941448	1710941448	1	1	WILLETT, DUWAYNE L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
171764	Fee-for-Service	1912943168	1912943168	1	1	WILSON, JAMES M MD	11/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75466	41	Internal Medicine	0	In state provider	None	200 MED PLAZA #365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
171807	Fee-for-Service	1962164921	1962164921	1	1	WATLINGTON, BENJAMIN CRNA	1/29/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
171819	Fee-for-Service	1205000122	1205000122	1	1	WILLIAMS, MELISSA J MD	8/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109254	78	Neoplastic Diseases/Oncology	0	In state provider	None	1020 29TH STREET	SUITE 680	SACRAMENTO	CA	95816	5126	34	06067	38.572803	-121.4685	Sacramento County
171852	Fee-for-Service	1578869129	1578869129	1	1	WHITEHEAD, JULIE K PSYD	8/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
171871	Fee-for-Service	1184702748	1184702748	1	1	WONG, ANGELA R MD	8/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74768	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
171893	Fee-for-Service	1124257324	1124257324	1	1	WELLSPACE HEALTH	9/2/2009	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY HEALTH CENTER	3415 MLK JR BLVD	None	SACRAMENTO	CA	95817	0000	34	06067	38.54376	-121.4644095	Sacramento County
171920	Fee-for-Service	1861424178	1861424178	1	1	WANG, MICHAEL L MD	9/30/1990	207W00000X	NA	Ophthalmology	026	PHYSICIANS	60598	18	Ophthalmology	0	In state provider	None	3300 WEBSTER ST	STE 212	OAKLAND	CA	94609	3120	01	06001	37.82132826	-122.2621843	Alameda County
171921	Fee-for-Service	1295881647	1295881647	1	1	WYATT, LORI A CRNA	3/30/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
171935	Fee-for-Service	1851711071	1851711071	1	1	WANG, KEVIN L MD	8/9/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	160156	04	Otology, Laryngology, Rhinology	0	In state provider	None	2950 RESEARCH PARK DR	None	SOQUEL	CA	95073	2000	44	06087	36.98692657	-121.9685264	Santa Cruz County
171962	Fee-for-Service	1841576014	1841576014	1	1	WOODWORTH, DEBORAH LMFT	9/6/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
172028	Fee-for-Service	1295834273	1295834273	1	1	WEBB, JANA L DO	8/29/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	7749	40	Pediatrics	0	In state provider	None	1600 E CITRUS AVE	None	REDLANDS	CA	92374	4270	36	06071	34.05557272	-117.1468659	San Bernardino County
172049	Fee-for-Service	1003836248	1003836248	1	1	WAGNER, WILLIS H MD	5/31/1986	2086S0129X	NA	General Surgery	026	PHYSICIANS	49464	02	General Surgery	0	In state provider	None	8631 W 3RD ST	STE 615E	LOS ANGELES	CA	90048	5910	19	06037	34.07361928	-118.3803143	Los Angeles County
172055	Fee-for-Service	1457684102	1457684102	1	1	WELTER, JENNIFER S	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
172087	Fee-for-Service	1740423201	1740423201	1	1	WILKINSON, EVELYN N	12/29/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
172109	Fee-for-Service	1205000122	1205000122	1	1	WILLIAMS, MELISSA J MD	8/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109254	68	Hematology	0	In state provider	None	1020 29TH STREET	SUITE 680	SACRAMENTO	CA	95816	5126	34	06067	38.572803	-121.4685	Sacramento County
172179	Fee-for-Service	1124257324	1124257324	1	1	WELLSPACE HEALTH	9/2/2009	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY HEALTH CENTER	3415 MLK JR BLVD	None	SACRAMENTO	CA	95817	0000	34	06067	38.54376	-121.4644095	Sacramento County
172184	Fee-for-Service	1629238829	1629238829	1	1	WALGREENS CO	10/6/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #09021	WALGREENS #09021 1811 S.	None	SAN JACINTO	CA	92583	5605	33	06065	0	0	None
172232	Fee-for-Service	1891883427	1891883427	1	1	WILLIAMS, CAROLYN D LCSW	5/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	8300 UTICA AVE	SUITE 155	RANCHO CUCAMONGA	CA	91730	3879	36	06071	34.10227306	-117.5715643	San Bernardino County
172240	Fee-for-Service	1679590905	1679590905	1	1	WAL-MART STORES, INC	12/20/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5048 VAN BUREN BLVD	None	RIVERSIDE	CA	92503	2667	33	06065	33.93562463	-117.4541686	Riverside County
172416	Fee-for-Service	1124045455	1124045455	1	1	WAL-MART STORES INC	10/6/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102053	470 AIRPORT AVE	None	WILLOWS	CA	95988	9701	11	06021	39.52381995	-122.2189793	Glenn County
172417	Fee-for-Service	1962635953	1962635953	1	1	WILLIAMS, LARABA LCSW	7/16/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
172477	Fee-for-Service	1003436064	1003436064	1	58	WS AUDIOLOGY (CALIFORNIA), P	7/28/2022	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4672 FLORIDA	SUITE 101	HEMET	CA	92545	3905	33	06065	33.7440453	-117.0218142	Riverside County
172491	Fee-for-Service	1205841590	1205841590	1	1	WALGREEN CO	8/1/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	24382 MUIRLANDS BLVD	None	LAKE FOREST	CA	92630	3679	30	06059	33.62847787	-117.7048119	Orange County
172518	Fee-for-Service	1255334587	1255334587	1	1	WDW JOINT VENTURE	3/25/1980	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	PO BOX 340	8425 IOWA ST	None	DOWNEY	CA	90241	4984	19	06037	33.93656525	-118.1322803	Los Angeles County
172555	Fee-for-Service	1417478926	1417478926	1	1	WONG, TAMMY P	9/25/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
172570	Fee-for-Service	1992737951	1992737951	1	1	WEINSTEIN, PHYLLIS A	6/14/1996	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	9822 LAS TUNAS DR	None	TEMPLE CITY	CA	91780	2208	19	06037	34.10738352	-118.0557019	Los Angeles County
172585	Fee-for-Service	1922520964	1922520964	1	1	WANG, QIAN	6/7/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
172588	Fee-for-Service	1184892796	1184892796	1	1	WEIR, DAVID C MD	5/28/2010	207R00000X	NA	Other	026	PHYSICIANS	111619	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
172605	Fee-for-Service	1003848581	1003848581	1	1	WU, YVONNE MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	78100	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
172637	Fee-for-Service	1023053857	1023053857	1	1	WARD, LYSA S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	400 S 43RD ST	None	RENTON	WA	98055	5714	00	None	47.44115887	-122.2138846	King County
172768	Fee-for-Service	1003436064	1003436064	1	58	WS AUDIOLOGY (CALIFORNIA), P	2/28/2022	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	4672 FLORIDA	SUITE 101	HEMET	CA	92545	3905	33	06065	33.7440453	-117.0218142	Riverside County
172801	Fee-for-Service	1053514588	1053514588	1	1	WALKER, IMANI J DO	1/12/2024	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	9660	-	NOT APPLICABLE	0	In state provider	None	1891 EFFIE ST	None	LOS ANGELES	CA	90026	1711	19	06037	34.08461594	-118.2570874	Los Angeles County
172808	Fee-for-Service	1619994845	1619994845	1	1	WAL-MART STORES INC	8/24/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 103516	1360 EASTLAKE PKWY	None	CHULA VISTA	CA	91915	4116	37	06073	32.63198831	-116.9665341	San Diego County
172855	Fee-for-Service	1821252628	1821252628	1	1	WOOLMORE, CAROLINA	7/1/1998	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1127 WILSHIRE BLVD	STE 901	LOS ANGELES	CA	90017	3910	19	06037	34.05270508	-118.2641005	Los Angeles County
172856	Fee-for-Service	1598037178	1598037178	1	1	WILCOX, WENONAH LAC	6/6/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
172901	Fee-for-Service	1720349061	1720349061	1	1	WATSON, THOMAS J MD	2/6/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	30 MARK WEST SPRINGS RD	None	SANTA ROSA	CA	95403	1436	49	06097	38.4962723	-122.752117	Sonoma County
172916	Fee-for-Service	1932436128	1932436128	1	1	WANG, BRUCE M MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	107381	10	Gastroenterology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
172933	Fee-for-Service	1306517289	1306517289	1	1	WILSON, KRISTINA M CCC-SLP	12/16/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 S HAVEN AVE	SUITE 190	ONTARIO	CA	91761	2969	36	06071	34.046307	-117.576387	San Bernardino County
172995	Fee-for-Service	1568443307	1568443307	1	1	WONG, ALVIN D MD	9/30/1989	207R00000X	NA	Other	026	PHYSICIANS	60945	41	Internal Medicine	0	In state provider	None	3838 CALIFORNIA ST	RM 310	SAN FRANCISCO	CA	94118	1505	38	06075	37.78591809	-122.4575439	San Francisco County
173062	Fee-for-Service	1942323746	1942323746	1	1	WALKER, CARLTON M JR	12/13/2006	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	7040 CROMWELL WAY	None	SACRAMENTO	CA	95822	4230	34	06067	38.497842	-121.4967645	Sacramento County
173070	Fee-for-Service	1467773978	1467773978	1	1	WHITE, TERRIS L MD	6/29/2022	208600000X	NA	General Surgery	026	PHYSICIANS	136250	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
173080	Fee-for-Service	1114536281	1114536281	1	1	WARMFUL LOVE HOSPICE, INC	11/5/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14416 HAMLIN ST	STE 209	VAN NUYS	CA	91401	1488	19	06037	34.18863949	-118.4472225	Los Angeles County
173122	Fee-for-Service	1447332036	1447332036	1	5	WELLSPACE HEALTH	4/23/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	5321 STOCKTON BLVD	None	SACRAMENTO	CA	95820	5428	34	06067	38.527101	-121.442508	Sacramento County
173156	Fee-for-Service	1386353746	1386353746	1	1	WILSON, SIERRA M NP	12/19/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	660 BAKER STREET	STE A-102	COSTA MESA	CA	92626	4407	30	06059	33.68014263	-117.8842009	Orange County
173159	Fee-for-Service	1538288337	1538288337	1	1	WANG, DAVID W MD	3/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103919	20	Orthopedic Surgery	0	In state provider	None	2801 K ST	STE 310	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
173192	Fee-for-Service	1639104847	1639104847	1	1	WELLS, EDWIN G. MD	5/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	7533	00	None	43.470198	-111.9901955	Bonneville County
173198	Fee-for-Service	1942369160	1942369160	1	1	WRIGHT,MARK D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 E AJO WAY	None	TUCSON	AZ	85713	6204	00	None	32.175801	-110.9306925	Pima County
173201	Fee-for-Service	1326346594	1326346594	1	1	WONG, HELEN M MD	8/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111444	08	Family Practice	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
173234	Fee-for-Service	1245339787	1245339787	1	2	WINKLER, DANIELLE M MD	8/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	64654	40	Pediatrics	0	In state provider	None	16300 SAND CANYON AVENUE	SUITE 311	IRVINE	CA	92618	3703	30	06059	33.66115075	-117.7742405	Orange County
173253	Fee-for-Service	1932209376	1932209376	1	1	WARM SPRINGS ROAD CVS LLC	11/14/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	2425 E DESERT INN RD	None	LAS VEGAS	NV	89121	3616	00	None	36.12979948	-115.117839	Clark County
173292	Fee-for-Service	1588952204	1588952204	1	1	WILSON, BRIAN A LMFT	7/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LING	507 W FOOTHILL BLVD	B	MONROVIA	CA	91016	2021	19	06037	34.1512953	-118.0102317	Los Angeles County
173314	Fee-for-Service	1518450113	1518450113	1	1	WILLIAMS, JOHN DO	11/1/2023	208M00000X	NA	Other	026	PHYSICIANS	21824	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
173367	Fee-for-Service	1114536281	1114536281	1	1	WARMFUL LOVE HOSPICE, INC	11/5/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14416 HAMLIN ST	STE 209	VAN NUYS	CA	91401	1488	19	06037	34.18863949	-118.4472225	Los Angeles County
173385	Fee-for-Service	1710673660	1710673660	1	1	WALIN, ERICA NP	7/31/2023	163WP0808X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1300 E SHAW AVE	SUITE 109	FRESNO	CA	93710	7903	10	06019	36.80872147	-119.765979	Fresno County
173409	Fee-for-Service	1447332036	1447332036	1	5	WELLSPACE HEALTH	4/23/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	5321 STOCKTON BLVD	None	SACRAMENTO	CA	95820	5428	34	06067	38.527101	-121.442508	Sacramento County
173461	Fee-for-Service	1003958976	1003958976	1	1	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	955 E THOMPSON BLVD	None	VENTURA	CA	93001	3008	56	06111	34.27831162	-119.286174	Ventura County
173466	Fee-for-Service	1205910288	1205910288	1	1	WILES, SHARON M DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1620 PENNSYLVANIA AVE	STE A	FAIRFIELD	CA	94533	3509	48	06095	38.2594713	-122.0498661	Solano County
173544	Fee-for-Service	1841275591	1841275591	1	1	WATTS, DARON	7/11/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	187173	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
173560	Fee-for-Service	1093931107	1093931107	1	1	WARNER MOUNTAIN INDIAN	3/3/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CLINIC	FT BIDWELL INDIAN	RESERVATION	FORT BIDWELL	CA	91112	0000	25	06049	0	0	None
173586	Fee-for-Service	1457409476	1457409476	1	1	WAKAMATSU, BENJAMIN K MD	3/18/2008	207P00000X	NA	Other	026	PHYSICIANS	89026	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
173628	Fee-for-Service	1700286945	1700286945	1	1	WALGREEN CO	11/18/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	105 E GLEN OAKS BLVD	None	GLENDALE	CA	91207	2007	19	06037	34.15926623	-118.2549129	Los Angeles County
173648	Fee-for-Service	1780921379	1780921379	1	1	WHITE, FRANCES-ANNE A NP	10/20/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
173665	Fee-for-Service	1346398740	1346398740	1	1	WHITE, GEOFFREY G MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	15580	18	Ophthalmology	0	In state provider	None	966 CASS ST	STE 100	MONTEREY	CA	93940	4540	27	06053	36.5924291	-121.8964192	Monterey County
173688	Fee-for-Service	1780770560	1780770560	1	1	WEISS, DONALD H MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	25184	01	General Practice	0	In state provider	None	3811 EL CAJON BLVD	None	SAN DIEGO	CA	92105	1020	37	06073	32.75512069	-117.1114152	San Diego County
173722	Fee-for-Service	1275593170	1275593170	1	1	WANG, CHIA-YING MD	1/7/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	52277	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
173724	Fee-for-Service	1487684445	1487684445	1	1	WAPEN, BRUCE D MD	2/25/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	28117	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1000 VENTURA AVE	None	CHOWCHILLA	CA	93610	2368	20	06039	37.12227595	-120.2716274	Madera County
173748	Fee-for-Service	1003958976	1003958976	1	1	WESTERN PACIFIC MED-CORP	7/1/1999	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	955 E THOMPSON BLVD	None	VENTURA	CA	93001	3008	56	06111	34.27831162	-119.286174	Ventura County
173765	Fee-for-Service	1003929712	1003929712	1	1	WYS, KENNETH G MD	5/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	64344	05	Anesthesiology	0	In state provider	None	616 WITMER ST	None	LOS ANGELES	CA	90017	2308	19	06037	34.0549933	-118.2658354	Los Angeles County
173779	Fee-for-Service	1699031252	1699031252	1	1	WU, ANNIE MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	123849	22	Pathology (M.D. only)	0	In state provider	None	305 PARK CREEK DRIVE	None	CLOVIS	CA	93611	4426	10	06019	36.84077548	-119.7076545	Fresno County
173809	Fee-for-Service	1093582421	1093582421	1	1	WEAVER, JAMIE T DOULA	6/10/2024	176B00000X	NA	Licensed Midwife	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	49	06097	0	0	None
173819	Fee-for-Service	1720173248	1720173248	1	1	WEBBER, DOUGLAS A MD INC	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83278	41	Internal Medicine	0	In state provider	None	3171 LOS FELIZ BLVD	STE 309	LOS ANGELES	CA	90039	1537	19	06037	34.12369709	-118.2682266	Los Angeles County
173845	Fee-for-Service	1093931107	1093931107	1	1	WARNER MOUNTAIN INDIAN	3/3/2003	261QR1300X	NA	Rural Health Center	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	0	In state provider	HEALTH CLINIC	FT BIDWELL INDIAN	RESERVATION	FORT BIDWELL	CA	91112	0000	25	06049	0	0	None
173913	Fee-for-Service	1821037912	1821037912	1	1	WHITE, KLANE K MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CHILDRENS UNIV MED GRP	4500 SAND POINT WAY NE,	#100	SEATTLE	WA	98105	0000	00	None	47.66165594	-122.2864502	King County
173918	Fee-for-Service	1134624521	1134624521	1	1	WHEELER, ROSEMARIE T LMFT	6/5/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	105045	-	NOT APPLICABLE	0	In state provider	None	23931 WARREN ROAD	None	SAN JACINTO	CA	92582	3795	33	06065	33.773895	-117.037683	Riverside County
173925	Fee-for-Service	1639516305	1639516305	1	1	WAL-MART STORES, INC	8/29/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12840 BEACH BLVD	None	STANTON	CA	90680	0001	30	06059	33.774876	-117.991134	Orange County
173977	Fee-for-Service	1780770560	1780770560	1	1	WEISS, DONALD H MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	25184	08	Family Practice	0	In state provider	None	3811 EL CAJON BLVD	None	SAN DIEGO	CA	92105	1020	37	06073	32.75512069	-117.1114152	San Diego County
173986	Fee-for-Service	1063020121	1063020121	1	1	WARKUS, ERICA L MD	6/11/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	54	06107	36.327888	-119.294919	Tulare County
174007	Fee-for-Service	1275593170	1275593170	1	1	WANG, CHIA-YING MD	1/7/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	52277	38	Geriatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
174012	Fee-for-Service	1881631935	1881631935	1	1	WANG, SAMUEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RADIOLOGY IMAGING ASSOC	LITTLETON HOSPITAL	3425 S CLARKSON	ENGELWOOD	CO	80113	0000	00	None	0	0	None
174022	Fee-for-Service	1538587019	1538587019	1	1	WASHINGTON, LATOYA A	3/13/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
174035	Fee-for-Service	1467792440	1467792440	1	1	WALDO, MICHAEL PHD	4/17/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
174063	Fee-for-Service	1215943261	1215943261	1	1	WANG, SHIH-FANG MD	1/31/1992	207R00000X	NA	Other	026	PHYSICIANS	69597	41	Internal Medicine	0	In state provider	PERMANENTE MEDICAL GROUP	4785 N 1ST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
174126	Fee-for-Service	1881615581	1881615581	1	1	WARD-GAINES, JACQUELINE A MD	12/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
174127	Fee-for-Service	1467608422	1467608422	1	1	WILLIAMS, NICOLE C LMFT	10/7/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	TH PSYCHOTHERAPY	17315 STUDEBAKER	300 K	CERRITOS	CA	90703	2563	19	06037	33.87330903	-118.0998456	Los Angeles County
174198	Fee-for-Service	1982743795	1982743795	1	1	WESTON-THOMPSON, JUDITH LMF	10/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	700 E ST	205	SAN RAFAEL	CA	94901	2782	21	06041	37.97112293	-122.533553	Marin County
174286	Fee-for-Service	1083069306	1083069306	1	1	WANG, KANG MD	6/24/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	160793	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
174328	Fee-for-Service	1912022492	1912022492	1	1	WALLACE, CAROL L LMFT	12/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2376 MARITIME DR	STE 200	ELK GROVE	CA	95758	3640	34	06067	38.411631	-121.4827695	Sacramento County
174346	Fee-for-Service	1215943261	1215943261	1	1	WANG, SHIH-FANG MD	1/31/1992	207R00000X	NA	Other	026	PHYSICIANS	69597	66	Emergency Medicine (Urgent Care)	0	In state provider	PERMANENTE MEDICAL GROUP	4785 N 1ST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
174357	Fee-for-Service	1386696748	1386696748	1	1	WRIGHT, MARK T MD	9/10/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	81144	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
174369	Fee-for-Service	1851931018	1851931018	1	1	WORKMAN, AMBER	6/28/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
174406	Fee-for-Service	1861569246	1861569246	1	1	WOLDERMARIAM, FISSEHA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4888 N STONE AVE	None	TUCSON	AZ	85704	5749	00	None	32.29425	-110.970225	Pima County
174409	Fee-for-Service	1417021718	1417021718	1	1	WILLIAMS, ERIC MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	83353	02	General Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
174414	Fee-for-Service	1649779042	1649779042	1	1	WRIGHT, TODD C CRNA	3/6/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
174416	Fee-for-Service	1831514330	1831514330	1	1	WAL-MART STORES, INC	5/16/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	83053 AVENUE 48	None	COACHELLA	CA	92236	9551	33	06065	33.70029848	-116.215191	Riverside County
174434	Fee-for-Service	1235253428	1235253428	1	1	WU, SHIRLEY X MD	12/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	93381	25	Physical Medicine and Rehabilitation	0	In state provider	None	3200 KEARNEY STREET	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
174441	Fee-for-Service	1811008469	1811008469	1	1	WHEELER, KATHRYN M MD	10/28/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	105633	40	Pediatrics	0	In state provider	None	320 W PUEBLO STREET	None	SANTA BARBARA	CA	93105	4311	42	06083	34.42954414	-119.7230551	Santa Barbara County
174504	Fee-for-Service	1245342708	1245342708	1	1	WANG, PAUL J MD	7/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86914	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
174510	Fee-for-Service	1790701175	1790701175	1	1	WARM SPRINGS HOME HEALTH INC	11/8/2007	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	54 WHITNEY PLACE	None	FREMONT	CA	94539	7662	01	06001	37.47000163	-121.918765	Alameda County
174557	Fee-for-Service	1275849903	1275849903	1	1	WEBER, LAUREN D DO	10/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12939	08	Family Practice	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
174592	Fee-for-Service	1417192634	1417192634	1	1	WAL-MART STORES, INC	1/21/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 105434	15555 HESPERIAN BLVD	None	SAN LEANDRO	CA	94579	1801	01	06001	37.68698246	-122.1301618	Alameda County
174656	Fee-for-Service	1285723767	1285723767	1	1	WARMINK, CORWIN A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 SEVENTH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
174658	Fee-for-Service	1710965249	1710965249	1	1	WILLIAMS,BEVERLY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2222 PHILADELPHIA DR	None	DAYTON	OH	45406	1813	00	None	39.78749248	-84.23490647	Montgomery County
174669	Fee-for-Service	1386905305	1386905305	1	1	WILLIAMS, CRYSTAL D LMFT	2/24/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
174734	Fee-for-Service	1609450550	1609450550	1	1	WOO, ANDY BON BARREDO NP	9/8/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
174741	Fee-for-Service	1548091150	1548091150	1	1	WEHNER, JESSELA	8/15/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	24	06047	0	0	None
174754	Fee-for-Service	1003231572	1003231572	1	1	WAL-MART STORES, INC	5/14/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	121 NORTH BEACH AVE	None	ANAHEIM	CA	92801	6135	30	06059	33.833151	-117.9936395	Orange County
174778	Fee-for-Service	1649479585	1649479585	1	1	WONG,TIMOTHY C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1515 LOCUST STREET	5TH FLOOR	PITTSBURGH	PA	15219	0000	00	None	40.43681854	-79.9845616	Allegheny County
174779	Fee-for-Service	1003436064	1003436064	1	26	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	4345 GLENCOE AVENUE	C12A	MARINA DEL REY	CA	90292	6466	19	06037	33.98663694	-118.4397916	Los Angeles County
174794	Fee-for-Service	1427791029	1427791029	1	1	WESSON-STOUT, LAUREN K CNP	6/10/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
174800	Fee-for-Service	1033537634	1033537634	1	1	WILSON, ZACHARY S MD	4/1/2019	207P00000X	NA	Other	026	PHYSICIANS	154953	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
174824	Fee-for-Service	1902894959	1902894959	1	1	WELTON, HERSHEL B OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	#120	303 W LINCOLN AVE	None	ANAHEIM	CA	92805	2936	30	06059	33.83508976	-117.9177981	Orange County
174847	Fee-for-Service	1275849903	1275849903	1	1	WEBER, LAUREN D DO	10/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12939	01	General Practice	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
174861	Fee-for-Service	1275018186	1275018186	1	1	WRIGHT, MONICA M NP	10/23/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
174878	Fee-for-Service	1326089079	1326089079	1	1	WU, JACK C MD	1/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70880	41	Internal Medicine	0	In state provider	None	3762 ATLANTIC AVE	STE C	LONG BEACH	CA	90807	6670	19	06037	33.826347	-118.1850025	Los Angeles County
174888	Fee-for-Service	1891130001	1891130001	1	2	WANG, KRISTINA E MD	10/19/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	136100	None	None	0	In state provider	None	8800 WHITTIER BLVD	None	PICO RIVERA	CA	90660	2658	19	06037	34.00205052	-118.0857646	Los Angeles County
174902	Fee-for-Service	1407331036	1407331036	1	2	WELLWORKS PHYSICAL THERAPY A	10/31/2024	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ND REHABILITATION, INC.	1110 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1812	19	06037	34.17656016	-118.3209834	Los Angeles County
174922	Fee-for-Service	1306119623	1306119623	1	1	WHISPER HEARING CENTER INC	6/20/2014	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 DOUGLAS BLVD	STE 992	ROSEVILLE	CA	95661	3639	31	06061	38.74415734	-121.2570324	Placer County
174947	Fee-for-Service	1326088964	1326088964	1	2	WHITE, BRETT A MD	11/25/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74766	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
174968	Fee-for-Service	1699091629	1699091629	1	1	WILLIAMS, BENJAMIN T MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124541	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1165 MONTGOMERY DRIVE	None	SANTA ROSA	CA	95405	4897	49	06097	38.443806	-122.701374	Sonoma County
175032	Fee-for-Service	1902111255	1902111255	1	1	WEBER, KATIE LCSW	2/26/2019	1041S0200X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
175038	Fee-for-Service	1710154299	1710154299	1	1	WAGNER, WILLIAM MD	6/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128086	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
175068	Fee-for-Service	1346458585	1346458585	1	1	WINER, BURTON N LMFT	4/7/2016	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	112 E CHAPMAN AVE	A5	ORANGE	CA	92866	1454	30	06059	33.78785148	-117.852237	Orange County
175070	Fee-for-Service	1003436064	1003436064	1	26	WS AUDIOLOGY (CALIFORNIA), P	8/27/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	4345 GLENCOE AVENUE	C12A	MARINA DEL REY	CA	90292	6466	19	06037	33.98663694	-118.4397916	Los Angeles County
175074	Fee-for-Service	1154390821	1154390821	1	1	WHANG, JACQUELINE MD	11/30/1993	207R00000X	NA	Other	026	PHYSICIANS	78268	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
175080	Fee-for-Service	1508511015	1508511015	1	1	WOOD, ADAM R CNP	4/13/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
175094	Fee-for-Service	1114137270	1114137270	1	1	WHYTE, MARK R MD INC	6/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85889	02	General Surgery	0	In state provider	None	608 G ST	STE 2B	BRAWLEY	CA	92227	7780	13	06025	32.97749255	-115.5318435	Imperial County
175122	Fee-for-Service	1417026436	1417026436	1	1	WILLIAMS, MARCUS L MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98711	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
175126	Fee-for-Service	1720427149	1720427149	1	1	WANG, ANDREW S MD	9/25/2019	208600000X	NA	General Surgery	026	PHYSICIANS	134517	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
175188	Fee-for-Service	1407331036	1407331036	1	2	WELLWORKS PHYSICAL THERAPY A	10/31/2024	225XH1200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ND REHABILITATION, INC.	1110 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1812	19	06037	34.17656016	-118.3209834	Los Angeles County
175219	Fee-for-Service	1225219322	1225219322	1	1	WATSON, PATRICK C DO	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9903	08	Family Practice	0	In state provider	None	3733 SAN DIMAS STREET	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
175260	Fee-for-Service	1568550408	1568550408	1	1	WOLF, TODD A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 SEVENTH AVE	None	FORT WORTH	TX	76104	0000	00	None	32.73710364	-97.3419336	Tarrant County
175294	Fee-for-Service	1881839389	1881839389	1	1	WEYMOUTH, DAVID A CP	5/3/2002	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2211 N CALIFORNIA ST	None	STOCKTON	CA	95204	5503	39	06077	37.97379136	-121.2903686	San Joaquin County
175303	Fee-for-Service	1306136155	1306136155	1	1	WOOD, WILLIAM S MD	9/14/2021	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
175312	Fee-for-Service	1497192710	1497192710	1	1	WON, ERIC H MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134658	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
175322	Fee-for-Service	1508391822	1508391822	1	1	WESTERN GASTROENTEROLOGY CAR	7/24/2019	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	E ASSOCIATES INC	8860 CENTER DR STE 420	None	LA MESA	CA	91942	7001	37	06073	32.78189749	-117.0075062	San Diego County
175335	Fee-for-Service	1467640011	1467640011	1	1	WILSHIRE ONCOLOGY	7/3/2008	174400000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	MEDICAL GROUP, INC	1250 S SUNSET	STE 303	WEST COVINA	CA	91790	3912	19	06037	34.0610671	-117.9463685	Los Angeles County
175426	Fee-for-Service	1881960870	1881960870	1	1	WHITE, SARAH M MD	7/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117266	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
175432	Fee-for-Service	1609858034	1609858034	1	1	WILBLIN, RAYMOND T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	STATE UNIV OF IOWA	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
175444	Fee-for-Service	1003436064	1003436064	1	41	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	363 LOWER SACRAMENTO ROA	SUITE B	LODI	CA	95242	3323	39	06077	38.12827053	-121.3067901	San Joaquin County
175451	Fee-for-Service	1417998808	1417998808	1	1	WARGO, EDWARD R MD	1/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	37273	01	General Practice	0	In state provider	None	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
175496	Fee-for-Service	1114048741	1114048741	1	1	WHITWAM, WAYNE B MD	12/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90625	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	25470 MEDICAL CENTER DR	SUITE 201	MURRIETA	CA	92562	4901	33	06065	33.55723646	-117.1859554	Riverside County
175623	Fee-for-Service	1467640011	1467640011	1	1	WILSHIRE ONCOLOGY	7/3/2008	174400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	MEDICAL GROUP, INC	1250 S SUNSET	STE 303	WEST COVINA	CA	91790	3912	19	06037	34.0610671	-117.9463685	Los Angeles County
175624	Fee-for-Service	1386697027	1386697027	1	1	WILLIAM F COUGHLIN	5/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	375 DIXMYTH AVE	None	CINCINNATI	OH	45220	2475	00	None	39.14076839	-84.52169161	Hamilton County
175628	Fee-for-Service	1366044778	1366044778	1	1	WAGNER, CHRISTOPHER LMFT	4/17/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 S FARRELL DR	STE B210	PALM SPRINGS	CA	92262	7933	33	06065	33.81787498	-116.5180068	Riverside County
175645	Fee-for-Service	1811055239	1811055239	1	1	WALKER, KATHERINE L PHD	10/10/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
175656	Fee-for-Service	1437128733	1437128733	1	1	WILLIAMS, TODD A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2770 CORTEZ AVE	None	IDAHO FALLS	ID	83404	7590	00	None	43.47282307	-111.9887831	Bonneville County
175663	Fee-for-Service	1962580639	1962580639	1	1	WALKER-BARNES, JANET MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	63998	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
175692	Fee-for-Service	1619314697	1619314697	1	1	WALTERS, MALLORY D LMFT	11/14/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	711 JEFFERSON STREET	SUITE 203	FAIRFIELD	CA	94533	5166	48	06095	38.249514	-122.0419165	Solano County
175705	Fee-for-Service	1376791616	1376791616	1	1	WEST, JUSTIN E MD	11/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102688	02	General Surgery	0	In state provider	None	230 S MAIN ST	STE 100	ORANGE	CA	92868	3851	30	06059	33.785154	-117.867318	Orange County
175723	Fee-for-Service	1508121914	1508121914	1	1	WAL-MART STORES, INC	12/28/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1421 COFFEE RD	None	MODESTO	CA	95355	3170	50	06099	37.66456718	-120.9757234	Stanislaus County
175732	Fee-for-Service	1841356037	1841356037	1	1	WARNE, THOMAS R MD	9/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83344	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
175742	Fee-for-Service	1417998808	1417998808	1	1	WARGO, EDWARD R MD	1/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	37273	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
175788	Fee-for-Service	1649835604	1649835604	1	1	WONG, CORINNE F OD	8/24/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9170 HAVEN AVE	SUITE 102	RANCHO CUCAMONGA	CA	91730	5416	36	06071	34.087491	-117.5758895	San Bernardino County
175822	Fee-for-Service	1861780934	1861780934	1	1	WANG, YEA-CHING MFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	96684	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	None	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
175823	Fee-for-Service	1164772604	1164772604	1	1	WAL-MART STORES, INC	12/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6005 MADISON AVE	None	CARMICHAEL	CA	95608	0521	34	06067	38.662596	-121.32486	Sacramento County
175869	Fee-for-Service	1154457026	1154457026	1	1	WEISS, ERIC L MD	1/31/1990	207P00000X	NA	Other	026	PHYSICIANS	58351	01	General Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
175909	Fee-for-Service	1588925614	1588925614	1	1	WOODSON, LATASHA	4/2/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6301 ARDEN AVENUE	None	HIGHLAND	CA	92346	2058	36	06071	34.139511	-117.234902	San Bernardino County
176009	Fee-for-Service	1851693071	1851693071	1	1	WU, KESHENG MD INC	6/1/2001	207R00000X	NA	Other	026	PHYSICIANS	66735	41	Internal Medicine	0	In state provider	None	9209 COLOMA RD	STE 4500	WHITTIER	CA	90605	1823	19	06037	33.9505367	-118.0054552	Los Angeles County
176022	Fee-for-Service	1689988271	1689988271	1	1	WATSONS PHARMACY INC	5/12/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8622 GARVEY AVE	SUITE 102	ROSEMEAD	CA	91770	3291	19	06037	34.06264953	-118.081098	Los Angeles County
176096	Fee-for-Service	1699126730	1699126730	1	1	WONG, JOEY T DO	6/22/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16167	None	None	0	In state provider	None	1211 W LA PALMA AVE	STE 207	ANAHEIM	CA	92801	2139	30	06059	33.84718298	-117.933758	Orange County
176109	Fee-for-Service	1760490163	1760490163	1	1	WANG, PETER K MD INC	1/1/1979	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	29582	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 306	GARDEN GROVE	CA	92843	1904	30	06059	33.77450946	-117.913041	Orange County
176112	Fee-for-Service	1679758692	1679758692	1	1	WALGREEN CO.	11/30/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15990 BROOKHURST ST.	None	FOUNTAIN VALLEY	CA	92708	1014	30	06059	33.73092238	-117.9545522	Orange County
176114	Fee-for-Service	1932423571	1932423571	1	1	WHELCHEL, MELANIE LCSW	3/6/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
176176	Fee-for-Service	1306811484	1306811484	1	1	WESTLAKE, DONNA Y MD	7/19/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	166761	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
176179	Fee-for-Service	1235144502	1235144502	1	1	WALGREEN CO	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	260 EL CAMINO REAL	None	BURLINGAME	CA	94010	5120	41	06081	37.5763288	-122.3496381	San Mateo County
176198	Fee-for-Service	1588925614	1588925614	1	1	WOODSON, LATASHA	4/2/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6301 ARDEN AVENUE	None	HIGHLAND	CA	92346	2058	36	06071	34.139511	-117.234902	San Bernardino County
176218	Fee-for-Service	1023293073	1023293073	1	1	WHITFIELD, DANIEL E NP	3/17/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1183 E FOOTHILL BLVD	None	UPLAND	CA	91786	9999	36	06071	34.10724648	-117.6359175	San Bernardino County
176287	Fee-for-Service	1073538518	1073538518	1	1	WEDL, STEFANI L MD	10/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89621	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
176288	Fee-for-Service	1568924330	1568924330	1	1	WU, DERRICK MD	12/28/2023	390200000X	NA	Other	026	PHYSICIANS	182406	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
176297	Fee-for-Service	1376049676	1376049676	1	1	WATSON, ROBERT MD	8/1/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	186759	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
176321	Fee-for-Service	1598782906	1598782906	1	1	WAL-MART STORES INC	1/3/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 101554	3223 E HAMMER LN	None	STOCKTON	CA	95212	2815	39	06077	38.023479	-121.2736095	San Joaquin County
176344	Fee-for-Service	1194780817	1194780817	1	1	WEISS, ARTHUR MD	6/1/1984	207RR0500X	NA	Other	026	PHYSICIANS	47287	83	Rheumatology	0	In state provider	None	505 PARNASSUS AVE	# 997M	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
176350	Fee-for-Service	1629214689	1629214689	1	1	WALGREEN CO	4/7/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#12761	41169 GOODWIN WAY	STE 100	MADERA	CA	93636	8766	20	06039	36.88577349	-119.800021	Madera County
176373	Fee-for-Service	1902811235	1902811235	1	1	WALGREEN CO	8/16/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	23958 HESPERIAN BLVD	None	HAYWARD	CA	94541	7241	01	06001	37.65404304	-122.1107337	Alameda County
176374	Fee-for-Service	1063888436	1063888436	1	1	WEBERG, DAVID E	4/18/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
176396	Fee-for-Service	1952746372	1952746372	1	1	WONG, MELISSA A MD	10/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133868	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
176427	Fee-for-Service	1740283043	1740283043	1	1	WILBUR J STRADER	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SOUTHWEST ENDOCRINE	2001 N OREGON	None	EL PASO	TX	79902	0000	00	None	31.77138005	-106.4995755	El Paso County
176484	Fee-for-Service	1346750478	1346750478	1	1	WE CARE SKILLED NURSING	9/23/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FACILITY INC	21863 VALLEJO STREET	None	HAYWARD	CA	94541	2523	01	06001	37.67673888	-122.0940859	Alameda County
176492	Fee-for-Service	1295710440	1295710440	1	1	WYCKAERT, CECILE J MD	8/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89089	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
176497	Fee-for-Service	1831244383	1831244383	1	1	WOODWARD, DAVID G MD	12/31/1989	207L00000X	NA	Other	026	PHYSICIANS	57139	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
176579	Fee-for-Service	1891264321	1891264321	1	1	WHITE, MICHAEL D PHD	7/20/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
176583	Fee-for-Service	1740216332	1740216332	1	1	WESTERN PHYSICAL THERAPY	3/1/2006	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	844 BRIDGE ST	STE C	COLUSA	CA	95932	2867	06	06011	39.20645023	-122.0035419	Colusa County
176622	Fee-for-Service	1841383858	1841383858	1	2	WILSON, MARCELLA M MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	59275	-	NOT APPLICABLE	0	In state provider	None	3288 EL CAJON BLVD	SUITE 3 6 10 11 12 13	SAN DIEGO	CA	92104	1430	37	06073	32.75537145	-117.1228095	San Diego County
176673	Fee-for-Service	1134111834	1134111834	1	1	WILLOW VALLEY MEDICAL CT	1/1/1985	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	-	01	General Practice	1	Border provider	DONOVAN J ANDERSON MD	8700 HIGHWAY 95	None	MOHAVE VALLEY	AZ	86440	8519	00	None	34.903944	-114.5974815	Mohave County
176685	Fee-for-Service	1336228253	1336228253	1	1	WU, SHANG C MD INC	1/31/2010	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	79748	10	Gastroenterology (M.D. only)	0	In state provider	None	3120 S HACIENDA BLVD	STE 201	HACIENDA HEIGHTS	CA	91745	6305	19	06037	33.98067045	-117.9727398	Los Angeles County
176741	Fee-for-Service	1720176423	1720176423	1	1	WONG, PRIMROSE F OD	4/23/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
176756	Fee-for-Service	1619102399	1619102399	1	1	WAKIL, LAURA A MD	10/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125395	36	Psychiatry	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
176760	Fee-for-Service	1578260378	1578260378	1	1	WHITE, BROOKE PT	4/20/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
176773	Fee-for-Service	1568775831	1568775831	1	1	WALSH, HUGH G MD INC	3/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	17606	02	General Surgery	0	In state provider	None	455 O'CONNOR	STE 280	SAN JOSE	CA	95128	1600	43	06085	37.326654	-121.939897	Santa Clara County
176779	Fee-for-Service	1295710440	1295710440	1	1	WYCKAERT, CECILE J MD	8/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89089	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
176804	Fee-for-Service	1063579613	1063579613	1	1	WYNN, VERONICA M LMFT	8/17/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1074 EAST AVE	SUITE A1	CHICO	CA	95926	1000	04	06007	39.76099443	-121.8353929	Butte County
176819	Fee-for-Service	1528263100	1528263100	1	1	WELLES, KELLY M MD	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102961	36	Psychiatry	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
176829	Fee-for-Service	1093892572	1093892572	1	1	WORKENEH, LISHAN T MD	12/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	76072	36	Psychiatry	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
176833	Fee-for-Service	1578023669	1578023669	1	1	WOLSTENCROFT, PAIGE W MD	7/25/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	179599	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
176841	Fee-for-Service	1053525816	1053525816	1	1	WILCHEK, SCOTT DO	12/22/2023	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	18956	None	None	0	In state provider	None	17822 BEACH BLVD	STE 430	HUNTINGTON BEACH	CA	92647	7508	30	06059	33.70331388	-117.9890471	Orange County
176844	Fee-for-Service	1639698343	1639698343	1	1	WONG, KAREN Y OD	11/14/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
176846	Fee-for-Service	1568896280	1568896280	1	1	WAL-MART STORE INC	6/8/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1046 MISSION AVE	None	OCEANSIDE	CA	92054	2843	37	06073	33.19893643	-117.3746335	San Diego County
176851	Fee-for-Service	1902163744	1902163744	1	1	WILLIAMS, TIFFANY M MD	4/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142936	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
176879	Fee-for-Service	1689675514	1689675514	1	1	WEYMER, ANDREW R MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67821	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
176884	Fee-for-Service	1902911886	1902911886	1	1	WINDEMUTH, RYAN S MD	4/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80645	66	Emergency Medicine (Urgent Care)	0	In state provider	None	36485 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9681	33	06065	33.591699	-117.2368285	Riverside County
176903	Fee-for-Service	1194407668	1194407668	1	1	WALLACE, SERENA PT	9/30/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	275 W HOSPITALITY LANE	100	SAN BERNARDINO	CA	92408	3238	36	06071	34.0659135	-117.289215	San Bernardino County
176924	Fee-for-Service	1730594375	1730594375	1	1	WANG, CHIEN-CHUNG C LAC	9/17/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	851 BURLWAY RD.	SUITE 316	BURLINGAME	CA	94010	3103	41	06081	37.59533247	-122.3663718	San Mateo County
176972	Fee-for-Service	1013246263	1013246263	1	1	WANG, CHUNGPO DC	3/1/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	9939 GARVEY AVE	A	EL MONTE	CA	91733	4712	19	06037	34.06277368	-118.0516203	Los Angeles County
176989	Fee-for-Service	1922790906	1922790906	1	1	WHOLE PERSON CARE CLINIC	7/10/2024	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1410 N GAREY AVENUE	None	POMONA	CA	91767	3810	19	06037	34.07202454	-117.7522105	Los Angeles County
176996	Fee-for-Service	1982782512	1982782512	1	1	WEISBERG, LAURIE J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42739	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
177042	Fee-for-Service	1730130923	1730130923	1	1	WEHNER, KYLE C MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82193	05	Anesthesiology	0	In state provider	None	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
177057	Fee-for-Service	1245249796	1245249796	1	1	WEN, YU-CHING MD	8/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80088	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 MED PLAZA	STE 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
177091	Fee-for-Service	1275789000	1275789000	1	1	WU, WILBUR OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
177098	Fee-for-Service	1699792002	1699792002	1	1	WAL-MART STORES INC	9/23/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 102117	1575 W PACHECO BLVD	None	LOS BANOS	CA	93635	8505	24	06047	37.054035	-120.878784	Merced County
177137	Fee-for-Service	1326697855	1326697855	1	1	WONG, JESSICA CAROL-MACIAS	6/8/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	15358 SAN BRUNO DR	None	LA MIRADA	CA	90638	5727	19	06037	33.88491922	-118.0033716	Los Angeles County
177142	Fee-for-Service	1841497039	1841497039	1	1	WANG, LEO D MD	4/22/2017	2080P0207X	NA	Hematology	026	PHYSICIANS	146322	40	Pediatrics	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
177184	Fee-for-Service	1093789729	1093789729	1	1	WATSON, REBECCA L MD	6/26/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
177235	Fee-for-Service	1457705543	1457705543	1	1	WANG, FU DO MD	9/30/2020	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
177237	Fee-for-Service	1477598050	1477598050	1	1	WILLIAM DILES INC	11/1/2001	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	55 MISSION CIR	STE. 105	SANTA ROSA	CA	95409	5398	49	06097	38.457288	-122.673987	Sonoma County
177256	Fee-for-Service	1679559157	1679559157	1	1	WONG, EDWARD T MD	3/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	63865	None	None	0	In state provider	None	44725 10TH ST W	STE 250	LANCASTER	CA	93534	3048	19	06037	34.695693	-118.1480965	Los Angeles County
177388	Fee-for-Service	1316914872	1316914872	1	1	WEAVER, VICTOR	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 E AJO WAY	None	TUCSON	AZ	85713	0000	00	None	32.175801	-110.9306925	Pima County
177424	Fee-for-Service	1326697855	1326697855	1	1	WONG, JESSICA CAROL-MACIAS	6/8/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	15358 SAN BRUNO DR	None	LA MIRADA	CA	90638	5727	19	06037	33.88491922	-118.0033716	Los Angeles County
177431	Fee-for-Service	1811955735	1811955735	1	1	WIMMER, TIMOTHY M MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54546	20	Orthopedic Surgery	0	In state provider	None	6719 ALVARADO RD	STE 200	SAN DIEGO	CA	92120	5256	37	06073	32.77684978	-117.055137	San Diego County
177498	Fee-for-Service	1144673518	1144673518	1	1	WADHWA, NISHA MD	9/12/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	152354	40	Pediatrics	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
177589	Fee-for-Service	1063652147	1063652147	1	1	WANG, SEAN S MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120264	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1798 NORTH GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
177639	Fee-for-Service	1699152876	1699152876	1	1	WINTERS, CAROLYN N DPM	7/3/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6620 COYLE AVE	SUITE 202	CARMICHAEL	CA	95608	6333	34	06067	38.66751	-121.310028	Sacramento County
177679	Fee-for-Service	1063981496	1063981496	1	1	WATKINS-OLADUNJOYE, HAKEEM M	11/18/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
177684	Fee-for-Service	1013959501	1013959501	1	1	WEISS, LORRAINE N MD	4/1/2000	2080P0203X	NA	Other	026	PHYSICIANS	79175	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
177714	Fee-for-Service	1386659662	1386659662	1	1	WALGREEN CO	10/6/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2900 N MAIN ST	None	WALNUT CREEK	CA	94597	2035	07	06013	37.92721212	-122.0621121	Contra Costa County
177725	Fee-for-Service	1972541266	1972541266	1	1	WONG, JAIR MD	4/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	75543	02	General Surgery	0	In state provider	None	10050 GARVEY AVE	SUITE 111	EL MONTE	CA	91731	2088	19	06037	34.06270952	-118.049481	Los Angeles County
177754	Fee-for-Service	1063674505	1063674505	1	1	WALSH, JOSEPH A MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123966	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
177774	Fee-for-Service	1356659932	1356659932	1	1	WALGREEN CO	3/4/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 E GAGE AVE	None	LOS ANGELES	CA	90001	1724	19	06037	33.98202771	-118.2473747	Los Angeles County
177784	Fee-for-Service	1588856249	1588856249	1	2	WHITTIER PREGNANCY CARE CLIN	10/1/2019	193200000X	NA	Other	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	ANGELES	16147 WHITTIER BLVD	None	WHITTIER	CA	90603	2560	19	06037	33.94157588	-117.9859969	Los Angeles County
177812	Fee-for-Service	1083068001	1083068001	1	1	WONG, MICHELE J MD	4/27/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	153137	08	Family Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
177846	Fee-for-Service	1083640213	1083640213	1	1	WAHIDULLAH, WAHIDULLAH	10/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86761	41	Internal Medicine	0	In state provider	MD	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
177885	Fee-for-Service	1194793976	1194793976	1	2	WENDT, ALLEN MD	11/12/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53816	40	Pediatrics	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
177889	Fee-for-Service	1073513156	1073513156	1	1	WONG, TSUNG-PI P MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	60539	08	Family Practice	0	In state provider	None	1111 E STANLEY BLVD	None	LIVERMORE	CA	94550	4115	01	06001	37.67881307	-121.7823992	Alameda County
177928	Fee-for-Service	1790895415	1790895415	1	1	WILKIN, NATHANIEL MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55280	07	Dermatology	0	In state provider	None	4785 N FIRST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
177967	Fee-for-Service	1639516149	1639516149	1	1	WHISLER, DONALD L MD	8/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155450	83	Rheumatology	0	In state provider	None	500 DOYLE PARK DR	SUITE 300	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
177971	Fee-for-Service	1649853615	1649853615	1	1	WASHINGTON, BRIAN CNP	9/17/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
178022	Fee-for-Service	1124025275	1124025275	1	1	WOHLMUTH, CINNA T MD	7/31/1988	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	58244	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1710 BROOKLYN AVE	STE 100	LOS ANGELES	CA	90033	2439	19	06037	34.040502	-118.191954	Los Angeles County
178049	Fee-for-Service	1447332036	1447332036	1	9	WELLSPACE HEALTH	5/1/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4241 FLORIN RD	SUITE 30	SACRAMENTO	CA	95823	2535	34	06067	38.496816	-121.4582625	Sacramento County
178065	Fee-for-Service	1417514233	1417514233	1	1	WONG, SAMANTHA A DO	7/18/2022	207P00000X	NA	Other	026	PHYSICIANS	19898	None	None	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
178070	Fee-for-Service	1588856249	1588856249	1	2	WHITTIER PREGNANCY CARE CLIN	10/1/2019	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ANGELES	16147 WHITTIER BLVD	None	WHITTIER	CA	90603	2560	19	06037	33.94157588	-117.9859969	Los Angeles County
178122	Fee-for-Service	1063717932	1063717932	1	1	WIEGHORST, COLLEEN P	4/1/2012	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
178153	Fee-for-Service	1639120694	1639120694	1	1	WAUKEGAN ILLINOIS HOSP CO	7/16/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1324 N SHERIDAN ROAD	None	WAUKEGAN	IL	60085	2161	00	None	42.378192	-87.8323635	Lake County
178210	Fee-for-Service	1073175725	1073175725	1	1	WANG, LEON J MD	8/11/2023	207L00000X	NA	Other	026	PHYSICIANS	181549	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
178231	Fee-for-Service	1902117153	1902117153	1	1	WHITE, SOPHIE M MD	5/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118386	40	Pediatrics	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
178254	Fee-for-Service	1639516149	1639516149	1	1	WHISLER, DONALD L MD	8/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155450	41	Internal Medicine	0	In state provider	None	500 DOYLE PARK DR	SUITE 300	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
178289	Fee-for-Service	1396771960	1396771960	1	1	WONG, JAIR MD INC	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	75543	41	Internal Medicine	0	In state provider	None	1535 W MERCED AVE	STE 102	WEST COVINA	CA	91790	3402	19	06037	34.06295577	-117.9482872	Los Angeles County
178336	Fee-for-Service	1447332036	1447332036	1	9	WELLSPACE HEALTH	5/1/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4241 FLORIN RD	SUITE 30	SACRAMENTO	CA	95823	2535	34	06067	38.496816	-121.4582625	Sacramento County
178360	Fee-for-Service	1588856249	1588856249	1	2	WHITTIER PREGNANCY CARE CLIN	10/1/2019	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	ANGELES	16147 WHITTIER BLVD	None	WHITTIER	CA	90603	2560	19	06037	33.94157588	-117.9859969	Los Angeles County
178372	Fee-for-Service	1871840603	1871840603	1	1	WILSON, JOSCELYN R PSYD	5/10/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
178441	Fee-for-Service	1639120694	1639120694	1	1	WAUKEGAN ILLINOIS HOSP CO	7/16/2009	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1324 N SHERIDAN ROAD	None	WAUKEGAN	IL	60085	2161	00	None	42.378192	-87.8323635	Lake County
178483	Fee-for-Service	1326440082	1326440082	1	1	WYLDE, GAIL A LCSW	10/25/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	555 SOQUEL AVE	SUITE 260	SANTA CRUZ	CA	95062	2340	44	06087	36.97623386	-122.0170137	Santa Cruz County
178497	Fee-for-Service	1245255587	1245255587	1	1	WANG, HENRY MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72545	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
178516	Fee-for-Service	1801967872	1801967872	1	1	WOLFNER, AMY L MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80911	08	Family Practice	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
178596	Fee-for-Service	1962196956	1962196956	1	1	WOODLANDER, LAURA BIRTH DOU	9/22/2024	225700000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	49	06097	0	0	None
178647	Fee-for-Service	1588856249	1588856249	1	2	WHITTIER PREGNANCY CARE CLIN	10/1/2019	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	ANGELES	16147 WHITTIER BLVD	None	WHITTIER	CA	90603	2560	19	06037	33.94157588	-117.9859969	Los Angeles County
178670	Fee-for-Service	1982990164	1982990164	1	1	WITT, LEAH J MD	6/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149546	38	Geriatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
178680	Fee-for-Service	1073525937	1073525937	1	1	WINTERS, CURTIS B MD	6/28/1988	207L00000X	NA	Other	026	PHYSICIANS	52678	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
178756	Fee-for-Service	1811200843	1811200843	1	2	WE CARE HOMEHEALTH INC	12/12/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14328 VICTORY BLVD	SUITE 201	BURBANK	CA	91401	1944	19	06037	34.1866137	-118.4454117	Los Angeles County
178764	Fee-for-Service	1598975138	1598975138	1	1	WILLIAMS, JEANETTE M MD	11/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	52939	08	Family Practice	0	In state provider	None	913 WASHINGTON ST	None	CALISTOGA	CA	94515	1433	28	06055	38.57812737	-122.5772111	Napa County
178784	Fee-for-Service	1245255587	1245255587	1	1	WANG, HENRY MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72545	78	Neoplastic Diseases/Oncology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
178831	Fee-for-Service	1578841615	1578841615	1	1	WU, FANG MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129348	41	Internal Medicine	0	In state provider	None	555 EAST VALLEY PARKWAY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
178907	Fee-for-Service	1255488250	1255488250	1	1	WANG, ANGELA A MD	3/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95306	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
178998	Fee-for-Service	1144392960	1144392960	1	1	WILSON, FRANCES MD	9/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	59220	40	Pediatrics	0	In state provider	None	1704 W MANCHESTER AVE	None	LOS ANGELES	CA	90047	3034	19	06037	33.9599425	-118.307079	Los Angeles County
179004	Fee-for-Service	1184780744	1184780744	1	1	WATSON, SUSANNE E PHD	1/30/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
179023	Fee-for-Service	1083619910	1083619910	1	1	WALKER, LAWRENCE R MD	12/1/2003	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	42773	01	General Practice	0	In state provider	None	399 E HIGHLAND AVE	STE 409	SAN BERNARDINO	CA	92404	3866	36	06071	34.1358627	-117.2757898	San Bernardino County
179034	Fee-for-Service	1891068334	1891068334	1	1	WESTMORELAND, CRYSTAL S LMFT	11/20/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
179065	Fee-for-Service	1306031711	1306031711	1	1	WARD, MELANIE K MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111019	05	Anesthesiology	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90028	7900	19	06037	34.09813032	-118.2901794	Los Angeles County
179072	Fee-for-Service	1306917299	1306917299	1	1	WOODS, MARIANNE MD	3/31/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	50353	40	Pediatrics	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
179073	Fee-for-Service	1245255587	1245255587	1	1	WANG, HENRY MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72545	68	Hematology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
179159	Fee-for-Service	1376928077	1376928077	1	1	WU PEDIATRICS CORP	11/2/2015	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3801 KATELLA AVE	STE 221	LOS ALAMITOS	CA	90720	3380	30	06059	33.80318951	-118.066068	Orange County
179232	Fee-for-Service	1154347979	1154347979	1	1	WARD, DAVID M MD	2/8/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	31860	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
179247	Fee-for-Service	1922060920	1922060920	1	1	WILLIAM R DREW	5/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	375 DIXMYTH AVE	None	CINCINNATI	OH	45220	2475	00	None	39.14076839	-84.52169161	Hamilton County
179309	Fee-for-Service	1487671715	1487671715	1	1	WAL MART PHARM 10-1630	1/1/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1906 FORT JONES RD	None	YREKA	CA	96097	9530	47	06093	41.698611	-122.644566	Siskiyou County
179311	Fee-for-Service	1093886079	1093886079	1	1	WILLIAMS, STEPHEN G MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	79866	34	Urology and Urological Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
179312	Fee-for-Service	1528087962	1528087962	1	1	WEST, WALTER C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1008 MINNEQUA AVE	None	PUEBLO	CO	81004	3733	00	None	38.23322546	-104.623598	Pueblo County
179318	Fee-for-Service	1811959141	1811959141	1	1	WILBUR, STEVEN R MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	41722	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
179320	Fee-for-Service	1750450714	1750450714	1	1	WALGREEN CO	3/5/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9830 LONG BEACH BLVD	None	SOUTH GATE	CA	90280	4153	19	06037	33.94602965	-118.21634	Los Angeles County
179372	Fee-for-Service	1396762639	1396762639	1	1	WAL-MART STORES, INC	1/23/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2560 N PERRIS BLVD	None	PERRIS	CA	92571	3267	33	06065	33.819705	-117.2262155	Riverside County
179397	Fee-for-Service	1437109709	1437109709	1	1	WISTOW, BRIAN WM MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33568	30	Radiology	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
179426	Fee-for-Service	1134197866	1134197866	1	1	WONG, IRVINE V LCSW	6/25/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16600 WOODRUFF AVE	SUITE 102	BELLFLOWER	CA	90706	4916	19	06037	33.88354622	-118.1173077	Los Angeles County
179470	Fee-for-Service	1477947760	1477947760	1	1	WATSON, WILLIAM A MD	12/22/2022	207L00000X	NA	Other	026	PHYSICIANS	172140	None	None	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
179511	Fee-for-Service	1316426679	1316426679	1	1	WALLACE, BRANDON M DPM	2/25/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	12520 MAGNOLIA BLVD	#304	VALLEY VILLAGE	CA	91607	2355	19	06037	34.16485451	-118.406106	Los Angeles County
179517	Fee-for-Service	1427248319	1427248319	1	1	WANG, YI MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98547	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
179519	Fee-for-Service	1407033301	1407033301	1	1	WESTSIDE NEIGHBORHOOD	7/17/2005	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CLINIC	628 W MICHELTORENA ST	None	SANTA BARBARA	CA	93101	4131	42	06083	34.41910081	-119.7158618	Santa Barbara County
179521	Fee-for-Service	1447468210	1447468210	1	1	WATSON, MATTHEW M MD	10/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	112697	41	Internal Medicine	0	In state provider	None	12140 NEW YORK RANCH ED	None	JACKSON	CA	95642	9407	03	06005	38.38465694	-120.739897	Amador County
179538	Fee-for-Service	1184287153	1184287153	1	1	WILLIAMS, ELTON M MD	7/8/2022	207R00000X	NA	Other	026	PHYSICIANS	176248	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
179625	Fee-for-Service	1144255258	1144255258	1	1	WHYTE, MARK R MD INC	1/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85889	02	General Surgery	0	In state provider	None	608 G ST	STE 2B	BRAWLEY	CA	92227	7780	13	06025	32.97749255	-115.5318435	Imperial County
179658	Fee-for-Service	1538276316	1538276316	1	1	WONG, K. K.	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73883	68	Hematology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
179672	Fee-for-Service	1780964999	1780964999	1	1	WILCOX, RICHARD L CP	12/31/1993	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	4747 J ST	None	SACRAMENTO	CA	95819	3739	34	06067	38.567502	-121.444137	Sacramento County
179681	Fee-for-Service	1992123285	1992123285	1	1	WILSON, MARK W	1/21/2015	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2820 ROOSEVELT RD	None	SAN DIEGO	CA	92106	6146	37	06073	32.73735211	-117.2142986	San Diego County
179759	Fee-for-Service	1205602323	1205602323	1	1	WESTERN PHYSICAL THERAPY, IN	5/2/2024	193200000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2580 VICTOR AVE	STE B	REDDING	CA	96002	1455	45	06089	40.56964465	-122.3390284	Shasta County
179844	Fee-for-Service	1700979390	1700979390	1	2	WESTERN DIAGNOSTIC AND	8/15/2007	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	THERAPEUTIC RADIOLOGY	4640 ADMIRALTY WAY	STE 102	MARINA DEL REY	CA	90292	6621	19	06037	33.98120707	-118.4409729	Los Angeles County
179881	Fee-for-Service	1770598864	1770598864	1	1	WALGREEN CO	7/22/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	303 2ND ST	None	LOS ALTOS	CA	94022	3622	43	06085	37.377242	-122.1157995	Santa Clara County
179884	Fee-for-Service	1104072446	1104072446	1	1	WASHINGTON, CHRISTOPHER P MD	9/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112304	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
179894	Fee-for-Service	1538348396	1538348396	1	1	WONG, JESSICA H MD	6/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99337	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
179898	Fee-for-Service	1568862423	1568862423	1	1	WATSON, JOHNATHAN C PSYD	4/5/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	270 E. 7TH STREET	SUITE 1C	UPLAND	CA	91786	6602	36	06071	34.08880656	-117.6475309	San Bernardino County
179900	Fee-for-Service	1417103177	1417103177	1	1	WATERHOUSE, MARIE R MD	8/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103920	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
179911	Fee-for-Service	1376366906	1376366906	1	1	WADE, KATELYN NP	12/29/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
179912	Fee-for-Service	1629691993	1629691993	1	1	WIMBERLY, FRANKLIN C LMFT	9/7/2021	103TB0200X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
179918	Fee-for-Service	1750380622	1750380622	1	1	WILLIAMS, DONALD J MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	41754	45	Nephrology (Renal-Kidney)	0	In state provider	APC	1505 WILSON TERRACE	STE 155	GLENDALE	CA	91206	4175	19	06037	34.14960934	-118.2313491	Los Angeles County
179934	Fee-for-Service	1578547022	1578547022	1	1	WHATCOM MEDIC ONE	1/1/2003	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1800 BROADWAY	None	BELLINGHAM	WA	98225	3133	00	None	48.76018222	-122.4878098	Whatcom County
179974	Fee-for-Service	1801214440	1801214440	1	1	WONG, CARRIE R MD	2/4/2022	207RI0008X	NA	Gastroenterology	026	PHYSICIANS	150513	None	None	0	In state provider	None	100 UCLA MEDICAL PLZ	755	LOS ANGELES	CA	90024	6990	19	06037	34.06544724	-118.4459249	Los Angeles County
179981	Fee-for-Service	1184002420	1184002420	1	1	WU, CLAY Y DO	6/14/2021	207RC0200X	NA	Other	026	PHYSICIANS	15317	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	0001	39	06077	37.97026329	-121.2890849	San Joaquin County
180001	Fee-for-Service	1578068276	1578068276	1	1	WILLIAMS, SAMANTHA L MD	7/27/2022	207P00000X	NA	Other	026	PHYSICIANS	164954	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
180036	Fee-for-Service	1407219033	1407219033	1	1	WOBGA-PASIAH, EMILIA MD	8/22/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158544	08	Family Practice	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
180046	Fee-for-Service	1205602323	1205602323	1	1	WESTERN PHYSICAL THERAPY, IN	5/2/2024	193200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2580 VICTOR AVE	STE B	REDDING	CA	96002	1455	45	06089	40.56964465	-122.3390284	Shasta County
180047	Fee-for-Service	1538663638	1538663638	1	1	WANG, ALEXIS MD	10/18/2023	208800000X	NA	Other	026	PHYSICIANS	191095	None	None	0	In state provider	None	100 WIGET	290	WALNUT CREEK	CA	94598	5988	07	06013	37.92514495	-122.0237725	Contra Costa County
180052	Fee-for-Service	1881761716	1881761716	1	1	WU, LENORA M MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61398	18	Ophthalmology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
180075	Fee-for-Service	1568880607	1568880607	1	1	WOODBURY, JENNIFER H MD	6/7/2021	207L00000X	NA	Other	026	PHYSICIANS	171039	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
180089	Fee-for-Service	1982848099	1982848099	1	1	WASSEF, ANDREW J MD	10/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120817	20	Orthopedic Surgery	0	In state provider	None	5750 DOWNEY AVE	#308	LAKEWOOD	CA	90712	1482	19	06037	33.859611	-118.1511435	Los Angeles County
180096	Fee-for-Service	1114092723	1114092723	1	1	WILKINSON, JOHN R MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	50507	68	Hematology	0	In state provider	None	5555 RESERVOIR DR	SUITE 207	SAN DIEGO	CA	92120	5149	37	06073	32.77628471	-117.0563688	San Diego County
180111	Fee-for-Service	1417423302	1417423302	1	1	WALL, ELIZABETH D OT	10/3/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4420 MARSH ELDER CT	None	CONCORD	CA	94521	4446	07	06013	37.95111016	-121.9900167	Contra Costa County
180152	Fee-for-Service	1396164414	1396164414	1	1	WILLS, KRISTOFER M DO	2/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	14384	01	General Practice	0	In state provider	None	1420 S CENTRAL AVENUE	None	GLENDALE	CA	91204	1000	19	06037	34.12811155	-118.2577764	Los Angeles County
180153	Fee-for-Service	1639382369	1639382369	1	1	WAGREICH, CARL R DPM	5/8/1979	261QP1100X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	23451 MADISON ST	STE 230	TORRANCE	CA	90505	4761	19	06037	33.81197627	-118.3478154	Los Angeles County
180189	Fee-for-Service	1417103177	1417103177	1	1	WATERHOUSE, MARIE R MD	8/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103920	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
180207	Fee-for-Service	1750380622	1750380622	1	1	WILLIAMS, DONALD J MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	41754	41	Internal Medicine	0	In state provider	APC	1505 WILSON TERRACE	STE 155	GLENDALE	CA	91206	4175	19	06037	34.14960934	-118.2313491	Los Angeles County
180219	Fee-for-Service	1093980344	1093980344	1	1	WISEMAN, STEPHEN A MD	1/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147786	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
180252	Fee-for-Service	1053773283	1053773283	1	1	WEINSTEIN, LEAH MD	7/31/2019	207R00000X	NA	Other	026	PHYSICIANS	152007	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
180268	Fee-for-Service	1952927667	1952927667	1	1	WILLIAMS, CONOR	1/22/2024	207R00000X	NA	Other	026	PHYSICIANS	191294	None	None	0	In state provider	None	460 PLUMAS BLVD	STE 202	YUBA CITY	CA	95991	5005	51	06101	39.13140416	-121.6141951	Sutter County
180286	Fee-for-Service	1164437430	1164437430	1	1	WALGREEN CO.	10/13/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14100 BLOSSOM HILL RD	None	LOS GATOS	CA	95032	5118	43	06085	37.23621854	-121.914054	Santa Clara County
180296	Fee-for-Service	1124034871	1124034871	2	1	WALGREEN CO	10/16/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2141 CHESTNUT ST	None	SAN FRANCISCO	CA	94123	2708	38	06075	37.80049399	-122.4385695	San Francisco County
180339	Fee-for-Service	1639112527	1639112527	1	1	WIRT II, MICHAEL D MD	6/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86918	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
180343	Fee-for-Service	1609439082	1609439082	1	1	WILKINS, KRYSTEL L CNM	11/13/2019	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
180383	Fee-for-Service	1003436064	1003436064	1	76	WS AUDIOLOGY (CALIFORNIA), P	3/13/2025	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	11260 WILBUR AVE	100	PORTER RANCH	CA	91326	2450	19	06037	34.2746575	-118.5470435	Los Angeles County
180418	Fee-for-Service	1003228248	1003228248	1	1	WANI, PRIYANKA MD	2/5/2021	207R00000X	NA	Other	026	PHYSICIANS	147434	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
180437	Fee-for-Service	1982659199	1982659199	1	2	WIJESINGHE, HIRAN S MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
180472	Fee-for-Service	1447266317	1447266317	1	1	WANG, LINA MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64308	22	Pathology (M.D. only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
180551	Fee-for-Service	1003436064	1003436064	1	53	WS AUDIOLOGY (CALIFORNIA), P	8/31/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	26504 BOUQUET CANYON	None	SANTA CLARITA	CA	91350	2353	19	06037	34.42742329	-118.5368396	Los Angeles County
180572	Fee-for-Service	1003436064	1003436064	1	17	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	41034 CALIFORNIA OAKS RO	#A	MURRIETA	CA	92562	5788	33	06065	33.56667036	-117.2062483	Riverside County
180611	Fee-for-Service	1386890770	1386890770	1	1	WANG, CHUNYANG T MD	11/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	105660	13	Neurology (M.D. only)	0	In state provider	None	3907 WARING ROAD	SUITE 2	OCEANSIDE	CA	92056	4454	37	06073	33.18780783	-117.2918439	San Diego County
180620	Fee-for-Service	1588270789	1588270789	1	1	WECARE HEALTH SERVICES, INC	4/23/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	10505 VALLEY BLVD	312	EL MONTE	CA	91731	2442	19	06037	34.07642059	-118.0436761	Los Angeles County
180628	Fee-for-Service	1558776542	1558776542	1	1	WALSH, CHRISTOPHER R MD	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155937	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
180651	Fee-for-Service	1003436064	1003436064	1	13	WS AUDIOLOGY (CALIFORNIA), P	5/13/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	20126 STANTON AVENUE	205	CASTRO VALLEY	CA	94546	5271	01	06001	37.69722866	-122.090936	Alameda County
180657	Fee-for-Service	1750483830	1750483830	1	1	WELLER, CYNTHIA Y MD	9/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84285	05	Anesthesiology	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
180671	Fee-for-Service	1003436064	1003436064	1	76	WS AUDIOLOGY (CALIFORNIA), P	10/8/2024	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	11260 WILBUR AVE	100	PORTER RANCH	CA	91326	2450	19	06037	34.2746575	-118.5470435	Los Angeles County
180696	Fee-for-Service	1558947234	1558947234	1	1	WEIL, HOLLY MD	10/18/2023	390200000X	NA	Other	026	PHYSICIANS	187240	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
180709	Fee-for-Service	1386834745	1386834745	1	1	WATSON, DENEEN L LMFT	4/9/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	94909	-	NOT APPLICABLE	0	In state provider	None	26166 CIRCLE DR	None	LAKE ARROWHEAD	CA	92352	1841	36	06071	34.24661208	-117.232314	San Bernardino County
180797	Fee-for-Service	1649943622	1649943622	1	1	WALDRON, MARGO L LMFT	2/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
180801	Fee-for-Service	1457552135	1457552135	1	1	WARREN, PATRICK S MD	2/11/2022	2085P0229X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
180808	Fee-for-Service	1215453998	1215453998	1	1	WALGREEN CO	6/6/2018	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16554	7000 INDIANA AVE	STE 112	RIVERSIDE	CA	92506	4153	33	06065	33.94079162	-117.3949924	Riverside County
180839	Fee-for-Service	1003436064	1003436064	1	53	WS AUDIOLOGY (CALIFORNIA), P	8/31/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	26504 BOUQUET CANYON	None	SANTA CLARITA	CA	91350	2353	19	06037	34.42742329	-118.5368396	Los Angeles County
180864	Fee-for-Service	1932153988	1932153988	1	1	WANG, JEAN C MD	9/1/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	143488	30	Radiology	0	In state provider	None	481 PLUMAS BLVD	SUITE 104	YUBA CITY	CA	95991	5075	51	06101	39.13306148	-121.6140103	Sutter County
180868	Fee-for-Service	1003436064	1003436064	1	17	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	41034 CALIFORNIA OAKS RO	#A	MURRIETA	CA	92562	5788	33	06065	33.56667036	-117.2062483	Riverside County
180869	Fee-for-Service	1669835534	1669835534	1	1	WILAISAKDITIPAKORN, TANAPORN	8/18/2022	390200000X	NA	Other	026	PHYSICIANS	180301	None	None	0	In state provider	J MD	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
180879	Fee-for-Service	1063469500	1063469500	1	1	WILLIAM L TAYLOR, M.D	3/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1512 12TH AVE RD	None	NAMPA	ID	83686	6008	00	None	43.55346193	-116.5727785	Canyon County
180894	Fee-for-Service	1679025365	1679025365	1	1	WILSON SMITH, KATHRINE A	1/11/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	7300 WYNDHAM DRIVE	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
180927	Fee-for-Service	1558323188	1558323188	1	1	WALID ADHAM MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1064 E RAY RD	None	CHANDLER	AZ	85225	1542	00	None	33.32124	-111.822273	Maricopa County
180938	Fee-for-Service	1003436064	1003436064	1	13	WS AUDIOLOGY (CALIFORNIA), P	5/13/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	20126 STANTON AVENUE	205	CASTRO VALLEY	CA	94546	5271	01	06001	37.69722866	-122.090936	Alameda County
180968	Fee-for-Service	1518949965	1518949965	1	1	WOO, LINDA J MD	9/1/1995	207R00000X	NA	Other	026	PHYSICIANS	79382	41	Internal Medicine	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
180990	Fee-for-Service	1588974505	1588974505	1	1	WOO, MINHEE OD	8/7/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
181041	Fee-for-Service	1689640864	1689640864	1	1	WEI, MARIA L MD	12/1/1997	207N00000X	NA	Dermatology	026	PHYSICIANS	53307	07	Dermatology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
181056	Fee-for-Service	1932425584	1932425584	1	1	WONG, WAYLAN MD	11/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120027	05	Anesthesiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
181060	Fee-for-Service	1730838301	1730838301	1	1	WONG, SAMANTHA MD	9/27/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	189939	08	Family Practice	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
181071	Fee-for-Service	1447332036	1447332036	1	16	WELLSPACE HEALTH	6/21/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7501 HOSPITAL DRIVE	STE 204	SACRAMENTO	CA	95831	5405	34	06067	38.464776	-121.416912	Sacramento County
181072	Fee-for-Service	1174797914	1174797914	1	1	WEI, ZHU P MD	9/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102258	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
181110	Fee-for-Service	1013457969	1013457969	1	1	WILLIAMS, KORI NP	1/31/2024	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3008 SILLECT AVE	220	BAKERSFIELD	CA	93308	6340	15	06029	35.38608607	-119.0398799	Kern County
181115	Fee-for-Service	1992756472	1992756472	1	1	WINANS, NINA S MD	4/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	71759	01	General Practice	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
181125	Fee-for-Service	1972032043	1972032043	1	1	WALGREEN CO	8/23/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#16561	1001 W CARSON ST	SUITE K	TORRANCE	CA	90502	2051	19	06037	33.83160647	-118.2928635	Los Angeles County
181144	Fee-for-Service	1003436064	1003436064	1	64	WS AUDIOLOGY (CALIFORNIA), P	10/6/2022	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2076 ATLANTIC AVENUE	None	MONTEREY PARK	CA	91754	6304	19	06037	34.03982522	-118.1427509	Los Angeles County
181157	Fee-for-Service	1518209162	1518209162	1	1	WAL-MART STORES, INC	5/23/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6855 N WILLOW AVE	None	FRESNO	CA	93710	5949	10	06019	36.83633503	-119.7296873	Fresno County
181165	Fee-for-Service	1598796799	1598796799	1	1	WAGUESPACK, ROBERT L MD	1/15/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84995	34	Urology and Urological Surgery	0	In state provider	APC	2530 F STREET	SUITE B	BAKERSFIELD	CA	93301	3824	15	06029	35.38253482	-119.0234498	Kern County
181193	Fee-for-Service	1497793624	1497793624	1	1	WINNICK, SHAWN R MD	10/3/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82311	05	Anesthesiology	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
181280	Fee-for-Service	1598768962	1598768962	1	1	WEST COUNTY HEALTH CTRS	8/15/2000	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OCCIDENTAL AREA HEALTH	3802 MAIN ST	None	OCCIDENTAL	CA	95465	0100	49	06097	38.40900707	-122.9476089	Sonoma County
181315	Fee-for-Service	1366658536	1366658536	1	1	WATCHER, MELISSA A MD IN	7/6/2005	207N00000X	NA	Dermatology	026	PHYSICIANS	71250	07	Dermatology	0	In state provider	None	1506 E CHAPMAN AVE	None	ORANGE	CA	92866	2231	30	06059	33.78778851	-117.837621	Orange County
181329	Fee-for-Service	1609179803	1609179803	1	1	WANG OPTOMETRIC ASSOCIATES I	8/28/2019	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15908 BEAR VALLEY RD	SUITE A	VICTORVILLE	CA	92395	9547	36	06071	34.4709788	-117.316553	San Bernardino County
181334	Fee-for-Service	1891854493	1891854493	1	1	WRAY, TERESA B MD	3/12/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52043	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
181359	Fee-for-Service	1447332036	1447332036	1	16	WELLSPACE HEALTH	6/21/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7501 HOSPITAL DRIVE	STE 204	SACRAMENTO	CA	95831	5405	34	06067	38.464776	-121.416912	Sacramento County
181363	Fee-for-Service	1992095988	1992095988	1	1	WEST COAST MEDICAL EQUIPMENT	9/28/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	& REPAIR, INC	9729 LURLINE AVE	None	CHATSWORTH	CA	91311	4404	19	06037	34.246863	-118.5842055	Los Angeles County
181410	Fee-for-Service	1144584913	1144584913	1	1	WOLFSON, AARON M MD	4/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135685	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
181419	Fee-for-Service	1003436064	1003436064	1	49	WS AUDIOLOGY (CALIFORNIA), P	6/7/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1835 NEWPORT BLVD	SUITE A111	COSTA MESA	CA	92627	5031	30	06059	33.64060991	-117.9194274	Orange County
181426	Fee-for-Service	1578739843	1578739843	1	1	WU, CHARLYNE MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83101	08	Family Practice	0	In state provider	None	1000 W WHITTIER BLVD	None	MONTEBELLO	CA	90640	4639	19	06037	34.01070086	-118.1110129	Los Angeles County
181430	Fee-for-Service	1003436064	1003436064	1	64	WS AUDIOLOGY (CALIFORNIA), P	2/6/2023	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2076 ATLANTIC AVENUE	None	MONTEREY PARK	CA	91754	6304	19	06037	34.03982522	-118.1427509	Los Angeles County
181444	Fee-for-Service	1902937816	1902937816	1	1	WHITAKER, CHRISTAL-JOI LMFT	5/31/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3711 LONG BEACH	SUITE 5039	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
181475	Fee-for-Service	1205241593	1205241593	1	1	WONG, CONNIE T OD	8/4/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
181483	Fee-for-Service	1649462243	1649462243	1	1	WAKAMATSU, MICAH F MD	9/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95654	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
181523	Fee-for-Service	1669564811	1669564811	1	1	WANG, MARY MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	61785	41	Internal Medicine	0	In state provider	None	18395 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2749	19	06037	33.9884853	-117.9044348	Los Angeles County
181555	Fee-for-Service	1629083910	1629083910	1	1	WALGREEN COMPANY	11/26/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E PACHECO BLVD	None	LOS BANOS	CA	93635	4938	24	06047	37.0569817	-120.8344525	Merced County
181564	Fee-for-Service	1598768962	1598768962	1	1	WEST COUNTY HEALTH CTRS	5/1/2000	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OCCIDENTAL AREA HEALTH	3802 MAIN ST	None	OCCIDENTAL	CA	95465	0100	49	06097	38.40900707	-122.9476089	Sonoma County
181591	Fee-for-Service	1538724968	1538724968	1	1	WINICKI, MALISSA A LMFT	9/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
181605	Fee-for-Service	1902834328	1902834328	1	1	WEINSTEIN, PHILIP R MD	2/2/1983	207T00000X	NA	General Surgery	026	PHYSICIANS	12672	14	Neurological Surgery	0	In state provider	None	1001 POTRERO AVE	RM 4M39	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
181618	Fee-for-Service	1477599553	1477599553	1	1	WONG, KEE P MD	9/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	32749	20	Orthopedic Surgery	0	In state provider	None	1135 S SUNSET AVE	STE 200	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
181646	Fee-for-Service	1003436064	1003436064	1	21	WS AUDIOLOGY (CALIFORNIA), P	4/27/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	20020 HAWTHORNE BLVD	None	TORRANCE	CA	90503	0000	19	06037	33.849909	-118.353614	Los Angeles County
181666	Fee-for-Service	1659816411	1659816411	1	1	WECARE HOME HEALTH LLC	5/28/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	910 FLORIN RD	SUITE 202	SACRAMENTO	CA	95831	3571	34	06067	38.495781	-121.5256455	Sacramento County
181678	Fee-for-Service	1609981471	1609981471	1	1	WILLIAM WHITTIER MD	10/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1426 W WASHINGTON BLVD	None	CHICAGO	IL	60607	1821	00	None	41.88290348	-87.663744	Cook County
181690	Fee-for-Service	1508883919	1508883919	1	1	WAL-MART STORES, INC	10/30/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102556	1168 W BRANCH ST	None	ARROYO GRANDE	CA	93420	1906	40	06079	35.12752538	-120.5988816	San Luis Obispo County
181705	Fee-for-Service	1003436064	1003436064	1	49	WS AUDIOLOGY (CALIFORNIA), P	6/7/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1835 NEWPORT BLVD	SUITE A111	COSTA MESA	CA	92627	5031	30	06059	33.64060991	-117.9194274	Orange County
181731	Fee-for-Service	1598933103	1598933103	1	1	WANG, ERICA T MD	9/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	102570	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
181736	Fee-for-Service	1396805586	1396805586	1	1	WONG, PETER H MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80967	30	Radiology	0	In state provider	ATTN MGA OFFICE	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
181834	Fee-for-Service	1003436064	1003436064	1	71	WS AUDIOLOGY (CALIFORNIA), P	8/28/2024	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	7730 HERSCHEL AVE	A1	LA JOLLA	CA	92037	4432	37	06073	32.84442176	-117.2724885	San Diego County
181867	Fee-for-Service	1407897226	1407897226	1	1	WILKINSON, JOHN D MD	11/1/1994	207L00000X	NA	Other	026	PHYSICIANS	62586	05	Anesthesiology	0	In state provider	None	CLAY & BUCHANNON STS	None	SAN FRANCISCO	CA	94120	0000	38	06075	37.791126	-122.4309105	San Francisco County
181874	Fee-for-Service	1275709230	1275709230	1	1	WUNSCH, MARTHA J MD	3/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	53893	36	Psychiatry	0	In state provider	None	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
181901	Fee-for-Service	1508805276	1508805276	1	1	WHITE, BARBARA J CRNA	3/15/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
181933	Fee-for-Service	1003436064	1003436064	1	21	WS AUDIOLOGY (CALIFORNIA), P	8/27/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	20020 HAWTHORNE BLVD	None	TORRANCE	CA	90503	0000	19	06037	33.849909	-118.353614	Los Angeles County
181942	Fee-for-Service	1740854892	1740854892	1	1	WYMA, REBECCA L NP	6/27/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
181987	Fee-for-Service	1386884302	1386884302	1	1	WEIHE, ELIZABETH K MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135679	30	Radiology	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
182077	Fee-for-Service	1679934657	1679934657	1	1	WILCOX, CIARA L LMFT	12/21/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1588 HOMESTEAD RD	M/B 10, SUITE B	SANTA CLARA	CA	95050	4721	43	06085	37.34637328	-121.9509049	Santa Clara County
182090	Fee-for-Service	1154610137	1154610137	1	1	WANG, OLIVIA J MD	4/15/2023	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	-	None	None	1	Border provider	None	10135 W TWAIN AVE	SUITE 100	LAS VEGAS	NV	89147	6720	00	None	36.12253856	-115.3134079	Clark County
182122	Fee-for-Service	1003436064	1003436064	1	71	WS AUDIOLOGY (CALIFORNIA), P	8/28/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7730 HERSCHEL AVE	A1	LA JOLLA	CA	92037	4432	37	06073	32.84442176	-117.2724885	San Diego County
182157	Fee-for-Service	1386270429	1386270429	1	1	WANG, JEFFREY K MD	12/16/2022	207R00000X	NA	Other	026	PHYSICIANS	180000	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
182160	Fee-for-Service	1043598345	1043598345	1	1	WILSON, LESLEY N LMFT	3/22/2019	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
182162	Fee-for-Service	1730267410	1730267410	1	1	WITTKOP, DAN S MD	11/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76642	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
182291	Fee-for-Service	1669416772	1669416772	1	1	WOLFREY, WAYNE T MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	48619	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
182343	Fee-for-Service	1851322762	1851322762	1	1	WASSON, ELIJAH R MD	11/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	82755	41	Internal Medicine	0	In state provider	None	11165 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1113	19	06037	34.2738618	-118.4678337	Los Angeles County
182456	Fee-for-Service	1104897503	1104897503	1	1	WU, MERIEL L MD INC	10/31/1988	207W00000X	NA	Ophthalmology	026	PHYSICIANS	25807	18	Ophthalmology	0	In state provider	None	595 E COLORADO BLVD	None	PASADENA	CA	91101	2039	19	06037	34.14588202	-118.1380722	Los Angeles County
182482	Fee-for-Service	1417136433	1417136433	1	1	WHITE, GABRIEL T MD	9/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115622	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
182515	Fee-for-Service	1215963863	1215963863	1	1	WADMAN, MICHAEL C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
182531	Fee-for-Service	1497176242	1497176242	1	1	WEITZMAN, JENNA PT	10/23/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7887 SOQUEL DR STE C&D&E	None	APTOS	CA	95003	3900	44	06087	36.97818934	-121.9069039	Santa Cruz County
182542	Fee-for-Service	1841582269	1841582269	1	1	WAVEREK, SUZANNE E LMFT	5/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ICE	51025 AVENIDA MENDOZA	201	LA QUINTA	CA	92253	7409	33	06065	33.67768148	-116.3062708	Riverside County
182555	Fee-for-Service	1316302441	1316302441	1	1	WONG, VINCENT J MD	9/1/2024	208800000X	NA	Other	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	489 E 21ST	None	SAN BERNARDINO	CA	92404	4816	36	06071	34.13403455	-117.2756115	San Bernardino County
182562	Fee-for-Service	1578529947	1578529947	1	1	WALSH, PAUL F MD	5/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	63330	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
182571	Fee-for-Service	1992489934	1992489934	1	1	WHITE, JAMES CRNA	11/28/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
182585	Fee-for-Service	1134240666	1134240666	1	1	WANG, ADAM B MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90197	30	Radiology	0	In state provider	None	330 LEWIS STREET	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
182594	Fee-for-Service	1497752836	1497752836	1	2	WITTGROVE, PERRI L MD	12/31/1985	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	56550	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	PERRI L MD	6719 ALVARADO RD	STE 302	SAN DIEGO	CA	92120	5263	37	06073	32.77684978	-117.055137	San Diego County
182627	Fee-for-Service	1285640243	1285640243	1	1	WESTPHAL, DENIS R MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	50664	02	General Surgery	0	In state provider	None	111 RALEY BLVD	STE 140	CHICO	CA	95928	8351	04	06007	39.71601447	-121.790817	Butte County
182647	Fee-for-Service	1225062532	1225062532	1	1	WASHINGTON INTERNAL MED	2/9/1981	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP	2557 MOWRY AVE	STE 12	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
182763	Fee-for-Service	1235179144	1235179144	1	1	WELBORN, JOHN H MD	7/19/2005	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	61831	20	Orthopedic Surgery	0	In state provider	None	2089 VALE RD	STE 32	SAN PABLO	CA	94806	3850	07	06013	37.95396781	-122.3375393	Contra Costa County
182774	Fee-for-Service	1992091623	1992091623	1	1	WONG, TIMOTHY P G DO	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12729	01	General Practice	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
182776	Fee-for-Service	1801240825	1801240825	1	1	WHITMAN, JEFFREY MD	6/21/2020	390200000X	NA	Other	026	PHYSICIANS	153689	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	RM 2M14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
182801	Fee-for-Service	1275635013	1275635013	1	1	WEISS, NANCY C MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	57005	38	Geriatrics	0	In state provider	None	16300 SAN CANYON AVE	SUITE 311	IRVINE	CA	92618	3703	30	06059	33.66115075	-117.7742405	Orange County
182816	Fee-for-Service	1346508983	1346508983	1	1	WOOD, BARRY A PT	2/25/2020	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	900 E WASHINGTON ST	STE 200	COLTON	CA	92324	4192	36	06071	34.04820662	-117.3128102	San Bernardino County
182821	Fee-for-Service	1265046791	1265046791	1	1	WEBER, HALEY M LMFT	3/3/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ES	353 PARK MARINA CIR	None	REDDING	CA	96001	0965	45	06089	40.57650059	-122.3737972	Shasta County
182840	Fee-for-Service	1528483203	1528483203	1	1	WIGGINGTON, JOELLEN L MFT	2/23/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13746 VICTORY BLVD	STE 211	VAN NUYS	CA	91401	6718	19	06037	34.18664551	-118.432764	Los Angeles County
182846	Fee-for-Service	1245588987	1245588987	1	1	WALKER, JILLIAN L PHD	6/11/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
182870	Fee-for-Service	1417035189	1417035189	1	1	WILSON, JEFFREY A MD	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	25536	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
182876	Fee-for-Service	1417302605	1417302605	1	1	WILLIAMS, MICHEAL	6/15/2017	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	16501 VENTURA BLVD	400	ENCINO	CA	91436	2067	19	06037	34.15764432	-118.4927792	Los Angeles County
182915	Fee-for-Service	1285640243	1285640243	1	1	WESTPHAL, DENIS R MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	50664	33	Thoracic Surgery	0	In state provider	None	111 RALEY BLVD	STE 140	CHICO	CA	95928	8351	04	06007	39.71601447	-121.790817	Butte County
182926	Fee-for-Service	1700019569	1700019569	1	1	WANG, SHIN CHERN MD	2/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	116864	02	General Surgery	0	In state provider	None	4333 TORRANCE BLVD	None	TORRANCE	CA	90503	4401	19	06037	33.83759353	-118.360089	Los Angeles County
182954	Fee-for-Service	1760556070	1760556070	1	1	WEISS, ERICA F MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75068	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
182976	Fee-for-Service	1831883677	1831883677	1	1	WARUHU, FRANCIS WANJOHI	8/29/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	961 E PHILLIPS BLVD	UNIT 11	POMONA	CA	91766	7553	19	06037	34.04452949	-117.737649	Los Angeles County
183004	Fee-for-Service	1912912288	1912912288	1	1	WALGREEN CO	11/19/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3416 DEER VALLEY RD	None	ANTIOCH	CA	94531	6650	07	06013	37.98943237	-121.7853073	Contra Costa County
183030	Fee-for-Service	1689032831	1689032831	1	1	WANG, JANE MD	7/28/2022	207R00000X	NA	Other	026	PHYSICIANS	177594	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
183089	Fee-for-Service	1275635013	1275635013	1	1	WEISS, NANCY C MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	57005	41	Internal Medicine	0	In state provider	None	16300 SAN CANYON AVE	SUITE 311	IRVINE	CA	92618	3703	30	06059	33.66115075	-117.7742405	Orange County
183137	Fee-for-Service	1154376200	1154376200	1	1	WESTIN, GEORGE W JR MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	44484	20	Orthopedic Surgery	0	In state provider	None	333 E ALPINE AVE	None	STOCKTON	CA	95204	3407	39	06077	37.98100681	-121.2957195	San Joaquin County
183150	Fee-for-Service	1609954726	1609954726	1	1	WU, HENRY MD INC	10/31/1991	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	54975	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	520 N PROSPECT AVE	STE 203	REDONDO BEACH	CA	90277	3042	19	06037	33.8529819	-118.3802954	Los Angeles County
183155	Fee-for-Service	1295486215	1295486215	1	1	WALSH, LAURA J CNP	12/31/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
183163	Fee-for-Service	1689107401	1689107401	1	1	WU, SAMANTHA MD	11/14/2020	207R00000X	NA	Other	026	PHYSICIANS	170545	None	None	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
183166	Fee-for-Service	1982619219	1982619219	1	1	WALGREEN CO	8/22/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	105 EAST EL CAMINO REAL	None	SUNNYVALE	CA	94087	1937	43	06085	37.3679948	-122.0325097	Santa Clara County
183180	Fee-for-Service	1477948511	1477948511	1	1	WAGNER, KIRSTEN J MD	10/21/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	168573	18	Ophthalmology	0	In state provider	None	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	42	06083	34.45144647	-119.7604485	Santa Barbara County
183189	Fee-for-Service	1003978842	1003978842	1	1	WASHINGTON, LYNDA M LCSW	5/25/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21142	-	NOT APPLICABLE	0	In state provider	None	614 TULLY ROAD	None	SAN JOSE	CA	95111	1048	43	06085	37.30851705	-121.8465917	Santa Clara County
183194	Fee-for-Service	1114696382	1114696382	1	1	WATERFRONT PHARMACY LTC LLC	11/3/2021	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	123 S COMMERCE ST	STE. A	STOCKTON	CA	95202	2837	39	06077	37.95105947	-121.2920715	San Joaquin County
183196	Fee-for-Service	1063701407	1063701407	1	1	WHITE, EVAN C MD	6/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122204	30	Radiology	0	In state provider	None	959 LANE AVE	None	CHULA VISTA	CA	91914	4528	37	06073	32.6508918	-116.9614999	San Diego County
183202	Fee-for-Service	1932116936	1932116936	1	1	WALGREEN CO	5/3/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2595 E BIDWELL ST	None	FOLSOM	CA	95630	6439	34	06067	38.65824	-121.129425	Sacramento County
183220	Fee-for-Service	1447332036	1447332036	1	2	WELLSPACE HEALTH	11/15/2012	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	105 DEAN WAY	None	FOLSOM	CA	95630	2801	34	06067	38.676942	-121.164237	Sacramento County
183242	Fee-for-Service	1760556070	1760556070	1	1	WEISS, ERICA F MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75068	41	Internal Medicine	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
183264	Fee-for-Service	1831883677	1831883677	1	1	WARUHU, FRANCIS WANJOHI	8/29/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	961 E PHILLIPS BLVD	UNIT 11	POMONA	CA	91766	7553	19	06037	34.04452949	-117.737649	Los Angeles County
183295	Fee-for-Service	1003376153	1003376153	1	1	WEMHOFF, RACHEL MD	10/4/2023	390200000X	NA	Other	026	PHYSICIANS	190824	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
183323	Fee-for-Service	1518107838	1518107838	1	1	WEI, CHRISTINA H MD	3/19/2019	207ZP0102X	NA	Other	026	PHYSICIANS	106479	22	Pathology (M.D. only)	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
183341	Fee-for-Service	1073652004	1073652004	1	1	WEISS, MARY M MD	2/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112699	36	Psychiatry	0	In state provider	None	995 GATEWAY CENTER WAY	SUITE 300	SAN DIEGO	CA	92102	4550	37	06073	32.71405516	-117.1158459	San Diego County
183347	Fee-for-Service	1720467509	1720467509	1	1	WOLF, LIBBY S NP	10/24/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
183350	Fee-for-Service	1003436064	1003436064	1	68	WS AUDIOLOGY (CALIFORNIA), P	5/24/2024	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	9166 MIRA MESA BLVD	SUITE 4	SAN DIEGO	CA	92126	4804	37	06073	32.91724549	-117.1264365	San Diego County
183367	Fee-for-Service	1245237486	1245237486	1	1	WEST VALLEY HOSPITAL	5/11/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	525 SE WASHINGTON ST	None	DALLAS	OR	97338	2834	00	None	44.91937853	-123.3104265	Polk County
183376	Fee-for-Service	1790003325	1790003325	1	1	WHITTLE, STEPHANIE M MD	2/14/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	116253	None	None	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
183408	Fee-for-Service	1558386524	1558386524	1	1	WISEMAN, CRAIG M MD	11/4/2008	174400000X	NA	Other	026	PHYSICIANS	89927	20	Orthopedic Surgery	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3194	07	06013	37.9141514	-122.0422089	Contra Costa County
183424	Fee-for-Service	1497929111	1497929111	1	1	WASHINGTON & ASSOCIATES	8/24/2021	163WP0000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	6501 TRUXTUN	None	BAKERSFIELD	CA	93309	0633	15	06029	35.36196445	-119.0749413	Kern County
183447	Fee-for-Service	1669472288	1669472288	1	1	WALKES, JON-CECIL M MD	7/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54082	33	Thoracic Surgery	0	In state provider	None	1860 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55887933	-121.9797796	Alameda County
183452	Fee-for-Service	1407868433	1407868433	1	1	WEXLEY, LILIA R MD	6/26/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	45560	None	None	0	In state provider	CLINIC	6200 WILSHIRE BLVD	# 908	LOS ANGELES	CA	90048	5801	19	06037	34.06319291	-118.3636025	Los Angeles County
183484	Fee-for-Service	1063701407	1063701407	1	1	WHITE, EVAN C MD	6/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122204	78	Neoplastic Diseases/Oncology	0	In state provider	None	959 LANE AVE	None	CHULA VISTA	CA	91914	4528	37	06073	32.6508918	-116.9614999	San Diego County
183503	Fee-for-Service	1114033412	1114033412	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3301 PANAMA LN	None	BAKERSFIELD	CA	93313	3631	15	06029	35.29582172	-119.039711	Kern County
183539	Fee-for-Service	1134366818	1134366818	1	1	WITKOSKY, MICHAEL MD	9/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106272	30	Radiology	0	In state provider	None	8700 BEVERLY BLVD M-335	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
183604	Fee-for-Service	1629657234	1629657234	1	1	WANG, DEYU MD	8/26/2024	207R00000X	NA	Other	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
183609	Fee-for-Service	1518107838	1518107838	1	1	WEI, CHRISTINA H MD	3/19/2019	207ZP0102X	NA	Other	026	PHYSICIANS	106479	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
183637	Fee-for-Service	1003436064	1003436064	1	68	WS AUDIOLOGY (CALIFORNIA), P	5/24/2024	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	9166 MIRA MESA BLVD	SUITE 4	SAN DIEGO	CA	92126	4804	37	06073	32.91724549	-117.1264365	San Diego County
183656	Fee-for-Service	1245237486	1245237486	1	1	WEST VALLEY HOSPITAL	5/11/2009	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	525 SE WASHINGTON ST	None	DALLAS	OR	97338	2834	00	None	44.91937853	-123.3104265	Polk County
183658	Fee-for-Service	1730427634	1730427634	1	1	WAL-MART STORES INC	6/12/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1320 N DEMAREE ST	None	VISALIA	CA	93291	7714	54	06107	36.341424	-119.330028	Tulare County
183668	Fee-for-Service	1417944893	1417944893	1	1	WANG, MINCHEN	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3023 BUNKER HILL ST	STE 206	SAN DIEGO	CA	92109	5706	37	06073	32.80338605	-117.2152206	San Diego County
183670	Fee-for-Service	1275546285	1275546285	1	1	WALDEN,HENRY D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SAINT LOUIS UNIV	3635 VISTA	None	ST LOUIS	MO	63110	0000	00	None	38.62249413	-90.23900688	St. Louis city
183711	Fee-for-Service	1194884817	1194884817	1	1	WHEELER, YVONNE A	1/22/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
183712	Fee-for-Service	1497384473	1497384473	1	1	WANG, CLARA MD	10/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	189619	None	None	0	In state provider	None	1721 TECHNOLOGY DR	None	SAN JOSE	CA	95110	1305	43	06085	37.36464282	-121.9163895	Santa Clara County
183728	Fee-for-Service	1245515972	1245515972	1	1	WONG, JENNY Y NP	5/17/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
183737	Fee-for-Service	1780022418	1780022418	1	1	WEST, KATIE L LMFT	12/19/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	505 S VILLA REAL	117	ANAHEIM	CA	92807	3441	30	06059	33.83712262	-117.8220203	Orange County
183761	Fee-for-Service	1003338252	1003338252	1	1	WATANABE, JOCELYN Y LAC	10/28/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1110 SUNNYVALE SARATOGA	B2	SUNNYVALE	CA	94087	2554	43	06085	37.35621	-122.032251	Santa Clara County
183777	Fee-for-Service	1831403195	1831403195	1	1	WHEELER, CARLINA R PHD	5/16/2022	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3160 FOLSOM BOULEVARD	STE 2900	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
183790	Fee-for-Service	1659646891	1659646891	1	1	WU, CALVIN C MD	5/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	122403	67	Endocrinology	0	In state provider	None	2215 TRUXTUN AVE	SUITE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
183843	Fee-for-Service	1295993707	1295993707	1	1	WU, ANDREA W MD	1/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110099	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
183864	Fee-for-Service	1427254457	1427254457	1	1	WILLY HWANG M.D.	7/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5171 W OLIVE AVE	None	GLENDALE	AZ	85302	4204	00	None	33.567093	-112.1719365	Maricopa County
183890	Fee-for-Service	1629657234	1629657234	1	1	WANG, DEYU MD	8/26/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
183908	Fee-for-Service	1427063700	1427063700	1	1	WALGREEN COMPANY	3/16/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12275 PERRIS BLVD	None	MORENO VALLEY	CA	92557	7432	33	06065	33.942231	-117.226418	Riverside County
183917	Fee-for-Service	1679853832	1679853832	1	1	WALGREEN CO	12/6/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15318 ROY ROGERS DR	None	VICTORVILLE	CA	92394	2160	36	06071	34.5214751	-117.3296486	San Bernardino County
183918	Fee-for-Service	1962622803	1962622803	1	1	WARREN REGH C GABRILLO III	7/9/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51794	None	None	0	In state provider	MD INC	631 N 13TH AVE	STE A	UPLAND	CA	91786	4946	36	06071	34.10139899	-117.6337368	San Bernardino County
183943	Fee-for-Service	1992024749	1992024749	1	1	WEISS, TIMOTHY E MD	6/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120627	01	General Practice	0	In state provider	None	1920 COLORADO AVE	None	LOS ANGELES	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles
183951	Fee-for-Service	1508901810	1508901810	1	1	WILDE, MARY K MD	2/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	65602	02	General Surgery	0	In state provider	None	9900 GENESEE AVE	STE D	LA JOLLA	CA	92037	1210	37	06073	32.88682239	-117.2264039	San Diego County
183972	Fee-for-Service	1760971717	1760971717	1	1	WU, VINCENT R CRNA	1/28/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
183978	Fee-for-Service	1407313513	1407313513	1	1	WONG, CHELSEA C NP	2/12/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
184010	Fee-for-Service	1548830268	1548830268	1	1	WEST COAST THORACIC SURGERY	6/2/2022	208G00000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	510 PROSPECT AVE	118	REDONDO BEACH	CA	90277	3028	19	06037	33.85259344	-118.379739	Los Angeles County
184015	Fee-for-Service	1548258502	1548258502	1	1	WANG, EMILY KUO OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1181 E HUNTINGTON DR	None	DUARTE	CA	91010	2400	19	06037	34.1397393	-117.978871	Los Angeles County
184035	Fee-for-Service	1952583569	1952583569	1	1	WALK-IN MEDICAL CARE	4/25/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	3760 ATLANTIC AVE	None	LONG BEACH	CA	90807	3409	19	06037	33.826347	-118.1850025	Los Angeles County
184038	Fee-for-Service	1518118892	1518118892	1	1	WU, DAVID T DO	9/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116749	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
184053	Fee-for-Service	1649743691	1649743691	1	1	WHITE, CAMERON LMFT	8/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
184056	Fee-for-Service	1275690778	1275690778	1	1	WERNER, SUSAN E LCSW	10/1/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	15715	-	NOT APPLICABLE	0	In state provider	None	925 BROCKHURST ST	None	OAKLAND	CA	94608	4222	01	06001	37.82348261	-122.2769038	Alameda County
184106	Fee-for-Service	1811993629	1811993629	1	1	WILSON, BARNARD G OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1150 W ROBINHOOD DR	STE 2A	STOCKTON	CA	95207	5631	39	06077	37.99953532	-121.3211248	San Joaquin County
184107	Fee-for-Service	1326093626	1326093626	1	1	WELLBOUND OF SANTA ROSA	2/24/2006	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	2301 CIRCADIAN WAY	STE B	SANTA ROSA	CA	95407	5416	49	06097	38.421936	-122.7533895	Sonoma County
184143	Fee-for-Service	1528313624	1528313624	1	1	WYATT, ALVIN R II MD	7/25/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	147190	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
184163	Fee-for-Service	1588774368	1588774368	2	1	WILLIAMS, NEVILLE MD	11/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	34071	34	Urology and Urological Surgery	0	In state provider	None	10 CONGRESS STREET	SUITE 210	PASADENA	CA	91105	3058	19	06037	34.13396893	-118.1528162	Los Angeles County
184167	Fee-for-Service	1649547795	1649547795	1	1	WALKER, BRIANNE E LMFT	1/9/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	505 E ROMIE LN	SUITE F	SALINAS	CA	93901	4031	27	06053	36.65998191	-121.6461895	Monterey County
184177	Fee-for-Service	1275576795	1275576795	1	1	WHITING, MIKEL R MD	3/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	36876	20	Orthopedic Surgery	0	In state provider	None	2151 N HARBOR BLVD	None	FULLERTON	CA	92835	3801	30	06059	33.89443025	-117.9288328	Orange County
184195	Fee-for-Service	1952704645	1952704645	1	1	WITH GRACE MINISTRIES INC	6/15/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4075 EVERGREEN VILLAGE	210	SAN JOSE	CA	95135	1766	43	06085	37.31407259	-121.7734535	Santa Clara County
184196	Fee-for-Service	1912432758	1912432758	1	1	WEINEL, KATIE V MD	8/22/2022	2084P0804X	NA	Psychiatry	026	PHYSICIANS	176904	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
184202	Fee-for-Service	1215701602	1215701602	1	1	WONG, MARIA A OT	5/3/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
184204	Fee-for-Service	1912220484	1912220484	1	1	WALGREEN CO	9/2/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	880 SUTTON WAY	None	GRASS VALLEY	CA	95945	5167	29	06057	39.23520763	-121.0340543	Nevada County
184291	Fee-for-Service	1356166060	1356166060	1	1	WU, CONNOR PT	2/3/2025	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	501 MARIN ST	SUITE 205	THOUSAND OAKS	CA	91360	4260	56	06111	34.18371146	-118.8824904	Ventura County
184293	Fee-for-Service	1710994777	1710994777	1	1	WALGREEN CO	7/25/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	199 PARNASSUS AVE	None	SAN FRANCISCO	CA	94117	4260	38	06075	37.7644964	-122.4523028	San Francisco County
184304	Fee-for-Service	1215001987	1215001987	1	1	WIJESEKERA, STANLEY MD	12/31/1985	193400000X	NA	Other	026	PHYSICIANS	31188	40	Pediatrics	0	In state provider	None	101 E BEVERLY BLVD	STE 305	MONTEBELLO	CA	90640	4316	19	06037	34.01556395	-118.0983878	Los Angeles County
184384	Fee-for-Service	1043240120	1043240120	1	1	WOO, Y JOSEPH MD	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128440	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
184436	Fee-for-Service	1952338378	1952338378	1	1	WILLIAM BALISTRERI	6/24/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3333 BURNET AVE	None	CINCINNATI	OH	45229	3026	00	None	39.14105892	-84.50040782	Hamilton County
184439	Fee-for-Service	1255631925	1255631925	1	1	WESTERN ACUTE CARE	11/29/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PHYSICIANS INC	2231 S WESTERN AVE	None	LOS ANGELES	CA	90018	1302	19	06037	34.03512469	-118.3090138	Los Angeles County
184448	Fee-for-Service	1376702415	1376702415	1	1	WEYL, TERRY C PHD	2/20/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	941 SPRING STREET	SUITE 5	PLACERVILLE	CA	95667	4546	09	06017	38.73242647	-120.801216	El Dorado County
184464	Fee-for-Service	1942508171	1942508171	1	1	WINDFLOWER HOLDINGS LLC	6/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	625 16TH STREET	None	LAKEPORT	CA	95453	3501	17	06033	39.05272149	-122.9198625	Lake County
184476	Fee-for-Service	1972866911	1972866911	1	1	WILLIS, ANTHONY MD	4/13/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	166750	30	Radiology	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
184486	Fee-for-Service	1952704645	1952704645	1	1	WITH GRACE MINISTRIES INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4075 EVERGREEN VILLAGE	210	SAN JOSE	CA	95135	1766	43	06085	37.31407259	-121.7734535	Santa Clara County
184509	Fee-for-Service	1730169988	1730169988	1	1	WU, MICHELLE W OD	6/22/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ENVISION OPTOMETRIC EYEC	655 W DUARTE RD	STE B	ARCADIA	CA	91007	7332	19	06037	34.12630473	-118.05356	Los Angeles County
184557	Fee-for-Service	1447332036	1447332036	1	6	WELLSPACE HEALTH	4/23/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3900 47TH AVE	None	SACRAMENTO	CA	95824	2430	34	06067	38.509506	-121.4626725	Sacramento County
184586	Fee-for-Service	1962429373	1962429373	1	1	WAL-MART STORES, INC	2/11/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-2648	1919 DAVIS ST	None	SAN LEANDRO	CA	94577	1208	01	06001	37.714644	-122.1776955	Alameda County
184628	Fee-for-Service	1790764389	1790764389	1	1	WHITNEY, BRUCE L PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2239 TOWNSGATE RD	STE 104	WESTLAKE VILLAGE	CA	91361	2429	56	06111	34.16117552	-118.8369945	Ventura County
184746	Fee-for-Service	1477084309	1477084309	1	1	WELDY, CHAD S MD	6/28/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	157175	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
184749	Fee-for-Service	1104809474	1104809474	1	1	WESTON, ABIGAL N NP	12/4/2006	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4800 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1530	34	06067	38.5461	-121.449258	Sacramento County
184762	Fee-for-Service	1487815460	1487815460	1	1	WERNER, RENEE A CCC-SLP	7/8/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2180 GRANT LINE RD	201	TRACY	CA	95377	7342	39	06077	37.75399789	-121.4571561	San Joaquin County
184787	Fee-for-Service	1316019946	1316019946	2	1	WILLIAM A WASWICK MD	4/6/2020	207RC0200X	NA	Other	026	PHYSICIANS	161788	None	None	0	In state provider	None	1730 PRAIRIE CITY ROAD	SUITE 120	FOLSOM	CA	95630	9594	34	06067	38.651472	-121.167387	Sacramento County
184814	Fee-for-Service	1821088659	1821088659	1	1	WILLIAMS, DOUGLAS OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6042 WARNER AVE	None	HUNTINGTON BEACH	CA	92647	5568	30	06059	33.71537445	-118.0235169	Orange County
184832	Fee-for-Service	1720240575	1720240575	1	1	WILKINSON, AMANDA N MD	10/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130085	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2601 E MAIN ST	SUITE 104	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
184844	Fee-for-Service	1447332036	1447332036	1	6	WELLSPACE HEALTH	4/23/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3900 47TH AVE	None	SACRAMENTO	CA	95824	2430	34	06067	38.509506	-121.4626725	Sacramento County
184850	Fee-for-Service	1467815175	1467815175	1	1	WANG, LIANG MD	8/31/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	169965	None	None	0	In state provider	None	18460 ROSCOE BLVD	FL 3	NORTHRIDGE	CA	91325	4107	19	06037	34.22071454	-118.5357375	Los Angeles County
184919	Fee-for-Service	1194779488	1194779488	1	1	WALSH, JUDITH M MD	4/1/1989	207R00000X	NA	Other	026	PHYSICIANS	65600	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1330 CUTTING BLVD	None	RICHMOND	CA	94804	2555	07	06013	37.92518651	-122.3564715	Contra Costa County
184945	Fee-for-Service	1497173355	1497173355	1	1	WANG, LEI MD	9/3/2019	207RR0500X	NA	Other	026	PHYSICIANS	144428	83	Rheumatology	0	In state provider	None	2081 BRONZE STAR DR	None	WOODLAND	CA	95776	5423	57	06113	38.67049812	-121.7238394	Yolo County
184952	Fee-for-Service	1053388702	1053388702	1	1	WOOD, KIRKHAM B MD	10/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136566	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
184986	Fee-for-Service	1003436064	1003436064	1	34	WS AUDIOLOGY (CALIFORNIA), P	4/30/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3525 PACIFIC COAST HWY	N	TORRANCE	CA	90505	0000	19	06037	33.80337655	-118.3474795	Los Angeles County
185022	Fee-for-Service	1669556734	1669556734	1	1	WRIGHT, EUGENE N MD	8/21/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	43349	36	Psychiatry	0	In state provider	None	2044 HAWTHORNE CT	None	SANTA ROSA	CA	95404	3223	49	06097	38.45394	-122.692176	Sonoma County
185056	Fee-for-Service	1265427835	1265427835	1	1	WEINER, HOWARD L MD	2/1/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
185084	Fee-for-Service	1609862333	1609862333	1	1	WOODRUFF, DAVID E JR MD	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	34162	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5301 F ST	STE 117	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
185152	Fee-for-Service	1144382920	1144382920	1	1	WALTERS-KNIGHT, CATHIA T PHD	1/15/2013	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	419 KEARNEY ST	None	EL CERRITO	CA	94530	3656	07	06013	37.90151953	-122.3019527	Contra Costa County
185207	Fee-for-Service	1194779488	1194779488	1	1	WALSH, JUDITH M MD	4/1/1989	207R00000X	NA	Other	026	PHYSICIANS	65600	41	Internal Medicine	0	In state provider	None	1330 CUTTING BLVD	None	RICHMOND	CA	94804	2555	07	06013	37.92518651	-122.3564715	Contra Costa County
185215	Fee-for-Service	1013142678	1013142678	1	1	WONG, CLARISSEE A R MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120435	08	Family Practice	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
185223	Fee-for-Service	1205502564	1205502564	1	1	WONG, ANNA L PT	9/14/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	855 S TRACY BLVD	None	TRACY	CA	95376	4744	39	06077	37.72411856	-121.4349148	San Joaquin County
185232	Fee-for-Service	1184615650	1184615650	1	1	WILSON, SEAN P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	606 N MAIN ST	None	EAGAR	AZ	85925	9813	00	None	34.122087	-109.2921255	Apache County
185240	Fee-for-Service	1316058530	1316058530	1	1	WADE, DONALD H MD	3/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	19254	30	Radiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
185246	Fee-for-Service	1477142214	1477142214	1	1	WALSH, LAUREN C CRNA	8/10/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	18111 BROOKHURST STREET	None	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
185273	Fee-for-Service	1003436064	1003436064	1	34	WS AUDIOLOGY (CALIFORNIA), P	4/30/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3525 PACIFIC COAST HWY	N	TORRANCE	CA	90505	0000	19	06037	33.80337655	-118.3474795	Los Angeles County
185333	Fee-for-Service	1134573645	1134573645	1	1	WINKLER, MARK MD	3/28/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	155895	None	None	0	In state provider	None	830 2ND ST	STE A	SANTA ROSA	CA	95404	4620	49	06097	38.440746	-122.7085605	Sonoma County
185354	Fee-for-Service	1114905494	1114905494	1	1	WONG, KALANE J MD	3/1/1990	207W00000X	NA	Ophthalmology	026	PHYSICIANS	62085	18	Ophthalmology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
185412	Fee-for-Service	1588665111	1588665111	1	1	WILLIAMS, LILLIE M MD	3/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	45814	40	Pediatrics	0	In state provider	None	24853 ALESSANDRO BLVD	STE 4	MORENO VALLEY	CA	92553	6102	33	06065	33.91718453	-117.228627	Riverside County
185418	Fee-for-Service	1780664664	1780664664	2	1	WILSON, DUANE C MD	10/4/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	50508	30	Radiology	0	In state provider	None	29101 HOSPITAL RD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
185420	Fee-for-Service	1649833039	1649833039	1	1	WU, VICTORIA L MD	6/18/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	178598	None	None	0	In state provider	None	1001 POTRERO AVE	RM 4M62	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
185426	Fee-for-Service	1366207623	1366207623	1	1	WONG, SYLVIA	11/15/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 W GLENOAKS BLVD	None	GLENDALE	CA	91202	2813	19	06037	34.15937082	-118.2644042	Los Angeles County
185503	Fee-for-Service	1013142678	1013142678	1	1	WONG, CLARISSEE A R MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120435	01	General Practice	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
185505	Fee-for-Service	1497760789	1497760789	1	1	WALGREEN CO	10/8/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1250 E CHAPMAN AVE	None	FULLERTON	CA	92831	3901	30	06059	33.87407154	-117.9059715	Orange County
185516	Fee-for-Service	1881795052	1881795052	1	1	WANG, CHING C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	DIGESTIVE DISEASE SPEC	1001 DIVISION ST, STE A	None	PRESCOTT	AZ	86301	0000	00	None	34.559667	-112.4793135	Yavapai County
185577	Fee-for-Service	1629422977	1629422977	1	1	WANG, YUN MD	10/26/2023	207RI0008X	NA	Gastroenterology	026	PHYSICIANS	152013	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
185596	Fee-for-Service	1568553626	1568553626	1	1	WANG, INGRID Y MD	9/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53968	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
185613	Fee-for-Service	1306073408	1306073408	1	1	WALKER, CHRISTIAN M R MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128812	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
185629	Fee-for-Service	1174073506	1174073506	1	1	WILSHIRE ENDOSCOPY CENTER LL	3/8/2023	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	C	3200 WILSHIRE BLVD	STE 101	LOS ANGELES	CA	90010	1333	19	06037	34.06176518	-118.2920553	Los Angeles County
185653	Fee-for-Service	1922184456	1922184456	1	1	WISDOM, JERALD MD	6/23/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	83714	18	Ophthalmology	0	In state provider	None	480 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13286634	-121.6142652	Sutter County
185669	Fee-for-Service	1508425257	1508425257	1	1	WALSH LANG, COLLEEN MD	9/7/2023	390200000X	NA	Other	026	PHYSICIANS	177335	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
185691	Fee-for-Service	1093720377	1093720377	1	1	WALGREEN CO	6/8/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1351 W CAPITOL AVE	None	WEST SACRAMENTO	CA	95691	3213	57	06113	38.58078833	-121.5255797	Yolo County
185716	Fee-for-Service	1730238783	1730238783	1	1	WHITE, SUZANNE J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	64192	08	Family Practice	0	In state provider	None	285 MERCEY SPRINGS RD	STE D	LOS BANOS	CA	93635	3878	24	06047	37.06510914	-120.8352557	Merced County
185754	Fee-for-Service	1932519790	1932519790	1	1	WU, DANIEL	9/1/2020	207R00000X	NA	Other	026	PHYSICIANS	138267	68	Hematology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
185809	Fee-for-Service	1780901520	1780901520	1	1	WESTWOOD EYE SURGICAL	11/26/2013	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	INSTITUTE INC	10884 SANTA MONICA BLVD	#2	LOS ANGELES	CA	90025	4646	19	06037	34.04943699	-118.4375804	Los Angeles County
185811	Fee-for-Service	1053595686	1053595686	1	1	WANG, SHIRLEY L MD	7/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	79607	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
185814	Fee-for-Service	1003436064	1003436064	1	66	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2360 S AZUSA AVE	A3	WEST COVINA	CA	91792	1539	19	06037	34.03422947	-117.9131031	Los Angeles County
185918	Fee-for-Service	1598897555	1598897555	1	1	WAAS, PAULINA	3/16/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20601 HIGHWAY 18	NUMBER 109	APPLE VALLEY	CA	92307	3567	36	06071	34.52356839	-117.217061	San Bernardino County
185931	Fee-for-Service	1982121927	1982121927	1	1	WILLARD, CHRISTEN LCSW	5/28/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
185955	Fee-for-Service	1053548115	1053548115	1	1	WEI-MESTER, SINDY H MD	5/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110550	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3095	19	06037	34.06373445	-118.443537	Los Angeles County
185993	Fee-for-Service	1699729558	1699729558	1	1	WONG, PHILIP Y MD	5/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90014	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
185995	Fee-for-Service	1932126356	1932126356	1	1	WAL-MART STORES, INC	3/27/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	479 N MCKINLEY ST	None	CORONA	CA	92879	1205	33	06065	33.890859	-117.517275	Riverside County
186036	Fee-for-Service	1942368576	1942368576	1	1	WOOD, BARRY E JR. CRNA	7/25/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	825 DELBON AVENUE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
186040	Fee-for-Service	1760685218	1760685218	1	1	WANG, SHARON	7/1/2020	103TC1900X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2033 GATEWAY PL	FL 5	SAN JOSE	CA	95110	3709	43	06085	37.37182372	-121.9248711	Santa Clara County
186043	Fee-for-Service	1114490398	1114490398	1	1	WANG, FLORENCE M PHD/PSYD	1/22/2019	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
186055	Fee-for-Service	1841392032	1841392032	1	1	WONG, LI C MD	2/27/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	60736	40	Pediatrics	0	In state provider	None	2100 FOOTHILL BLVD	SUITE A	LA VERNE	CA	91750	2905	19	06037	34.11308422	-117.764666	Los Angeles County
186078	Fee-for-Service	1710254313	1710254313	1	1	WAHID MEDICAL CORPORATION	12/23/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1108 WARD AVENUE	BLDG A,STE 1	PATTERSON	CA	95363	8529	50	06099	37.48636445	-121.1407911	Stanislaus County
186100	Fee-for-Service	1710065404	1710065404	1	1	WIPER, CHRISTINE M MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71681	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
186121	Fee-for-Service	1497075600	1497075600	1	1	WOZNICA, MAURA A MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121618	01	General Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
186145	Fee-for-Service	1033182829	1033182829	1	1	WOOD, JOHN W OD APC	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	525 NEW LOS ANGELES AVE	STE F	MOORPARK	CA	93021	2068	56	06111	34.27895451	-118.873728	Ventura County
186160	Fee-for-Service	1841589777	1841589777	1	1	WHITMORE, WENDY LMFT	2/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1060 E FOOTHILL BLVD	204	UPLAND	CA	91786	4070	36	06071	34.1070235	-117.6371235	San Bernardino County
186181	Fee-for-Service	1194717025	1194717025	1	1	WECARE HEALTH INC	2/6/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	MOLINAS PHARMACY	3746 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1704	19	06037	34.02398968	-118.1924183	Los Angeles County
186221	Fee-for-Service	1437521663	1437521663	1	1	WHITE, IMANI R LPCC	10/30/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
186240	Fee-for-Service	1144208885	1144208885	1	1	WAITE, BRANDEE L MD	11/3/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79238	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
186244	Fee-for-Service	1568640720	1568640720	1	1	WU, THOMAS Y MD	9/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98923	20	Orthopedic Surgery	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
186265	Fee-for-Service	1598057333	1598057333	1	1	WAI, ANDREW W MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122799	40	Pediatrics	0	In state provider	None	25845 BARTON RD	SUITE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
186269	Fee-for-Service	1194155325	1194155325	1	1	WISE, THOMAS A	5/21/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	9033 BASE LINE ROAD	SUITE F	RANCHO CUCAMONGA	CA	91730	1214	36	06071	34.12151248	-117.6080805	San Bernardino County
186276	Fee-for-Service	1093764151	1093764151	1	1	WEBB, MELVIN MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	38608	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
186313	Fee-for-Service	1639497985	1639497985	1	1	WELLS, TREVOR O MD	4/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119988	36	Psychiatry	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
186349	Fee-for-Service	1518105022	1518105022	1	1	WANG, WILLIAM MD	9/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103764	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
186367	Fee-for-Service	1710254313	1710254313	1	1	WAHID MEDICAL CORPORATION	12/23/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1108 WARD AVENUE	BLDG A,STE 1	PATTERSON	CA	95363	8529	50	06099	37.48636445	-121.1407911	Stanislaus County
186439	Fee-for-Service	1114625654	1114625654	1	1	WERU, GRACE NYAMBURA	6/7/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6850 MASSY HARRIS WAY	None	EASTVALE	CA	92880	3427	33	06065	33.962652	-117.5630915	Riverside County
186444	Fee-for-Service	1528377553	1528377553	1	1	WHITE, CHRISTOPHER L MD	10/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126600	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
186513	Fee-for-Service	1790801439	1790801439	1	1	WONG, DORIS H OPT	3/8/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	36 W 10TH ST	None	TRACY	CA	95376	3902	39	06077	37.73844816	-121.426868	San Joaquin County
186521	Fee-for-Service	1740909514	1740909514	1	1	WASHINGTON, SHAWNTRES NP	3/22/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2777 LONG BEACH BLVD	STE 200	LONG BEACH	CA	90806	1513	19	06037	33.80734327	-118.189472	Los Angeles County
186542	Fee-for-Service	1023083185	1023083185	1	1	WU, HUI MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	67731	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
186544	Fee-for-Service	1659384121	1659384121	1	1	WEILAND, DAVID S MD	7/31/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	60093	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
186564	Fee-for-Service	1093764151	1093764151	1	1	WEBB, MELVIN MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	38608	41	Internal Medicine	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
186576	Fee-for-Service	1245383256	1245383256	1	1	WEAVER, KATHERINE M	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
186592	Fee-for-Service	1740476761	1740476761	1	1	WELTY, KATHRYN M MD	11/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126967	None	None	0	In state provider	None	20055 LAKE CHABOT RD	STE 230	CASTRO VALLEY	CA	94546	5333	01	06001	37.69836512	-122.0873587	Alameda County
186616	Fee-for-Service	1144484973	1144484973	1	1	WATT, MRIDULA B MD	10/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110073	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
186654	Fee-for-Service	1710254313	1710254313	1	1	WAHID MEDICAL CORPORATION	1/20/2012	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1108 WARD AVENUE	BLDG A,STE 1	PATTERSON	CA	95363	8529	50	06099	37.48636445	-121.1407911	Stanislaus County
186702	Fee-for-Service	1861846867	1861846867	1	1	WOODALL, BRITTANY M DO	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15963	20	Orthopedic Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
186726	Fee-for-Service	1114625654	1114625654	1	1	WERU, GRACE NYAMBURA	6/7/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6850 MASSY HARRIS WAY	None	EASTVALE	CA	92880	3427	33	06065	33.962652	-117.5630915	Riverside County
186733	Fee-for-Service	1861717605	1861717605	1	1	WESTERN PHYSICAL THERAPY INC	12/28/2010	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1495 VICTOR AVE	STE D	REDDING	CA	96003	4093	45	06089	40.586022	-122.338834	Shasta County
186747	Fee-for-Service	1285720797	1285720797	1	1	WATKINS, MELANIE M MD	12/5/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	89159	36	Psychiatry	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
186821	Fee-for-Service	1174084610	1174084610	1	1	WENG, JULIUS MD	7/25/2024	2085R0001X	NA	Other	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1000 FIVEPOINT	None	IRVINE	CA	92618	2377	30	06059	33.65251244	-117.7317885	Orange County
186830	Fee-for-Service	1588353312	1588353312	1	1	WECARE MEDICAL PHARMACY LLC	8/11/2024	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1955 CITRACADO PKWY	101	ESCONDIDO	CA	92029	4111	37	06073	33.11301099	-117.1202081	San Diego County
186834	Fee-for-Service	1659384121	1659384121	1	1	WEILAND, DAVID S MD	7/31/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	60093	41	Internal Medicine	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
186886	Fee-for-Service	1215374913	1215374913	1	1	WAL-MART STORES INC	8/15/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2050 NUT TREE RD	None	VACAVILLE	CA	95687	7108	48	06095	38.350575	-121.9530605	Solano County
186894	Fee-for-Service	1093342362	1093342362	1	1	WU, KEVIN K MD	6/30/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	181215	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
186901	Fee-for-Service	1144484973	1144484973	1	1	WATT, MRIDULA B MD	10/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110073	40	Pediatrics	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
186929	Fee-for-Service	1265241988	1265241988	1	1	WU, JERRY	2/28/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
186931	Fee-for-Service	1164616223	1164616223	2	1	WU, DEREK J MD	4/8/2016	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	101672	40	Pediatrics	0	In state provider	None	3801 KATELLA AVE	STE 221	LOS ALAMITOS	CA	90720	3380	30	06059	33.80318951	-118.066068	Orange County
186942	Fee-for-Service	1417186388	1417186388	1	1	WALSH, SHARON JEAN	11/1/2013	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	10282 MCCRACKEN DR	None	RANCHO CORDOVA	CA	95670	5419	34	06067	38.585457	-121.308372	Sacramento County
186943	Fee-for-Service	1750370391	1750370391	1	1	WILLIAMS, DIANE C MD	2/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	251 MAPLE ST	None	ASHLAND	OR	97520	1516	00	None	42.20650947	-122.7244455	Jackson County
187035	Fee-for-Service	1508555780	1508555780	1	1	WEN, JIARONG NP	5/31/2024	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
187119	Fee-for-Service	1730477621	1730477621	1	1	WATERS, ELIZABETH J MD	8/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113933	40	Pediatrics	0	In state provider	None	292 EUCLID AVE	STE 220	SAN DIEGO	CA	92114	3629	37	06073	32.70706919	-117.0850896	San Diego County
187217	Fee-for-Service	1033614482	1033614482	1	1	WONG, SAMANTHA MD	7/12/2021	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	165098	None	None	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
187228	Fee-for-Service	1417186388	1417186388	1	1	WALSH, SHARON JEAN	11/1/2013	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	10282 MCCRACKEN DR	None	RANCHO CORDOVA	CA	95670	5419	34	06067	38.585457	-121.308372	Sacramento County
187248	Fee-for-Service	1427317403	1427317403	1	1	WENTZEL, KRISTOPHER P MD	9/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	128813	78	Neoplastic Diseases/Oncology	0	In state provider	None	2001 SANTA MONICA BLVD	560W	SANTA MONICA	CA	90404	2182	19	06037	34.02891163	-118.4797466	Los Angeles County
187253	Fee-for-Service	1629437819	1629437819	1	1	WAL-MART STORES INC	6/22/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 N VICTORY PL	None	BURBANK	CA	91502	1649	19	06037	34.18876413	-118.3246411	Los Angeles County
187270	Fee-for-Service	1649294133	1649294133	1	1	WORSHAM, STEPHEN ALLEN	3/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	49792	34	Urology and Urological Surgery	0	In state provider	None	1115 LOS PALOS DR	None	SALINAS	CA	93901	3853	27	06053	36.65750452	-121.6453892	Monterey County
187276	Fee-for-Service	1861925463	1861925463	1	1	WHEELER, MICHELLE E MD	12/13/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	2	Out of state provider	None	10123 SE MARKET STREET	None	PORTLAND	OR	97216	2532	00	None	45.51158947	-122.5586205	Multnomah County
187322	Fee-for-Service	1528251840	1528251840	1	1	WILK, JACQUELINE C MD	6/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	1	Border provider	None	2825 E BARNETT ROAD	None	MEDFORD	OR	97505	8332	00	None	42.31650147	-122.8306005	Jackson County
187344	Fee-for-Service	1396768883	1396768883	1	1	WRIGHT, PHILLIP G MD	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	17389	33	Thoracic Surgery	0	In state provider	None	2844 SUMMIT ST	STE 212	OAKLAND	CA	94609	3642	01	06001	37.81754276	-122.2646445	Alameda County
187384	Fee-for-Service	1972548139	1972548139	1	1	WENDT, FREDERCIK C MD	4/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	85365	30	Radiology	0	In state provider	None	2800 L STREET	STE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
187460	Fee-for-Service	1447432984	1447432984	1	1	WIERENGA, CHRISTINA E PHD	9/20/2010	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
187475	Fee-for-Service	1285052860	1285052860	1	1	WINOGRAD, PAUL D MD	10/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141274	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
187533	Fee-for-Service	1427317403	1427317403	1	1	WENTZEL, KRISTOPHER P MD	9/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	128813	68	Hematology	0	In state provider	None	2001 SANTA MONICA BLVD	560W	SANTA MONICA	CA	90404	2182	19	06037	34.02891163	-118.4797466	Los Angeles County
187562	Fee-for-Service	1891873626	1891873626	1	1	WATTER, NEIL F MD	9/13/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	37373	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
187564	Fee-for-Service	1396958559	1396958559	1	1	WATTS, WILLIAM J MD	12/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	82647	None	None	0	In state provider	None	7592 METROPOLITAN DR	SUITE 405	SAN DIEGO	CA	92108	4428	37	06073	32.77772014	-117.1575637	San Diego County
187614	Fee-for-Service	1093445421	1093445421	1	1	WEI, HSIAO-CHEN	1/7/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	568 N SUNRISE AVE	STE 100	ROSEVILLE	CA	95661	3035	31	06061	38.7576732	-121.2534645	Placer County
187618	Fee-for-Service	1326307430	1326307430	1	1	WEN, KWUN W MD	6/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136853	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.76344756	-122.4581992	San Francisco County
187629	Fee-for-Service	1295742161	1295742161	1	1	WAYNE, BARBARA J LMFT	6/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14081 YORBA ST	STE 224	TUSTIN	CA	92780	2011	30	06059	33.7582604	-117.8296904	Orange County
187630	Fee-for-Service	1396768883	1396768883	1	1	WRIGHT, PHILLIP G MD	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	17389	01	General Practice	0	In state provider	None	2844 SUMMIT ST	STE 212	OAKLAND	CA	94609	3642	01	06001	37.81754276	-122.2646445	Alameda County
187821	Fee-for-Service	1427317403	1427317403	1	1	WENTZEL, KRISTOPHER P MD	9/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	128813	41	Internal Medicine	0	In state provider	None	2001 SANTA MONICA BLVD	560W	SANTA MONICA	CA	90404	2182	19	06037	34.02891163	-118.4797466	Los Angeles County
187826	Fee-for-Service	1508871872	1508871872	1	1	WALGREEN CO.	1/30/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14885 TELEGRAPH RD	None	LA MIRADA	CA	90638	1940	19	06037	33.91748456	-118.0134841	Los Angeles County
187827	Fee-for-Service	1134750375	1134750375	1	1	WORDS AND MOTION SPEECH THER	9/14/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	APY GROUP, INC.	7128 PACIFIC BLVD	2ND FLOOR, SUITE I	HUNTINGTON PARK	CA	90255	4776	19	06037	33.97494243	-118.2251099	Los Angeles County
187888	Fee-for-Service	1285934455	1285934455	1	1	WILLIAMS, SARA E PHD	4/26/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
187921	Fee-for-Service	1396768883	1396768883	1	1	WRIGHT, PHILLIP G MD	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	17389	38	Geriatrics	0	In state provider	None	2844 SUMMIT ST	STE 212	OAKLAND	CA	94609	3642	01	06001	37.81754276	-122.2646445	Alameda County
187936	Fee-for-Service	1134143001	1134143001	1	1	WONG, WILLIAM W MD	6/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75940	05	Anesthesiology	0	In state provider	None	995 BLANCO CIR	# A	SALINAS	CA	93901	4447	27	06053	36.65488958	-121.6372749	Monterey County
187961	Fee-for-Service	1790794188	1790794188	1	1	WRIGHT, TODD M.	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1203 4TH ST	None	SANTA ROSA	CA	95404	4011	49	06097	38.445957	-122.703561	Sonoma County
187982	Fee-for-Service	1013324383	1013324383	1	1	WOODS, BANNUPRIYA R MSW LCSW	2/26/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	214 ESTATES DRIVE,	STE. E	ROSEVILLE	CA	95682	7652	31	06061	38.74766054	-121.273092	Placer County
187997	Fee-for-Service	1821349465	1821349465	1	1	WEIMAR MEDICAL GROUP, INC.	5/1/2014	207QA0505X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	13300 NEW AIRPORT RD	STE 100	AUBURN	CA	95602	7407	31	06061	38.94975486	-121.079471	Placer County
188027	Fee-for-Service	1881139608	1881139608	1	1	WEEKS, ANTHONY J LMFT	3/2/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	118444	-	NOT APPLICABLE	0	In state provider	None	2049 SKYLINE DR	None	LEMON GROVE	CA	91945	4221	37	06073	32.72729271	-117.0254695	San Diego County
188047	Fee-for-Service	1801801196	1801801196	1	1	WALGREEN CO.	10/30/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8201 GREENLEAF AVE	None	WHITTIER	CA	90602	2910	19	06037	33.96517117	-118.0376617	Los Angeles County
188073	Fee-for-Service	1750437349	1750437349	2	1	WOODS, ALYN Q MD	10/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109485	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
188079	Fee-for-Service	1861888331	1861888331	1	1	WEST COAST MEDICAL CARE	12/21/2021	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	PROFESSIONAL CORPORATION	5350 MADISON AVENUE	None	SACRAMENTO	CA	95841	3169	34	06067	38.66031	-121.339125	Sacramento County
188147	Fee-for-Service	1639525926	1639525926	1	1	WHITAKER, ASHLEY M PHD	8/9/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
188154	Fee-for-Service	1457727513	1457727513	1	1	WALMART STORES INC	1/25/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 N LONG BEACH BLVD	None	COMPTON	CA	90221	1252	19	06037	33.91008659	-118.208874	Los Angeles County
188168	Fee-for-Service	1881061802	1881061802	1	1	WEST HILLS ANESTHESIA AND	12/22/2015	207LP2900X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	PERIOPERATIVE PHYSICIANS	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
188177	Fee-for-Service	1780984195	1780984195	1	1	WREN-RUSS, HELEN C LMFT	2/20/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	87027	-	NOT APPLICABLE	0	In state provider	None	30500 ARRASTRE CANYON RD	None	ACTON	CA	93510	2160	19	06037	34.449291	-118.1973465	Los Angeles County
188192	Fee-for-Service	1457378168	1457378168	1	1	WROBEL, BOZENA B MD	11/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	86257	04	Otology, Laryngology, Rhinology	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5301	19	06037	34.06269295	-118.2030006	Los Angeles County
188210	Fee-for-Service	1528294436	1528294436	1	1	WILLIAMS, TREVOR MICHAEL MD	7/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87074	02	General Surgery	0	In state provider	None	3315 MISSION DRIVE	None	SANTA CRUZ	CA	95065	1868	44	06087	36.99102371	-121.9802459	Santa Cruz County
188213	Fee-for-Service	1831256130	1831256130	1	1	WINSTEAD,DENNIS R CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
188215	Fee-for-Service	1265876510	1265876510	1	1	WOO, JENNIFER S MD	2/12/2018	390200000X	NA	Other	026	PHYSICIANS	134674	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
188266	Fee-for-Service	1619329679	1619329679	1	1	WASINACK, REBECCA LMFT	5/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7545 IRVINE CENTER DR	200	IRVINE	CA	92618	2932	30	06059	33.662781	-117.75096	Orange County
188284	Fee-for-Service	1780617811	1780617811	1	1	WELLS, BECKY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	305 NORTH MAIN STREET	None	ENNIS	MT	59729	0000	00	None	45.351585	-111.7321155	Madison County
188308	Fee-for-Service	1275795874	1275795874	1	1	WILLIAMS, KELLY D MD	11/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110923	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	12462 PUTNAM STREET	None	WHITTIER	CA	90602	1049	19	06037	33.9709236	-118.0460596	Los Angeles County
188327	Fee-for-Service	1487696464	1487696464	1	2	WARD, MINOR E MD	4/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	23027	02	General Surgery	0	In state provider	None	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
188328	Fee-for-Service	1083894257	1083894257	1	1	WILLIAMS, JASON E MD	5/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96986	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
188336	Fee-for-Service	1861509689	1861509689	1	1	WILLIAMS, BENJAMIN A II MD	7/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53095	20	Orthopedic Surgery	0	In state provider	None	11795 EDUCATION ST	STE 224	AUBURN	CA	95602	2469	31	06061	38.94433757	-121.098912	Placer County
188339	Fee-for-Service	1457419335	1457419335	1	1	WONG, IRENE L CA	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	909 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4442	19	06037	34.085763	-118.123089	Los Angeles County
188365	Fee-for-Service	1083000913	1083000913	1	1	WAGNER, KURT MD	9/25/2020	207L00000X	NA	Other	026	PHYSICIANS	168791	05	Anesthesiology	0	In state provider	None	PUEBLO AT BATH STREETS	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
188366	Fee-for-Service	1861888331	1861888331	1	1	WEST COAST MEDICAL CARE	2/25/2016	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PROFESSIONAL CORPORATION	5350 MADISON AVENUE	None	SACRAMENTO	CA	95841	3169	34	06067	38.66031	-121.339125	Sacramento County
188402	Fee-for-Service	1447332036	1447332036	1	11	WELLSPACE HEALTH	1/8/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3441 MARYSVILLE BLVD	None	SACRAMENTO	CA	95838	4512	34	06067	38.631231	-121.431402	Sacramento County
188405	Fee-for-Service	1629017165	1629017165	1	1	WAKEFIELD, WILLIAM M MD	11/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84209	08	Family Practice	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
188412	Fee-for-Service	1679589246	1679589246	1	1	WALGREEN CO	11/24/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #05672	2000 W WHITTIER BLVD	None	LA HABRA	CA	90631	3535	30	06059	33.93977553	-117.968895	Orange County
188413	Fee-for-Service	1699791491	1699791491	1	1	WITZTUM, JOSEPH MD	11/27/1985	207RE0101X	NA	Endocrinology	026	PHYSICIANS	29598	47	Miscellaneous	0	In state provider	None	225 DICKINSON ST	# H207	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
188415	Fee-for-Service	1164506150	1164506150	1	1	WOOD, CREED W MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	16621	39	Preventive (M.D. only)	0	In state provider	None	1496 PROFESSIONAL DR	STE 601	PETALUMA	CA	94954	6698	49	06097	38.25575122	-122.6329158	Sonoma County
188448	Fee-for-Service	1154714640	1154714640	1	1	WESTMONT HOUSE INC	3/30/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1212 W ROWAN ST	None	ANAHEIM	CA	92801	5944	30	06059	33.83663844	-117.9304711	Orange County
188465	Fee-for-Service	1437382009	1437382009	1	1	WANG, JEAN L LCSW	6/7/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
188585	Fee-for-Service	1992168884	1992168884	1	1	WONG, JESSALYN L DO	2/17/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
188606	Fee-for-Service	1437412418	1437412418	1	1	WANG, HUAN MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148131	05	Anesthesiology	0	In state provider	None	3626 RUFFIN ROAD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
188616	Fee-for-Service	1417200106	1417200106	1	1	WARREN, TOMI C CNM	11/21/2016	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
188617	Fee-for-Service	1083894257	1083894257	1	1	WILLIAMS, JASON E MD	5/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96986	10	Gastroenterology (M.D. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
188672	Fee-for-Service	1265871693	1265871693	1	1	WINSHIP, EMORY S DO	3/1/2022	207R00000X	NA	Other	026	PHYSICIANS	17642	None	None	0	In state provider	None	4955 VAN NUYS BLVD	SUITE 308	SHERMAN OAKS	CA	91403	1811	19	06037	34.160805	-118.4487295	Los Angeles County
188679	Fee-for-Service	1134182777	1134182777	1	2	WREN, DAVID JR MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	22810	20	Orthopedic Surgery	0	In state provider	None	120 BROADWAY AVE	STE 21	RICHMOND	CA	94804	1938	07	06013	37.93262878	-122.3463311	Contra Costa County
188688	Fee-for-Service	1447332036	1447332036	1	11	WELLSPACE HEALTH	1/8/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3441 MARYSVILLE BLVD	None	SACRAMENTO	CA	95838	4512	34	06067	38.631231	-121.431402	Sacramento County
188734	Fee-for-Service	1902012362	1902012362	1	1	WANG, LILLIAN T OD	1/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
188736	Fee-for-Service	1467815175	1467815175	1	2	WANG, LIANG MD	2/20/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	169965	None	None	0	In state provider	None	1745 N BROADWAY	101	SANTA MARIA	CA	93454	0001	42	06083	34.971759	-120.4356175	Santa Barbara County
188741	Fee-for-Service	1750470985	1750470985	1	1	WONG, UYEN PHUONG H OD	11/12/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
188778	Fee-for-Service	1184889362	1184889362	1	1	WILSON, SUSAN F	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142472	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
188783	Fee-for-Service	1366127201	1366127201	1	1	WHITTEN LLC	3/30/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	200 WEST WHITTIER BLVD	None	LA HABRA	CA	90631	3877	30	06059	33.93909252	-117.9477945	Orange County
188798	Fee-for-Service	1164607461	1164607461	1	1	WANG, TISHA S MD	1/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86107	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365, 450	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
188859	Fee-for-Service	1205414497	1205414497	1	1	WANG-SELFRIDGE, ANGELA DO	9/23/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22139	08	Family Practice	0	In state provider	None	8701 CUYAMACA ST	None	SANTEE	CA	92071	4253	37	06073	32.83439779	-116.98366	San Diego County
188862	Fee-for-Service	1295834265	1295834265	1	1	WU, ROLAND S MD	11/27/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110283	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
188891	Fee-for-Service	1386679975	1386679975	1	1	WIESNER, JASON B MD	8/29/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95468	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
188938	Fee-for-Service	1013151331	1013151331	1	1	WEHRLI, BENJAMIN S DPM	3/12/2020	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	39000 BOB HOPE DR	PROBST BUILDING SUITE 20	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
188962	Fee-for-Service	1285992461	1285992461	1	1	WITTY, PHILLIP J LMFT	2/4/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29700 GREENWATER DR	None	TEHACHAPI	CA	93561	9600	15	06029	35.17470386	-118.6587348	Kern County
188968	Fee-for-Service	1134182777	1134182777	1	2	WREN, DAVID JR MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	22810	08	Family Practice	0	In state provider	None	120 BROADWAY AVE	STE 21	RICHMOND	CA	94804	1938	07	06013	37.93262878	-122.3463311	Contra Costa County
188999	Fee-for-Service	1740460088	1740460088	1	1	WOODS, CHRISTOPHER E MD	10/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100919	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
189008	Fee-for-Service	1871928341	1871928341	1	1	WU, CLAYTON MD	7/22/2019	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89119	5168	00	None	36.163269	-115.1654465	Clark County
189033	Fee-for-Service	1336436369	1336436369	1	1	WAHBA, GEORGE M MD INC	9/1/2011	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	97606	20	Orthopedic Surgery	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
189049	Fee-for-Service	1275982514	1275982514	1	1	WONG, HARRY J MD	7/25/2023	208600000X	NA	General Surgery	026	PHYSICIANS	186517	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
189071	Fee-for-Service	1760060453	1760060453	1	1	WANG, IRENE MD	2/28/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	2336 SANTA MONICA BLVD	301, 304	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
189074	Fee-for-Service	1013985191	1013985191	1	1	WESCHE, DANIEL E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	77 W FOREST AVE	STE 201	FLAGSTAFF	AZ	86001	1483	00	None	35.210619	-111.6436275	Coconino County
189112	Fee-for-Service	1649711813	1649711813	1	1	WILLIAMS, SHAUTE NP	9/25/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	148 NORTH GRAND AVENUE	None	GLENDORA	CA	91741	2434	19	06037	34.13786301	-117.8724781	Los Angeles County
189121	Fee-for-Service	1659782514	1659782514	1	1	WARD, ERIC T MD	12/8/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	153281	36	Psychiatry	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
189133	Fee-for-Service	1609062637	1609062637	1	1	WEI, MICHAEL MD	7/15/2008	2080P0207X	NA	Hematology	026	PHYSICIANS	92268	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
189150	Fee-for-Service	1295834265	1295834265	1	1	WU, ROLAND S MD	11/27/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110283	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
189167	Fee-for-Service	1093108334	1093108334	1	1	WINTERS, STEPHANIE L LCSW	11/7/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
189171	Fee-for-Service	1689219420	1689219420	1	1	WOOD, KATHRYN CSW	9/29/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
189189	Fee-for-Service	1033278189	1033278189	1	1	WATSON, RONALD M OD INC	2/26/2008	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3653 AVOCADO BLVD	None	LA MESA	CA	91941	7337	37	06073	32.74642082	-116.9629891	San Diego County
189200	Fee-for-Service	1083605265	1083605265	1	1	WU, SEAN M MD	3/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55725	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
189227	Fee-for-Service	1043379787	1043379787	1	1	WANG, SUSAN E MD	5/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87924	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
189245	Fee-for-Service	1346269982	1346269982	1	1	WILLAMETTE VALLEY MED CT	2/1/1999	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2700 SE THREE MILE LN	None	MCMINNVILLE	OR	97128	6251	00	None	45.19818	-123.1651305	Yamhill County
189272	Fee-for-Service	1962480137	1962480137	1	1	WINTER,JERROLD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4892 N STONE AVE	None	TUCSON	AZ	85704	0000	00	None	32.295168	-110.970315	Pima County
189275	Fee-for-Service	1376857409	1376857409	1	1	WASCHE, JASON N DO	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11163	08	Family Practice	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
189313	Fee-for-Service	1215169396	1215169396	1	1	WASSILY, VICTOR M MD INC	8/2/1995	193400000X	NA	Other	026	PHYSICIANS	53474	41	Internal Medicine	0	In state provider	None	101 E BEVERLY BLVD	STE 202	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
189324	Fee-for-Service	1497886048	1497886048	1	1	WHITELOCK, STACY E MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84206	None	None	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
189369	Fee-for-Service	1790715399	1790715399	1	1	WEITZ, ILENE C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35326	78	Neoplastic Diseases/Oncology	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
189432	Fee-for-Service	1235137738	1235137738	1	1	WILSHIRE HEALTH AND	10/1/2001	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY SERVICE, INC	277 SOUTH ST	STE W	SAN LUIS OBISPO	CA	93401	5058	40	06079	35.2695025	-120.6663615	San Luis Obispo County
189436	Fee-for-Service	1851372288	1851372288	1	1	WEIDMANN, CHARLES E MD	9/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	48620	41	Internal Medicine	0	In state provider	APMC	15243 VANOWEN ST	STE 306	VAN NUYS	CA	91405	3649	19	06037	34.19394848	-118.4654115	Los Angeles County
189469	Fee-for-Service	1255968830	1255968830	1	1	WU, VENUS MD	8/20/2024	390200000X	NA	Other	026	PHYSICIANS	187670	05	Anesthesiology	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
189478	Fee-for-Service	1538540836	1538540836	1	1	WATANABE, MIKA MD	2/24/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	147421	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
189531	Fee-for-Service	1346269982	1346269982	1	1	WILLAMETTE VALLEY MED CT	2/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2700 SE THREE MILE LN	None	MCMINNVILLE	OR	97128	6251	00	None	45.19818	-123.1651305	Yamhill County
189554	Fee-for-Service	1235341520	1235341520	1	1	WOODS, MARIA F MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94726	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
189571	Fee-for-Service	1447332036	1447332036	1	3	WELLSPACE HEALTH	11/15/2012	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	10495 WHITE ROCK ROAD	None	RANCHO CORDOVA	CA	95670	5530	34	06067	38.586735	-121.2997005	Sacramento County
189586	Fee-for-Service	1033555396	1033555396	1	1	WAL-MART STORES INC	6/28/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1250 E GIBSON RD	None	WOODLAND	CA	95776	6315	57	06113	38.66278354	-121.763682	Yolo County
189598	Fee-for-Service	1518017086	1518017086	1	1	WU, JULIE M MD	2/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108304	22	Pathology (M.D. only)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
189600	Fee-for-Service	1215169396	1215169396	1	1	WASSILY, VICTOR M MD INC	8/2/1995	193400000X	NA	Other	026	PHYSICIANS	53474	45	Nephrology (Renal-Kidney)	0	In state provider	None	101 E BEVERLY BLVD	STE 202	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
189640	Fee-for-Service	1548697782	1548697782	1	1	WALGREEN CO	1/14/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	600 TRES PINOS RD	None	HOLLISTER	CA	95023	0000	35	06069	36.83934301	-121.3916943	San Benito County
189650	Fee-for-Service	1093042491	1093042491	1	1	WALIA, RINKY J MD	10/6/2020	207R00000X	NA	Other	026	PHYSICIANS	169045	41	Internal Medicine	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
189657	Fee-for-Service	1790715399	1790715399	1	1	WEITZ, ILENE C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35326	68	Hematology	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
189718	Fee-for-Service	1619562667	1619562667	1	1	WALSTON, MICHAEL E DO	1/18/2023	390200000X	NA	Other	026	PHYSICIANS	20300	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
189724	Fee-for-Service	1851372288	1851372288	1	1	WEIDMANN, CHARLES E MD	9/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	48620	83	Rheumatology	0	In state provider	APMC	15243 VANOWEN ST	STE 306	VAN NUYS	CA	91405	3649	19	06037	34.19394848	-118.4654115	Los Angeles County
189727	Fee-for-Service	1679950018	1679950018	1	1	WANG, ELISABETH DO	8/19/2019	207QA0000X	NA	Pediatric Primary Care	026	PHYSICIANS	16929	08	Family Practice	0	In state provider	None	31946 MISSION TRAIL	STE A	LAKE ELSINORE	CA	92530	4539	33	06065	33.65640803	-117.2979656	Riverside County
189753	Fee-for-Service	1023109683	1023109683	1	1	WELLING, THEODORE H MD	6/6/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	89	Surgery-Traumatic	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
189776	Fee-for-Service	1306864558	1306864558	1	1	WASHINGTON, KEVIN T DO	11/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9972	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
189780	Fee-for-Service	1508352394	1508352394	1	1	WU, XINMING MD	10/17/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	3001 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1114	00	None	42.25288307	-121.7896138	Klamath County
189793	Fee-for-Service	1164771457	1164771457	1	1	WHITE, MATTHEW J NP	6/19/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
189811	Fee-for-Service	1538121272	1538121272	1	1	WOOD, CHRISTOPHER K	6/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85569	None	None	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
189813	Fee-for-Service	1053736546	1053736546	1	1	WEST, KELLY RAE	9/21/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	19197 GOLDEN VALLEY RD	923	SANTA CLARITA	CA	91387	1428	19	06037	34.39260825	-118.4654474	Los Angeles County
189835	Fee-for-Service	1326090556	1326090556	1	1	WAGNER, DAVID K MD	11/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	62145	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
189854	Fee-for-Service	1457937922	1457937922	1	1	WEN, JESSICA	6/13/2024	207R00000X	NA	Other	026	PHYSICIANS	185311	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
189881	Fee-for-Service	1003436064	1003436064	1	75	WS AUDIOLOGY (CALIFORNIA), P	8/30/2024	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1620 E 2ND STREET	M	BEAUMONT	CA	92223	0000	33	06065	33.92359885	-116.9480354	Riverside County
189886	Fee-for-Service	1053532143	1053532143	1	1	WONG, MICHAEL C MD INC	11/22/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CALIFORNIA WOMENS MED CL	4282 GENESEE AVE	STE 201	SAN DIEGO	CA	92117	4964	37	06073	32.82092667	-117.1828683	San Diego County
189888	Fee-for-Service	1215169396	1215169396	1	1	WASSILY, VICTOR M MD INC	8/2/1995	193400000X	NA	Other	026	PHYSICIANS	53474	04	Otology, Laryngology, Rhinology	0	In state provider	None	101 E BEVERLY BLVD	STE 202	MONTEBELLO	CA	90640	4315	19	06037	34.01556395	-118.0983878	Los Angeles County
189924	Fee-for-Service	1790985331	1790985331	1	1	WALKER, VALERI D MD	9/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95305	05	Anesthesiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
189940	Fee-for-Service	1346313459	1346313459	1	1	WONG, SHIRLEY P MD	6/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8691	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
189946	Fee-for-Service	1790715399	1790715399	1	1	WEITZ, ILENE C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35326	41	Internal Medicine	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
189964	Fee-for-Service	1275848269	1275848269	1	1	WRIGHT, KRISTEN D LMFT	12/23/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4929 WILSHIRE BLVD	SUITE 245	LOS ANGELES	CA	90010	3859	19	06037	34.0621435	-118.3380975	Los Angeles County
189977	Fee-for-Service	1619236783	1619236783	1	1	WANG, BING MD	10/18/2019	207ZP0102X	NA	Other	026	PHYSICIANS	132937	None	None	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
189986	Fee-for-Service	1619001815	1619001815	1	1	WANG, KAREN C OD	9/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1055 E COLORADO BLVD	None	PASADENA	CA	91188	2327	19	06037	34.14595648	-118.1287575	Los Angeles County
189989	Fee-for-Service	1811079858	1811079858	1	1	WILLIAMS,MICHELLE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5301 E GRANT	None	TUCSON	AZ	85712	0000	00	None	32.252391	-110.8790055	Pima County
190006	Fee-for-Service	1861474116	1861474116	1	1	WANG, ARTHUR MD	11/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
190096	Fee-for-Service	1184018095	1184018095	1	1	WESSEL, LAUREN E MD	4/19/2021	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	171939	None	None	0	In state provider	None	100 UCLA MEDICAL PLZ	755	LOS ANGELES	CA	90024	6990	19	06037	34.06544724	-118.4459249	Los Angeles County
190098	Fee-for-Service	1053736546	1053736546	1	1	WEST, KELLY RAE	9/21/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	19197 GOLDEN VALLEY RD	923	SANTA CLARITA	CA	91387	1428	19	06037	34.39260825	-118.4654474	Los Angeles County
190106	Fee-for-Service	1750396040	1750396040	1	1	WALGREEN CO	5/3/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1241 W FOOTHILL BLVD	None	UPLAND	CA	91786	3681	36	06071	34.10698077	-117.6713946	San Bernardino County
190164	Fee-for-Service	1679036719	1679036719	1	1	WANG, JENNY Z MD	11/21/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	179146	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
190169	Fee-for-Service	1003436064	1003436064	1	75	WS AUDIOLOGY (CALIFORNIA), P	8/30/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1620 E 2ND STREET	M	BEAUMONT	CA	92223	0000	33	06065	33.92359885	-116.9480354	Riverside County
190193	Fee-for-Service	1134203201	1134203201	1	1	WELCH, RONALD MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36095	36	Psychiatry	0	In state provider	None	95 MONTGOMERY DR	None	SANTA ROSA	CA	95404	6630	49	06097	38.442357	-122.704641	Sonoma County
190232	Fee-for-Service	1578840872	1578840872	1	1	WONG, LARRY F CP	3/1/1995	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2669 MYRTLE AVE	#101	SIGNAL HILL	CA	90755	2746	19	06037	33.805971	-118.181828	Los Angeles County
190328	Fee-for-Service	1962865063	1962865063	1	1	WICKMAN, DANIELLE A MD	11/15/2021	207P00000X	NA	Other	026	PHYSICIANS	151112	None	None	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4304	37	06073	32.63282707	-117.0829101	San Diego County
190347	Fee-for-Service	1639673783	1639673783	1	1	WONG, ALEXANDRA MD	8/1/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	164160	41	Internal Medicine	0	In state provider	None	1250 S SUNSET AVE	STE 303	WEST COVINA	CA	91790	3912	19	06037	34.0610671	-117.9463685	Los Angeles County
190392	Fee-for-Service	1568843787	1568843787	1	1	WU, LITA OD	5/22/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
190431	Fee-for-Service	1699741777	1699741777	1	1	WALLACE, DENNIS J OD	1/1/1979	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	662 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.2977934	-119.201361	Tulare County
190459	Fee-for-Service	1689738494	1689738494	1	1	WONG, ANDREW A LAC	9/10/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
190474	Fee-for-Service	1588712418	1588712418	1	1	WILEY, BRYAN V MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67578	20	Orthopedic Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
190507	Fee-for-Service	1881608578	1881608578	1	1	WORKMAN POLLINGTON, SUE ANNE	3/9/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T LCSW	811 W. 7TH ST.	12TH FLOOR	LOS ANGELES	CA	90017	3403	19	06037	34.0489635	-118.2591312	Los Angeles County
190535	Fee-for-Service	1235217134	1235217134	1	1	WAXMAN, MICHAEL D MD	11/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	58455	18	Ophthalmology	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
190594	Fee-for-Service	1760559264	1760559264	1	1	WIEDER, JEFFREY A MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71035	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
190632	Fee-for-Service	1407938731	1407938731	1	1	WARD, RICHARD B MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61934	41	Internal Medicine	0	In state provider	None	909 HYDE ST	STE 317	SAN FRANCISCO	CA	94109	4846	38	06075	37.78939387	-122.4170945	San Francisco County
190633	Fee-for-Service	1639673783	1639673783	1	1	WONG, ALEXANDRA MD	8/1/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	164160	68	Hematology	0	In state provider	None	1250 S SUNSET AVE	STE 303	WEST COVINA	CA	91790	3912	19	06037	34.0610671	-117.9463685	Los Angeles County
190689	Fee-for-Service	1629057625	1629057625	1	1	WALWORTH, CHARLES M MD	2/8/2015	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	83332	41	Internal Medicine	0	In state provider	None	361 HOSPITAL RD	STE 126	NEWPORT BEACH	CA	92663	3510	30	06059	33.62579141	-117.9299554	Orange County
190750	Fee-for-Service	1679995948	1679995948	1	1	WALCOTT DIALYSIS LLC	8/17/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4300 VON KARMAN AVE	None	NEWPORT BEACH	CA	92660	2004	30	06059	33.66349338	-117.8616743	Orange County
190754	Fee-for-Service	1003436064	1003436064	1	25	WS AUDIOLOGY (CALIFORNIA), P	4/8/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3825 THOUSAND OAKS BLVD	O	THOUSAND OAKS	CA	91362	3639	56	06111	34.16243394	-118.8254491	Ventura County
190781	Fee-for-Service	1710919782	1710919782	1	1	WOLNY, YVONNE MD	9/23/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	87669	09	Gynecology (D.O. only)	0	In state provider	None	136 N 3RD ST	None	LOMPOC	CA	93436	7002	42	06083	34.64013944	-120.4451768	Santa Barbara County
190811	Fee-for-Service	1962417386	1962417386	1	1	WALLENSTEIN, DAVID J MD	3/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81052	41	Internal Medicine	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
190833	Fee-for-Service	1801277256	1801277256	1	1	WOMBLE, LUKE MD	11/16/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169169	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
190860	Fee-for-Service	1679645089	1679645089	1	1	WILSON, AMBER LMFT	4/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1320 STANDIFORD AVE	STE 5	MODESTO	CA	95350	0726	50	06099	37.68934252	-121.0140405	Stanislaus County
190867	Fee-for-Service	1275084295	1275084295	1	1	WONG, RICHARD MD	8/20/2019	207ZP0102X	NA	Other	026	PHYSICIANS	136239	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
190885	Fee-for-Service	1235114703	1235114703	1	1	WONG, MICHAEL S MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78666	24	Plastic Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
190921	Fee-for-Service	1407938731	1407938731	1	1	WARD, RICHARD B MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61934	01	General Practice	0	In state provider	None	909 HYDE ST	STE 317	SAN FRANCISCO	CA	94109	4846	38	06075	37.78939387	-122.4170945	San Francisco County
190944	Fee-for-Service	1528697703	1528697703	1	1	WILKINSON, MICHAEL MD	4/4/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	178040	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
190961	Fee-for-Service	1124650080	1124650080	1	1	WINNER, STEPHANIE CRNA	8/28/2023	390200000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
190967	Fee-for-Service	1497772818	1497772818	1	1	WAL-MART PHARMACY	9/19/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	10-1616	2900 MAIN ST	None	SUSANVILLE	CA	96130	4730	18	06035	40.40980027	-120.6353539	Lassen County
190978	Fee-for-Service	1629057625	1629057625	1	1	WALWORTH, CHARLES M MD	2/8/2015	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	83332	77	Infectious Disease	0	In state provider	None	361 HOSPITAL RD	STE 126	NEWPORT BEACH	CA	92663	3510	30	06059	33.62579141	-117.9299554	Orange County
190985	Fee-for-Service	1992109748	1992109748	1	1	WALTERS, CHRISTOPHER L CRNA	10/27/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
190995	Fee-for-Service	1942727839	1942727839	1	1	WONG, STACEY	5/24/2023	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
191030	Fee-for-Service	1760977474	1760977474	1	1	WINEBAUM, JENNA G MD	8/15/2023	208800000X	NA	Other	026	PHYSICIANS	187868	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
191042	Fee-for-Service	1003436064	1003436064	1	25	WS AUDIOLOGY (CALIFORNIA), P	8/27/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3825 THOUSAND OAKS BLVD	O	THOUSAND OAKS	CA	91362	3639	56	06111	34.16243394	-118.8254491	Ventura County
191051	Fee-for-Service	1295814929	1295814929	1	1	WONG, PATRICK MD	6/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45354	36	Psychiatry	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
191063	Fee-for-Service	1578010534	1578010534	1	1	WERNER, REX AARON OD INC	5/25/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2650 JAMACHA RD	SUITE 155	EL CAJON	CA	92019	4319	37	06073	32.74399718	-116.9320709	San Diego County
191069	Fee-for-Service	1255402160	1255402160	1	1	WALLACE, SUSAN L MD	2/28/1982	2084P0800X	NA	Psychiatry	026	PHYSICIANS	42602	41	Internal Medicine	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
191083	Fee-for-Service	1326029398	1326029398	1	1	WHANG, GILBERT MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94627	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
191096	Fee-for-Service	1104027150	1104027150	1	1	WISEMAN, COLETTE H MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106115	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
191104	Fee-for-Service	1972965200	1972965200	1	1	WELTE, WILLIAM MD	9/20/2021	207RC0200X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
191115	Fee-for-Service	1164480224	1164480224	1	1	WILLIAMS, KATHLEEN DO	4/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	9620	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1625 PINE ST	STE 102	REDDING	CA	96001	1018	45	06089	40.58321511	-122.388937	Shasta County
191199	Fee-for-Service	1417480625	1417480625	1	1	WHITHAM, ELIZABETH MD	5/23/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	173089	None	None	0	In state provider	None	3801 KATELLA AVE	STE 330	LOS ALAMITOS	CA	90720	6900	30	06059	33.80318951	-118.066068	Orange County
191212	Fee-for-Service	1528050606	1528050606	1	1	WANG, FUSHENG	11/1/2000	207R00000X	NA	Other	026	PHYSICIANS	60824	01	General Practice	0	In state provider	None	890 JACKSON ST	STE 303	SAN FRANCISCO	CA	94133	4848	38	06075	37.79566645	-122.4097018	San Francisco County
191221	Fee-for-Service	1952690828	1952690828	1	1	WELLNITZ, KARI A MD	6/17/2022	2080P0203X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
191283	Fee-for-Service	1609827930	1609827930	1	1	WESBEY, GEORGE E III MD	7/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	46278	30	Radiology	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
191312	Fee-for-Service	1851318109	1851318109	1	1	WAL-MART STORES, INC	2/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-2636	8230 TALBERT AVE	None	HUNTINGTON BEACH	CA	92646	1545	30	06059	33.7011445	-117.985509	Orange County
191332	Fee-for-Service	1003436064	1003436064	1	7	WS AUDIOLOGY (CALIFORNIA), P	3/29/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	16940 SLOVER	A	FONTANA	CA	92337	7566	36	06071	34.06313948	-117.434637	San Bernardino County
191379	Fee-for-Service	1326113671	1326113671	1	2	WANG, LISA MD	11/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81128	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
191427	Fee-for-Service	1487647244	1487647244	1	1	WESMAN, ROBERT M MD	12/31/1980	174400000X	NA	Other	026	PHYSICIANS	29964	04	Otology, Laryngology, Rhinology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
191435	Fee-for-Service	1740317817	1740317817	1	1	WILLIAMS, KATHERINE E MD	7/31/1994	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72846	36	Psychiatry	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
191447	Fee-for-Service	1548045164	1548045164	1	1	WARNER, JACQUELINE LMFT	9/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
191457	Fee-for-Service	1225146970	1225146970	1	1	WASHINGTON NEWARK	3/1/1999	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP INC	46752 MISSION BLVD	# A	FREMONT	CA	94539	7949	01	06001	37.49039813	-121.9286833	Alameda County
191485	Fee-for-Service	1841873536	1841873536	1	1	WRAY-MILLER, BRIGITTE M DO	8/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22352	08	Family Practice	0	In state provider	None	2081 BRONZE STAR DR	None	WOODLAND	CA	95776	5423	57	06113	38.67049812	-121.7238394	Yolo County
191506	Fee-for-Service	1912468398	1912468398	1	1	WOLFINGER, NATALIE	5/20/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
191547	Fee-for-Service	1184821373	1184821373	1	1	WESTERN BARIATRIC, A MEDICAL	6/11/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	CORPORATION	401 E HIGHLAND AVE	STE 351	SAN BERNARDINO	CA	92404	3830	36	06071	34.1358627	-117.2757778	San Bernardino County
191607	Fee-for-Service	1932198140	1932198140	1	1	WINNS, PATRICIA J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	411 SE 14TH ST	None	PENDLETON	OR	97801	3207	00	None	45.673596	-118.7715275	Umatilla County
191617	Fee-for-Service	1003436064	1003436064	1	7	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	16940 SLOVER	A	FONTANA	CA	92337	7566	36	06071	34.06313948	-117.434637	San Bernardino County
191671	Fee-for-Service	1942311378	1942311378	1	1	WILBUR, STANLEY M MD	11/30/1994	207R00000X	NA	Other	026	PHYSICIANS	72614	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
191713	Fee-for-Service	1689691008	1689691008	1	2	WALMART INC.	3/13/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	301 MONTARA RD	None	BARSTOW	CA	92311	5708	36	06071	34.884603	-116.993712	San Bernardino County
191784	Fee-for-Service	1225397201	1225397201	1	1	WAL-MART STORES, INC	12/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1000 E IMPERITAL HWY	None	LA HABRA	CA	90631	7452	30	06059	33.91737689	-117.9349347	Orange County
191814	Fee-for-Service	1669914941	1669914941	1	1	WOLFE, KRISINDA J CNP	10/30/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	33205 TEMECULA PKWY	None	TEMECULA	CA	92592	9142	33	06065	33.48600119	-117.0789409	Riverside County
191924	Fee-for-Service	1649660234	1649660234	1	1	WILLSEY, MATTHEW S MD	6/30/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	176158	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
191929	Fee-for-Service	1033277231	1033277231	1	1	WEINTRAUB, JAMES S MD	8/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	40636	07	Dermatology	0	In state provider	None	1240 S WESTLAKE BLVD	STE 102	WESTLAKE VILLAGE	CA	91361	1972	56	06111	34.14966879	-118.8378084	Ventura County
191938	Fee-for-Service	1477578425	1477578425	1	1	WENG, MARK W DO	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8940	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
191949	Fee-for-Service	1063459824	1063459824	1	1	WAYNE L. DAVIS, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3819 STEPHENS AVE	STE 200	MISSOULA	MT	59801	8522	00	None	46.835955	-114.0137955	Missoula County
191953	Fee-for-Service	1720547110	1720547110	1	1	WU, WING CNP	12/12/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5915 HOLLIS	SUITE B	EMERYVILLE	CA	94608	2002	01	06001	37.84148798	-122.2898215	Alameda County
191998	Fee-for-Service	1306866520	1306866520	1	1	WALLACE, NIVEDITA S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75615	05	Anesthesiology	0	In state provider	MEDICAL CORPORATION	1600 N ROSE AVE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
192054	Fee-for-Service	1154361889	1154361889	1	1	WESTERHOUT, NELSON M MD	10/1/1998	207L00000X	NA	Other	026	PHYSICIANS	69841	05	Anesthesiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
192098	Fee-for-Service	1003436064	1003436064	1	31	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1185 MAGNOLIA AVENUE	SUITE C-D	CORONA	CA	92879	3218	33	06065	33.86372325	-117.5461972	Riverside County
192099	Fee-for-Service	1811103443	1811103443	1	1	WALGREEN CO.	1/31/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2424 N BRAWLEY AVE.	None	FRESNO	CA	93722	5109	10	06019	36.772461	-119.8623015	Fresno County
192133	Fee-for-Service	1922215896	1922215896	1	1	WOODLAND RESIDENTIAL	1/16/2003	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SERVICES, INC	1381 E GUM AVE	None	WOODLAND	CA	95776	4275	57	06113	38.66830031	-121.7568564	Yolo County
192139	Fee-for-Service	1619773322	1619773322	1	1	WALSHIRE, JASMARINA	3/13/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
192158	Fee-for-Service	1063499176	1063499176	1	1	WITMEYER, KATHERINE J OD	1/19/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3939 3RD AVE	None	SAN DIEGO	CA	92103	3002	37	06073	32.74905668	-117.16268	San Diego County
192159	Fee-for-Service	1124257324	1124257324	1	2	WELLSPACE HEALTH	3/1/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	811 GRAND AVENUE	SUITE A-3	SACRAMENTO	CA	95838	3466	34	06067	38.637621	-121.4470125	Sacramento County
192180	Fee-for-Service	1083191639	1083191639	1	1	WONG, CHARISSA M PT	5/2/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
192218	Fee-for-Service	1831867506	1831867506	1	1	WASHINGTON, SAVANAH L CNM	10/4/2021	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
192337	Fee-for-Service	1942906797	1942906797	1	1	WASHINGTON, KAISHA JANAE	5/23/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3558 WASHINGTON ST	None	RIVERSIDE	CA	92504	3949	33	06065	33.94179971	-117.3989389	Riverside County
192344	Fee-for-Service	1699965707	1699965707	1	1	WILSON, SHEILA R MD	6/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120723	None	None	0	In state provider	None	1516 COTNER AVE	None	LOS ANGELES	CA	90025	3303	19	06037	34.04905416	-118.4477438	Los Angeles County
192357	Fee-for-Service	1154779585	1154779585	1	1	WEBSTER, JARED M MD	9/1/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	150797	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
192363	Fee-for-Service	1043225337	1043225337	1	1	WALGREEN CO	4/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2950 S ARCHIBALD AVE	None	ONTARIO	CA	91761	7303	36	06071	34.019559	-117.5936625	San Bernardino County
192370	Fee-for-Service	1962847145	1962847145	1	1	WILKINS, EMILIA G MD	6/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133431	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
192374	Fee-for-Service	1902994197	1902994197	1	1	WITTNER, RICHARD S MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	16378	40	Pediatrics	0	In state provider	None	2865 ATLANTIC AVE	STE 149	LONG BEACH	CA	90806	7411	19	06037	33.809418	-118.185058	Los Angeles County
192384	Fee-for-Service	1003436064	1003436064	1	31	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1185 MAGNOLIA AVENUE	SUITE C-D	CORONA	CA	92879	3218	33	06065	33.86372325	-117.5461972	Riverside County
192401	Fee-for-Service	1811339450	1811339450	1	1	WANG, MICHAEL D MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133885	41	Internal Medicine	0	In state provider	None	15400 FOOTHILL BLVD	None	SAN LEANDRO	CA	94578	1009	01	06001	37.7069698	-122.1191104	Alameda County
192447	Fee-for-Service	1124257324	1124257324	1	2	WELLSPACE HEALTH	3/1/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	811 GRAND AVENUE	SUITE A-3	SACRAMENTO	CA	95838	3466	34	06067	38.637621	-121.4470125	Sacramento County
192489	Fee-for-Service	1942307152	1942307152	1	1	WESTERN PLACER USD	8/10/2001	251300000X	NA	Other	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	600 6TH ST	STE 400	LINCOLN	CA	95648	1787	31	06061	38.8931585	-121.2919335	Placer County
192597	Fee-for-Service	1891044186	1891044186	1	1	WILLIAMS, LYNDSIE M LCSW	1/25/2019	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	STE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
192599	Fee-for-Service	1720400526	1720400526	1	1	WOODS, SAMUEL B MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128045	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
192619	Fee-for-Service	1265435762	1265435762	1	1	WAKASA, MARC K MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81705	25	Physical Medicine and Rehabilitation	0	In state provider	None	450 STANYAN ST	STE 658	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
192621	Fee-for-Service	1760536163	1760536163	1	1	WOODCOX, LARRY H DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2647 E 14TH ST	STE 419	OAKLAND	CA	94601	1539	01	06001	37.78099267	-122.2320006	Alameda County
192625	Fee-for-Service	1942906797	1942906797	1	1	WASHINGTON, KAISHA JANAE	5/23/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3558 WASHINGTON ST	None	RIVERSIDE	CA	92504	3949	33	06065	33.94179971	-117.3989389	Riverside County
192642	Fee-for-Service	1053491332	1053491332	1	1	WIJEYAKUMAR, VIJAYALAKSHMI	11/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	49216	45	Nephrology (Renal-Kidney)	0	In state provider	MD	11100 WARNER AVENUE	SUITE 218	FOUNTAIN VALLEY	CA	92708	7512	30	06059	33.716291	-117.9355051	Orange County
192680	Fee-for-Service	1255480877	1255480877	1	1	WESCO MEDICAL SUPPLIES &	4/12/1998	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	EQUIPMENT CO,INC	701 HIGHLAND SPRINGS AVE	None	BEAUMONT	CA	92223	2550	33	06065	33.93142778	-116.946913	Riverside County
192744	Fee-for-Service	1164486338	1164486338	1	1	WITTENBERG, AARON MD	6/15/2018	2085R0204X	NA	Other	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
192754	Fee-for-Service	1912513037	1912513037	1	1	WELLNESS EMPIRE	7/4/2023	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	805 E WILSON AVE	UNIT B	GLENDALE	CA	91206	4457	19	06037	34.14816475	-118.2453196	Los Angeles County
192764	Fee-for-Service	1720685290	1720685290	1	1	WESTMORELAND, CHARLOTTE	8/1/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2082 SWEET LN	None	EUREKA	CA	95503	6086	12	06023	40.76911972	-124.1467192	Humboldt County
192819	Fee-for-Service	1033104377	1033104377	1	1	WARNER, MARIE J DO	5/30/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16188	08	Family Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
192826	Fee-for-Service	1972550150	1972550150	1	1	WELDETENSAE, SHEWIT MD	4/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88881	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1540 FLORIDA AVE	STE 100	MODESTO	CA	95350	4430	50	06099	37.667115	-120.9962205	Stanislaus County
192833	Fee-for-Service	1245259761	1245259761	1	1	WHITE, VINCENT W OD	1/31/1987	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15230 BURBANK BLVD	STE 109	VAN NUYS	CA	91411	3534	19	06037	34.17206654	-118.4649705	Los Angeles County
192855	Fee-for-Service	1033496245	1033496245	1	1	WILSON, CLARENCE C LPCC	5/21/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	C	851 S. MT. VERNON AVE	7A	COLTON	CA	92324	3926	36	06071	34.056468	-117.3091965	San Bernardino County
192902	Fee-for-Service	1306905971	1306905971	1	1	WEINSTEIN, STEVEN J MD	7/31/1988	208600000X	NA	General Surgery	026	PHYSICIANS	53588	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
192951	Fee-for-Service	1922503697	1922503697	1	1	WALDRON, LAUREN R MD	4/25/2023	2084N0402X	NA	Neurology	026	PHYSICIANS	164458	None	None	0	In state provider	None	300 UCLA MEDICAL PLAZA	3300	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
193003	Fee-for-Service	1093784670	1093784670	1	1	WEISMAN, MICHAEL H MD	8/24/2004	174400000X	NA	Other	026	PHYSICIANS	18036	41	Internal Medicine	0	In state provider	DEPT OF MEDICINE	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
193007	Fee-for-Service	1114965894	1114965894	1	1	WATERFORD OPERATIONS LLC	1/27/2014	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	1	Border provider	None	835 CRATER LAKE AVE	None	MEDFORD	OR	97504	6505	00	None	42.33755072	-122.8612034	Jackson County
193023	Fee-for-Service	1194912048	1194912048	1	1	WIN, KYI KYI THWIN MD INC	3/1/1999	193400000X	NA	Other	026	PHYSICIANS	56373	41	Internal Medicine	0	In state provider	None	29099 HOSPITAL RD	STE 107	LAKE ARROWHEAD	CA	92352	2229	36	06071	34.26652661	-117.1690546	San Bernardino County
193024	Fee-for-Service	1154414936	1154414936	1	1	WATSON, DAVID B PHD	7/29/1985	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16152 BEACH BLVD	STE 170	HUNTINGTON BEACH	CA	92647	3818	30	06059	33.72889962	-117.9891397	Orange County
193041	Fee-for-Service	1740343292	1740343292	1	1	WHEELER, DANETRA L LMFT	6/16/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1101 CALIFORNIA AVE	STE 100	CORONA	CA	92881	6472	33	06065	33.86171794	-117.5440764	Riverside County
193048	Fee-for-Service	1720094055	1720094055	1	1	WAGNER, ROBERT L MD	1/30/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	41244	05	Anesthesiology	0	In state provider	None	2209 WEBSTER ST	None	SAN FRANCISCO	CA	94115	1820	38	06075	37.79112453	-122.4326386	San Francisco County
193059	Fee-for-Service	1285686030	1285686030	1	1	WILSON, WILLIAM M MD	1/1/1982	207P00000X	NA	Other	026	PHYSICIANS	36960	66	Emergency Medicine (Urgent Care)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
193106	Fee-for-Service	1144227158	1144227158	1	1	WU, GEORGE C MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62531	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2001 SANTA MONICA BLVD	# 280W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
193158	Fee-for-Service	1003436064	1003436064	1	44	WS AUDIOLOGY (CALIFORNIA), P	7/16/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	1354 FITZGERALD DRIVE	None	PINOLE	CA	94564	2249	07	06013	37.98783649	-122.3112838	Contra Costa County
193182	Fee-for-Service	1144563339	1144563339	1	1	WONG-SEXTON, HELEN M MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134258	None	None	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
193320	Fee-for-Service	1073985107	1073985107	1	1	WING, EMILY MD	5/1/2020	207P00000X	NA	Other	026	PHYSICIANS	158422	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3460 E LA PALMA AVENUE	None	ANAHEIM	CA	92806	2020	30	06059	33.85429451	-117.8446551	Orange County
193355	Fee-for-Service	1548226491	1548226491	1	1	WOMEN'S CLINIC MEDICAL	3/18/2008	174400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	GROUP	44105 N 15TH ST W	STE 304	LANCASTER	CA	93534	4089	19	06037	34.684218	-118.1568465	Los Angeles County
193372	Fee-for-Service	1740212182	1740212182	1	1	WILLIAMS, CHARLES A MD	7/31/2018	207SG0201X	NA	Other	026	PHYSICIANS	74158	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
193384	Fee-for-Service	1386683621	1386683621	1	1	WOLF, EUGENE M MD	6/11/1979	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	33945	20	Orthopedic Surgery	0	In state provider	None	3000 CALIFORNIA ST	FL 3	SAN FRANCISCO	CA	94115	2411	38	06075	37.78762785	-122.443976	San Francisco County
193413	Fee-for-Service	1023422730	1023422730	1	1	WATCHA, DAENA S MD	3/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140302	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13100 STUDEBAKER RD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
193445	Fee-for-Service	1003436064	1003436064	1	44	WS AUDIOLOGY (CALIFORNIA), P	6/7/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	1354 FITZGERALD DRIVE	None	PINOLE	CA	94564	2249	07	06013	37.98783649	-122.3112838	Contra Costa County
193474	Fee-for-Service	1053768515	1053768515	1	1	WGM CONSULTING LLC	7/2/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1255 W COLTON AVE	STE 529	REDLANDS	CA	92374	2861	36	06071	34.06285254	-117.20178	San Bernardino County
193489	Fee-for-Service	1578665725	1578665725	1	1	WELLING, ERIC C MD	11/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	48457	05	Anesthesiology	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
193573	Fee-for-Service	1962457267	1962457267	1	1	WELLBOUND OF MILPITAS,	8/2/2006	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	1850 MILMONT DR	None	MILPITAS	CA	95035	2512	43	06085	37.45699497	-121.9181493	Santa Clara County
193576	Fee-for-Service	1245260579	1245260579	1	1	WEED, THOMAS M MD	6/18/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	39475	18	Ophthalmology	0	In state provider	None	436 E YOSEMITE AVE	STE A	MERCED	CA	95340	8489	24	06047	37.33211553	-120.461976	Merced County
193594	Fee-for-Service	1568489813	1568489813	1	1	WAL-MART STORES, INC	8/12/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101789	1601 S LOWER SACRAMENTO	ROAD	LODI	CA	95242	9571	39	06077	38.113038	-121.3099425	San Joaquin County
193624	Fee-for-Service	1174554026	1174554026	1	1	WORTHEN, HOWARD M MD	6/30/1986	207L00000X	NA	Other	026	PHYSICIANS	47955	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
193765	Fee-for-Service	1053768515	1053768515	1	1	WGM CONSULTING LLC	7/2/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1255 W COLTON AVE	STE 529	REDLANDS	CA	92374	2861	36	06071	34.06285254	-117.20178	San Bernardino County
193790	Fee-for-Service	1720817018	1720817018	1	1	WICKHAM, VANESSA NP	12/6/2024	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	27720 JEFFERSON	SUITE 200	TEMECULA	CA	92590	2610	33	06065	33.51188961	-117.1586219	Riverside County
193818	Fee-for-Service	1881844298	1881844298	1	1	WHITE, AMY E CCC-A	8/17/2009	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	11775 EDUCATION STREET	SUTE 102	AUBURN	CA	95602	2453	31	06061	38.94431947	-121.0999275	Placer County
193833	Fee-for-Service	1780911032	1780911032	1	2	WATANABE, NARUHITO MD	4/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124858	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
193862	Fee-for-Service	1073686713	1073686713	1	1	WOODRUFF, ROGER D MD	6/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	60539	01	General Practice	0	In state provider	None	25455 BARTON RD	None	LOMA LINDA	CA	92354	3130	36	06071	34.04805253	-117.249534	San Bernardino County
193878	Fee-for-Service	1023223518	1023223518	1	1	WATSON, ANGELA C	1/13/2014	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	322 E THOUSAND OAKS BLVD	100	THOUSAND OAKS	CA	91360	5804	56	06111	34.17896875	-118.8712017	Ventura County
193899	Fee-for-Service	1073226007	1073226007	1	1	WHETZEL, KATHARINE R	11/28/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
193921	Fee-for-Service	1578580817	1578580817	1	1	WAL-MART STORES INC	4/18/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10655 FOLSOM BLVD	None	RANCHO CORDOVA	CA	95670	4828	34	06067	38.595888	-121.2912135	Sacramento County
193934	Fee-for-Service	1891518882	1891518882	1	1	WOODLAND NATURE THERAPY LICE	11/13/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NSED CLINICAL SOCIAL WOR	12383 MAYS CANYON RD	None	GUERNEVILLE	CA	95446	9499	49	06097	38.48356205	-122.9832464	Sonoma County
193960	Fee-for-Service	1255309258	1255309258	1	1	WALLACE, KEVIN P MD	12/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151609	41	Internal Medicine	0	In state provider	None	1300 CRANE ST	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
193968	Fee-for-Service	1598815300	1598815300	1	1	WINTER, BRIAN D MD	9/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95707	08	Family Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
193983	Fee-for-Service	1619004587	1619004587	1	1	WELLS, DANIELE B LCSW	11/21/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1643 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.74688342	-121.2469903	Placer County
194008	Fee-for-Service	1922130608	1922130608	1	1	WESLEY, NAISSAN O MD	5/7/2008	207N00000X	NA	Dermatology	026	PHYSICIANS	93306	07	Dermatology	0	In state provider	None	401 BICENTENNIAL WY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
194046	Fee-for-Service	1659431237	1659431237	1	1	WRIGHT, LORNA L	1/24/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
194137	Fee-for-Service	1528112430	1528112430	1	1	WIENS, LOREN M LCSW	11/28/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
194196	Fee-for-Service	1366754848	1366754848	1	1	WALGREEN CO	9/30/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3300 BUENA VISTA RD	BLDG A	BAKERSFIELD	CA	93311	9731	15	06029	35.322642	-119.1278625	Kern County
194198	Fee-for-Service	1053771071	1053771071	1	2	WOODLAND CHIROPRACTIC AND WE	6/18/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	LLNESS CLINIC INC	3 COURT ST	None	WOODLAND	CA	95695	3111	57	06113	38.67888652	-121.783788	Yolo County
194211	Fee-for-Service	1649670076	1649670076	1	1	WARNER, DEBRA LMFT	6/11/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5743 CORSA AVE	STE 221	WESTLAKE VILLAGE	CA	91362	6864	19	06037	34.156863	-118.7994295	Los Angeles County
194217	Fee-for-Service	1790116879	1790116879	1	1	WITTMERSHAUS, CHANEL R LMFT	12/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
194219	Fee-for-Service	1114457827	1114457827	1	1	WHETSTONE, COURTNEY LMFT	2/3/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6840 INDIANA AVE	275	RIVERSIDE	CA	92506	4279	33	06065	33.94246965	-117.3926366	Riverside County
194259	Fee-for-Service	1972007706	1972007706	1	1	WIRTH, HANNAH R MD	12/3/2019	363LX0001X	NA	Nurse Practitioner	026	PHYSICIANS	164551	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
194269	Fee-for-Service	1508063108	1508063108	1	1	WEI WANG MEDICAL CORPORATION	2/13/2023	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	223 N GARFIELD AVE	#208	MONTEREY PARK	CA	91754	1700	19	06037	34.0646166	-118.1228948	Los Angeles County
194294	Fee-for-Service	1336119510	1336119510	1	1	WILLIAMS, SHARON R MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	61236	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
194296	Fee-for-Service	1396766846	1396766846	1	1	WELLMEYER, ERIC K MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75125	05	Anesthesiology	0	In state provider	None	14900 IMPERIAL HWY	None	LA MIRADA	CA	90638	2172	19	06037	33.91710433	-118.0132986	Los Angeles County
194344	Fee-for-Service	1659459360	1659459360	1	1	WIESENFARTH, JOHN M MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	61978	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2024 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.60237854	-121.3921357	Sacramento County
194351	Fee-for-Service	1386982015	1386982015	1	1	WAL-MART STORES, INC	6/3/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1185 HERNDON AVE	None	CLOVIS	CA	93611	0409	10	06019	36.8397	-119.6957565	Fresno County
194364	Fee-for-Service	1346234051	1346234051	1	1	WALTHER, HENRY C MD	4/30/1992	207L00000X	NA	Other	026	PHYSICIANS	48310	05	Anesthesiology	0	In state provider	None	1900 POINT WEST WAY	STE 222	SACRAMENTO	CA	95815	4704	34	06067	38.599677	-121.431447	Sacramento County
194462	Fee-for-Service	1487271359	1487271359	1	1	WILCOX, HOLLYNN F LMFT	3/27/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1162 MONTGOMERY DR	SUITE 200 & 300	SANTA ROSA	CA	95405	4802	49	06097	38.442978	-122.6999565	Sonoma County
194463	Fee-for-Service	1467654509	1467654509	1	1	WHITAKER, GARRISON L MD	4/5/2021	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	158292	None	None	0	In state provider	None	240 E 13TH STREET	None	MERCED	CA	95341	6234	24	06047	37.2929228	-120.4743925	Merced County
194490	Fee-for-Service	1558707414	1558707414	1	1	WESTERN HEALTH RESOURCES	6/1/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	281 HARVEY DR	UNIT B	GLENDALE	CA	91206	4112	19	06037	34.14922116	-118.2276936	Los Angeles County
194495	Fee-for-Service	1275558298	1275558298	1	1	WANG, XUEDONG MD	4/30/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	63196	None	None	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
194532	Fee-for-Service	1548655855	1548655855	1	1	WU, PHIL F MD	3/23/2020	111NR0200X	NA	Other	026	PHYSICIANS	143831	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
194536	Fee-for-Service	1669661724	1669661724	1	1	WALZ, PATRICE LMFT	3/12/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2240 MERCURY WAY	None	SANTA ROSA	CA	95407	5413	49	06097	38.421135	-122.752008	Sonoma County
194558	Fee-for-Service	1710117932	1710117932	1	1	WONG, KELVIN S MD	6/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128942	34	Urology and Urological Surgery	0	In state provider	None	1700 N ROSE AVE	STE 370	OXNARD	CA	93030	7652	56	06111	34.21746	-119.155545	Ventura County
194572	Fee-for-Service	1588751945	1588751945	1	1	WALGREENS CO	11/30/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	460 W FELICITA AVE	None	ESCONDIDO	CA	92025	6518	37	06073	33.10362671	-117.0751891	San Diego County
194591	Fee-for-Service	1427264084	1427264084	1	1	WU, BO B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	855 MONTGOMERY ST	None	FORT WORTH	TX	76107	2553	00	None	32.750541	-97.3698605	Tarrant County
194613	Fee-for-Service	1003436064	1003436064	1	6	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	1244 UNIVERSITY	None	SAN DIEGO	CA	92103	3312	37	06073	32.74858435	-117.15183	San Diego County
194638	Fee-for-Service	1245240324	1245240324	1	1	WILMARTH, STEPHEN SCOTT	6/23/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	37438	18	Ophthalmology	0	In state provider	MVT	1700 ALHAMBRA BLVD	STE 202	SACRAMENTO	CA	95816	7050	34	06067	38.564847	-121.469121	Sacramento County
194653	Fee-for-Service	1104496850	1104496850	1	1	WILSON, ALEXANDRIA C CNP	9/13/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1325 E. COOLEY DR	SUITE 101	COLTON	CA	92324	3947	36	06071	34.05468148	-117.306261	San Bernardino County
194680	Fee-for-Service	1528266582	1528266582	1	1	WANG, CATHERINE B OD	7/14/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	323 NORTH MATHILDA AVE	None	SUNNYVALE	CA	94085	4207	43	06085	37.38565917	-122.0317807	Santa Clara County
194682	Fee-for-Service	1982704011	1982704011	1	1	WEBB, JOHN R MD	6/30/1988	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	42454	08	Family Practice	0	In state provider	None	10201 MISSION GORGE RD	None	SANTEE	CA	92071	3027	37	06073	32.83844552	-116.9759925	San Diego County
194683	Fee-for-Service	1174802755	1174802755	1	1	WIGHTMAN, SEAN C MD	7/23/2019	208G00000X	NA	General Surgery	026	PHYSICIANS	147815	33	Thoracic Surgery	0	In state provider	None	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
194732	Fee-for-Service	1972680015	1972680015	1	1	WUSSOW, KATHRYN A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	345 NORTH SMITH AVENUE	None	ST PAUL	MN	55102	0000	00	None	44.94251219	-93.1074995	Ramsey County
194747	Fee-for-Service	1891732905	1891732905	1	1	WEST VALLEY MEDICAL CTR	1/1/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	4802	00	None	43.654374	-116.694738	Canyon County
194777	Fee-for-Service	1558707414	1558707414	1	1	WESTERN HEALTH RESOURCES	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	281 HARVEY DR	UNIT B	GLENDALE	CA	91206	4112	19	06037	34.14922116	-118.2276936	Los Angeles County
194818	Fee-for-Service	1144427956	1144427956	1	1	WNW UNC DBA GARDENA RETI	2/15/2006	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	17471 S VERMONT AVE	None	GARDENA	CA	90248	3420	19	06037	33.87222654	-118.2909614	Los Angeles County
194845	Fee-for-Service	1659328631	1659328631	1	1	WILLIAMS, THEODORE G MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	23087	-	NOT APPLICABLE	0	In state provider	None	27281 LAS RAMBLAS ST	STE 140	MISSION VIEJO	CA	92691	6324	30	06059	33.56652088	-117.668662	Orange County
194905	Fee-for-Service	1003436064	1003436064	1	6	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	1244 UNIVERSITY	None	SAN DIEGO	CA	92103	3312	37	06073	32.74858435	-117.15183	San Diego County
194917	Fee-for-Service	1548041064	1548041064	1	1	WU, SARAH CNP	1/23/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4235 PACIFIC COAST HWY	None	TORRANCE	CA	90505	5525	19	06037	33.80817211	-118.3588219	Los Angeles County
194925	Fee-for-Service	1386427797	1386427797	1	1	WILDFERN DOULA	8/20/2023	261QH0100X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	12	06023	0	0	None
194946	Fee-for-Service	1548337744	1548337744	1	1	WANG, DIANA TING-SOI MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79949	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
194947	Fee-for-Service	1396011300	1396011300	1	1	WRIGHT, ALEXANDER G MD	10/2/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	146981	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
194966	Fee-for-Service	1780734590	1780734590	1	1	WILEY, KIMBERLY MD	10/15/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72737	08	Family Practice	0	In state provider	None	6615 VALLEY HI DR	None	SACRAMENTO	CA	95823	4601	34	06067	38.470986	-121.4276985	Sacramento County
194974	Fee-for-Service	1871013193	1871013193	1	1	WOLFSON, HEIDI PHD	5/5/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2100 E STREET	None	BAKERSFIELD	CA	93301	4703	15	06029	35.3781843	-119.0245697	Kern County
194988	Fee-for-Service	1083222707	1083222707	1	1	WAFULA, MERCY W	8/6/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2165 DICKINSON LN	None	CORONA	CA	92880	5492	33	06065	33.90852739	-117.5989601	Riverside County
195019	Fee-for-Service	1477740546	1477740546	1	1	WOLL, LAURIE M DO	8/18/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	4394	07	Dermatology	0	In state provider	AFFILIATED DERM MED CLIN	9369 CENTRAL AVE	None	MONTCLAIR	CA	91763	2420	36	06071	34.084224	-117.689463	San Bernardino County
195032	Fee-for-Service	1154384352	1154384352	1	1	WANG, JOHN C DO	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14522	34	Urology and Urological Surgery	0	In state provider	None	370 DEL NORTE AVE	STE 201	YUBA CITY	CA	95991	4142	51	06101	39.14466521	-121.6166961	Sutter County
195063	Fee-for-Service	1326485004	1326485004	1	1	WAL MART STORES INC	6/16/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	530 WOOLLOMES AVE	None	DELANO	CA	93215	9581	15	06029	35.744481	-119.247903	Kern County
195094	Fee-for-Service	1386755767	1386755767	1	1	WALSH, JILL A MD	8/7/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66619	40	Pediatrics	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
195099	Fee-for-Service	1316510746	1316510746	1	1	WALK IN GYN CARE PC	4/6/2022	207VG0400X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	852 S ROBERTSON BLVD	None	LOS ANGELES	CA	90035	1601	19	06037	34.06139351	-118.3835652	Los Angeles County
195109	Fee-for-Service	1629067244	1629067244	2	1	WANG, STEPHANIE	5/7/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	184444	30	Radiology	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
195115	Fee-for-Service	1568441236	1568441236	1	1	WILSON, MICHAEL L MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	166 4TH E. STREET	None	SAIN PAUL	MN	55101	1421	00	None	44.88685199	-93.16203318	Dakota County
195125	Fee-for-Service	1962678862	1962678862	1	1	WEISMAN, AMY C	11/10/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	0601	43	06085	37.43721275	-122.1744449	Santa Clara County
195172	Fee-for-Service	1235452624	1235452624	1	1	WEEKLY, SARA S MD	8/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	113636	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
195174	Fee-for-Service	1245897446	1245897446	1	1	WEST COVINA CARE INC	4/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	919 N SUNSET AVE	None	WEST COVINA	CA	91790	1244	19	06037	34.08746233	-117.9341836	Los Angeles County
195184	Fee-for-Service	1316301120	1316301120	1	1	WOLFE, TIERNEY MD	3/16/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
195260	Fee-for-Service	1497795595	1497795595	1	1	WELCH, DENNIS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8TH AVE + C STREET	None	SALT LAKE CTY	UT	84143	0001	00	None	40.779063	-111.8805548	Salt Lake County
195271	Fee-for-Service	1316952690	1316952690	1	1	WALGREEN CO	10/30/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1399 W SAN CARLOS ST	None	SAN JOSE	CA	95126	3446	43	06085	37.32360523	-121.9134307	Santa Clara County
195279	Fee-for-Service	1083222707	1083222707	1	1	WAFULA, MERCY W	8/6/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2165 DICKINSON LN	None	CORONA	CA	92880	5492	33	06065	33.90852739	-117.5989601	Riverside County
195294	Fee-for-Service	1952565103	1952565103	1	1	WU, ARTHUR W MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	101951	04	Otology, Laryngology, Rhinology	0	In state provider	None	8631 W 3RD ST	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
195304	Fee-for-Service	1457302069	1457302069	1	1	WALUCH, VICTOR MD	5/31/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	42835	30	Radiology	0	In state provider	None	910 S FAIRFAX AVE	None	LOS ANGELES	CA	90036	4419	19	06037	34.0597882	-118.3630234	Los Angeles County
195316	Fee-for-Service	1114908159	1114908159	1	1	WIESE, DON E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	166 4TH ST E	None	SAINT PAUL	MN	55101	1421	00	None	44.94748068	-93.08830943	Ramsey County
195360	Fee-for-Service	1114949443	1114949443	1	1	WYATT, DEBORAH D.	2/1/2001	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	49664	40	Pediatrics	0	In state provider	None	3700 CALIFORNIA ST	FL 1	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
195366	Fee-for-Service	1710565858	1710565858	1	1	WAINWRIGHT, MARK MD	8/12/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
195387	Fee-for-Service	1316510746	1316510746	1	1	WALK IN GYN CARE PC	4/6/2022	207VG0400X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	852 S ROBERTSON BLVD	None	LOS ANGELES	CA	90035	1601	19	06037	34.06139351	-118.3835652	Los Angeles County
195416	Fee-for-Service	1265409759	1265409759	1	1	WATKINS, CAROL D DO	2/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	8599	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
195451	Fee-for-Service	1003436064	1003436064	1	24	WS AUDIOLOGY (CALIFORNIA), P	3/30/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1539 SLOAT BLVD	None	SAN FRANCISCO	CA	94132	1222	38	06075	37.73396982	-122.4897505	San Francisco County
195452	Fee-for-Service	1508207275	1508207275	1	1	WAL-MART STORES, INC	9/20/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5609 PACIFIC ST	None	ROCKLIN	CA	95677	3174	31	06061	38.78428405	-121.2405548	Placer County
195462	Fee-for-Service	1164845616	1164845616	1	1	WATSON, MICHELLE S	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
195467	Fee-for-Service	1235269465	1235269465	1	1	WEISFELNER, MAYA LCSW	1/9/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24405 CHESTNUT ST.,	SUITE 205	NEWHALL	CA	91321	1000	19	06037	34.37967818	-118.531332	Los Angeles County
195473	Fee-for-Service	1558580985	1558580985	1	1	WEST MARIN PHARMACY INC	6/8/2007	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11 FOURTH ST	None	PT REYES STA	CA	94956	0000	21	06041	38.06853658	-122.8070928	Marin County
195476	Fee-for-Service	1003436064	1003436064	1	28	WS AUDIOLOGY (CALIFORNIA), P	5/13/2021	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	19367 VICTORY BLVD	SUITE 14	TARZANA	CA	91335	6302	19	06037	34.18658599	-118.5557169	Los Angeles County
195563	Fee-for-Service	1326019944	1326019944	1	1	WEST, CARL G MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	35020	10	Gastroenterology (M.D. only)	0	In state provider	None	47647 CALEO BAY DR	STE 200	LA QUINTA	CA	92253	8856	33	06065	33.70305235	-116.2936509	Riverside County
195673	Fee-for-Service	1316510746	1316510746	1	1	WALK IN GYN CARE PC	4/6/2022	207VG0400X	NA	Obstetrics & Gynecology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	852 S ROBERTSON BLVD	None	LOS ANGELES	CA	90035	1601	19	06037	34.06139351	-118.3835652	Los Angeles County
195711	Fee-for-Service	1841438074	1841438074	1	1	WHITTIER BREAST IMAGING	10/23/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	12393 WASHINGTON BLVD	None	WHITTIER	CA	90606	2502	19	06037	33.96719187	-118.0496563	Los Angeles County
195737	Fee-for-Service	1003436064	1003436064	1	24	WS AUDIOLOGY (CALIFORNIA), P	5/5/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1539 SLOAT BLVD	None	SAN FRANCISCO	CA	94132	1222	38	06075	37.73396982	-122.4897505	San Francisco County
195746	Fee-for-Service	1063881951	1063881951	1	1	WESTERN HORIZON HOSPICE AND	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	2 SOUTH POINTE DR	SUITE 130	LAKE FOREST	CA	92630	2246	30	06059	33.65929522	-117.6985463	Orange County
195764	Fee-for-Service	1003436064	1003436064	1	28	WS AUDIOLOGY (CALIFORNIA), P	5/13/2021	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	19367 VICTORY BLVD	SUITE 14	TARZANA	CA	91335	6302	19	06037	34.18658599	-118.5557169	Los Angeles County
195766	Fee-for-Service	1629575337	1629575337	1	1	WAXER, JONATHAN MD	10/1/2019	111NR0200X	NA	Other	026	PHYSICIANS	163392	30	Radiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
195767	Fee-for-Service	1861988925	1861988925	1	1	WANG, JUNTIAN MD	9/9/2024	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	165835	20	Orthopedic Surgery	0	In state provider	None	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
195837	Fee-for-Service	1821359753	1821359753	1	1	WANG, JEFF J MD	9/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138481	01	General Practice	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
195844	Fee-for-Service	1124800214	1124800214	1	1	WHITEHURST, UNIQUE NP	1/17/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
195845	Fee-for-Service	1679783906	1679783906	1	1	WEINER, AHNDREA E MFT	12/2/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	31142	-	NOT APPLICABLE	0	In state provider	None	20350 VENTURA BLVD	SUITE 230	WOODLAND HILLS	CA	91364	2487	19	06037	34.16912779	-118.5759948	Los Angeles County
195852	Fee-for-Service	1326019944	1326019944	1	1	WEST, CARL G MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	35020	41	Internal Medicine	0	In state provider	None	47647 CALEO BAY DR	STE 200	LA QUINTA	CA	92253	8856	33	06065	33.70305235	-116.2936509	Riverside County
195947	Fee-for-Service	1851785703	1851785703	1	1	WONG, ANGELA Y MD	8/30/2019	207RH0002X	NA	Adult Primary Care	026	PHYSICIANS	162555	41	Internal Medicine	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
195954	Fee-for-Service	1841383858	1841383858	1	1	WILSON, MARCELLA M MD	9/20/2007	2084P0800X	NA	Psychiatry	026	PHYSICIANS	59275	36	Psychiatry	0	In state provider	None	3131 CAMINO DEL RIO N	STE 270	SAN DIEGO	CA	92108	5703	37	06073	32.77548044	-117.127293	San Diego County
195972	Fee-for-Service	1801082334	1801082334	1	1	WALTER, JEANINE L MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97864	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
196016	Fee-for-Service	1659665289	1659665289	1	1	WOOD, ZACKERY S DO	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11748	08	Family Practice	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
196031	Fee-for-Service	1063881951	1063881951	1	1	WESTERN HORIZON HOSPICE AND	3/15/2018	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	2 SOUTH POINTE DR	SUITE 130	LAKE FOREST	CA	92630	2246	30	06059	33.65929522	-117.6985463	Orange County
196038	Fee-for-Service	1720260953	1720260953	1	1	WEIR, JUSTIN B MD	3/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119056	30	Radiology	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
196119	Fee-for-Service	1922024306	1922024306	1	1	WESTMAN, DAVID MD	2/12/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	80965	30	Radiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
196128	Fee-for-Service	1093135311	1093135311	1	1	WILSON, TREVOR C MD	8/1/2018	207P00000X	NA	Other	026	PHYSICIANS	140144	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2309 ANTONIO AVE	None	CAMARILLO	CA	93010	1414	56	06111	34.24435917	-119.0191975	Ventura County
196153	Fee-for-Service	1033594460	1033594460	1	1	WAITE, TERRY R LMFT	2/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9324 W STOCKTON BLVD	None	ELK GROVE	CA	95758	8012	34	06067	38.418309	-121.3939665	Sacramento County
196183	Fee-for-Service	1356323786	1356323786	1	1	WILSON, MARK C MD	1/23/2022	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
196188	Fee-for-Service	1003131392	1003131392	1	1	WALGREEN CO	10/26/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1801 N ROSE AVE	None	OXNARD	CA	93030	2613	56	06111	34.21761901	-119.1584531	Ventura County
196190	Fee-for-Service	1194082768	1194082768	1	1	WEST, ANDREW K MD	7/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127758	None	None	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
196194	Fee-for-Service	1487730313	1487730313	1	1	WANG, WILLIAM MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	56372	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
196223	Fee-for-Service	1497994065	1497994065	1	1	WAIGHT, EMILY N NP	11/17/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
196250	Fee-for-Service	1730350596	1730350596	1	1	WILLIAMS, ALBERT A	12/1/1997	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	5360 JACKSON DR	STE 110	LA MESA	CA	91942	3012	37	06073	32.77680573	-117.0176327	San Diego County
196300	Fee-for-Service	1982893772	1982893772	1	1	WAHBA, GEORGE M MD	11/1/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	97606	None	None	0	In state provider	None	117 BUNNY AVE	None	SANTA MARIA	CA	93458	2805	42	06083	34.96327701	-120.4368111	Santa Barbara County
196334	Fee-for-Service	1366862377	1366862377	1	1	WELLS, CASSANDRA R LMFT	9/27/2024	390200000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
196351	Fee-for-Service	1033211651	1033211651	1	1	WHANG, GEORGE A	1/31/1988	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	SAN JOSE MEDICAL GROUP	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
196469	Fee-for-Service	1871555979	1871555979	1	1	WESTERN LAB MEDICAL GRP	10/1/1983	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
196479	Fee-for-Service	1619422953	1619422953	1	1	WHITE, KAYLA D LCSW	11/30/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
196489	Fee-for-Service	1225055635	1225055635	1	1	WAL-MART STORES INC	1/10/1991	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	465 CAL OAK RD	None	OROVILLE	CA	95965	4183	04	06007	39.4925698	-121.5711555	Butte County
196527	Fee-for-Service	1548450604	1548450604	1	1	WEISS, SUNSHINE A MD	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88119	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2210	43	06085	37.313433	-121.9318385	Santa Clara County
196571	Fee-for-Service	1326335944	1326335944	1	1	WHITTIER, JABAR MD	11/2/2018	207R00000X	NA	Other	026	PHYSICIANS	150208	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
196582	Fee-for-Service	1043287618	1043287618	1	1	WILSON, CHRISTOPHER J MD	5/7/2009	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	106196	46	Hand Surgery	0	In state provider	None	1201 ALHAMBRA BLVD	STE 410	SACRAMENTO	CA	95816	5243	34	06067	38.570076	-121.4657145	Sacramento County
196592	Fee-for-Service	1043665441	1043665441	1	1	WU, SAMANTHA MD	10/4/2021	208600000X	NA	General Surgery	026	PHYSICIANS	163393	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
196604	Fee-for-Service	1003199225	1003199225	1	1	WALGREEN CO	2/21/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1685 TRANCAS STREET	None	NAPA	CA	94558	3323	28	06055	38.32184267	-122.3054503	Napa County
196623	Fee-for-Service	1407953755	1407953755	1	1	WONG, BRYAN M MD	3/1/1984	207RN0300X	NA	Nephrology	026	PHYSICIANS	45482	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1330 CUTTING BLVD	None	RICHMOND	CA	94804	2555	07	06013	37.92518651	-122.3564715	Contra Costa County
196655	Fee-for-Service	1215111935	1215111935	1	1	WELLS, KENNETH DPM INC	6/30/1987	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	286 EUCLID AVE	STE 204	SAN DIEGO	CA	92114	3612	37	06073	32.70706919	-117.0850896	San Diego County
196790	Fee-for-Service	1366281982	1366281982	1	1	WACHTER, KALI M CRNA	6/25/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
196810	Fee-for-Service	1639112246	1639112246	1	1	WISNIEWSKI, MORRIS MD	3/31/1986	207R00000X	NA	Other	026	PHYSICIANS	48942	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2067 W VISTA WAY	STE 200	VISTA	CA	92083	6033	37	06073	33.18505594	-117.285958	San Diego County
196815	Fee-for-Service	1548450604	1548450604	1	1	WEISS, SUNSHINE A MD	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88119	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2210	43	06085	37.313433	-121.9318385	Santa Clara County
196847	Fee-for-Service	1831119403	1831119403	1	1	WADA, SCOTT J MD	4/27/2006	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	54251	None	None	0	In state provider	None	3903 LONE TREE WAY	STE 104	ANTIOCH	CA	94509	6251	07	06013	37.98216807	-121.8054744	Contra Costa County
196851	Fee-for-Service	1740661776	1740661776	1	1	WANG, ALBERT T DO	7/1/2018	207P00000X	NA	Other	026	PHYSICIANS	14872	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
196855	Fee-for-Service	1831295138	1831295138	1	1	WU,JOYCE Y MD	1/1/2001	2080P0008X	NA	Neurology	026	PHYSICIANS	72828	79	Neurology-Child	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
196868	Fee-for-Service	1962913582	1962913582	1	1	WILHELM, GINA LMFT	12/30/2024	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
196913	Fee-for-Service	1235306937	1235306937	1	1	WALGREEN CO.	9/5/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2750 PINOLE VALLEY RD.	None	PINOLE	CA	94564	1425	07	06013	37.9939821	-122.285688	Contra Costa County
196918	Fee-for-Service	1982783379	1982783379	1	1	WARM, KENNETH A MD INC	8/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38070	08	Family Practice	0	In state provider	None	230 PROSPECT PL	STE 340B	CORONADO	CA	92118	1991	37	06073	32.69468235	-117.1677128	San Diego County
197000	Fee-for-Service	1205930252	1205930252	1	2	WESTCHESTER PHARMACY INC	3/1/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8930 S SEPULVEDA BLVD	SUITE 103	LOS ANGELES	CA	90045	3606	19	06037	33.955128	-118.3961915	Los Angeles County
197044	Fee-for-Service	1184981037	1184981037	1	1	WOODWARD, ERIN L LMFT	3/24/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6276 N 1ST ST	103	FRESNO	CA	93710	5400	10	06019	36.82794977	-119.7721574	Fresno County
197100	Fee-for-Service	1639112246	1639112246	1	1	WISNIEWSKI, MORRIS MD	3/31/1986	207R00000X	NA	Other	026	PHYSICIANS	48942	41	Internal Medicine	0	In state provider	None	2067 W VISTA WAY	STE 200	VISTA	CA	92083	6033	37	06073	33.18505594	-117.285958	San Diego County
197105	Fee-for-Service	1265776587	1265776587	1	1	WANG, VICTOR C MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	113969	78	Neoplastic Diseases/Oncology	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
197152	Fee-for-Service	1124476841	1124476841	1	1	WALKER, CHRISTINA B DO	7/6/2022	207P00000X	NA	Other	026	PHYSICIANS	19877	None	None	0	In state provider	None	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
197180	Fee-for-Service	1295868719	1295868719	1	1	WARNESKY, COLLEEN P PSYD	11/14/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
197182	Fee-for-Service	1003436064	1003436064	1	51	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	30271 GOLDEN LANTERN	SUITE B	LAGUNA NIGUEL	CA	92677	5992	30	06059	33.52255101	-117.6859055	Orange County
197183	Fee-for-Service	1003436064	1003436064	1	16	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2220 OTAY LAKES RD	SUITE 503	CHULA VISTA	CA	91915	1004	37	06073	32.64697315	-116.9683274	San Diego County
197195	Fee-for-Service	1003436064	1003436064	1	35	WS AUDIOLOGY (CALIFORNIA), P	4/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	13512 WHITTIER BLVD	G-3	WHITTIER	CA	90605	0000	19	06037	33.96024	-118.032381	Los Angeles County
197249	Fee-for-Service	1447425913	1447425913	1	1	WATERHOUSE, GARET LCSW	7/18/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	24560	-	NOT APPLICABLE	0	In state provider	None	144 STONY POINT RD	None	SANTA ROSA	CA	95401	4122	49	06097	38.440494	-122.74353	Sonoma County
197257	Fee-for-Service	1316297815	1316297815	1	1	WU, SIMON MD	12/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141728	41	Internal Medicine	0	In state provider	None	1680 E 120TH ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
197275	Fee-for-Service	1235306564	1235306564	1	1	WACHTER, MICHAEL W MD	6/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76765	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
197278	Fee-for-Service	1225733116	1225733116	1	1	WONG, CHO KUI	7/29/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
197286	Fee-for-Service	1811318462	1811318462	1	1	WHITCOMB, CRAIG W	9/20/2016	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	780 W OLIVE ST	STE 100	MERCED	CA	95348	2437	24	06047	37.31916174	-120.4814268	Merced County
197291	Fee-for-Service	1417311408	1417311408	1	1	WEI, MIKE T MD	9/7/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	150927	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
197393	Fee-for-Service	1265776587	1265776587	1	1	WANG, VICTOR C MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	113969	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
197449	Fee-for-Service	1275809568	1275809568	1	1	WALGREEN CO	7/27/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1990 MONUMENT BLVD	None	CONCORD	CA	94520	3800	07	06013	37.95593881	-122.0395891	Contra Costa County
197451	Fee-for-Service	1295761005	1295761005	1	1	WATSON, ROBERT W MD	5/8/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	89	Surgery-Traumatic	1	Border provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
197471	Fee-for-Service	1003436064	1003436064	1	51	WS AUDIOLOGY (CALIFORNIA), P	9/2/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	30271 GOLDEN LANTERN	SUITE B	LAGUNA NIGUEL	CA	92677	5992	30	06059	33.52255101	-117.6859055	Orange County
197474	Fee-for-Service	1003436064	1003436064	1	16	WS AUDIOLOGY (CALIFORNIA), P	8/27/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2220 OTAY LAKES RD	SUITE 503	CHULA VISTA	CA	91915	1004	37	06073	32.64697315	-116.9683274	San Diego County
197481	Fee-for-Service	1003436064	1003436064	1	35	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	13512 WHITTIER BLVD	G-3	WHITTIER	CA	90605	0000	19	06037	33.96024	-118.032381	Los Angeles County
197511	Fee-for-Service	1063638161	1063638161	1	1	WILLIAMS, FRANK L MD	4/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	25306	-	NOT APPLICABLE	0	In state provider	None	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	19	06037	34.007238	-118.2653065	Los Angeles County
197522	Fee-for-Service	1023035375	1023035375	1	1	WAL-MART STORES, INC	7/11/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102190	1716 E MAIN ST	None	WOODLAND	CA	95776	6223	57	06113	38.67711352	-121.7412175	Yolo County
197535	Fee-for-Service	1063962678	1063962678	1	1	WOOD, SAMANTHA M CRNA	4/16/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
197556	Fee-for-Service	1316130321	1316130321	1	1	WONG, JEFFREY A MD	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104571	40	Pediatrics	0	In state provider	None	5400 BALBOA BLVD	#202	ENCINO	CA	91316	1529	19	06037	34.169283	-118.501072	Los Angeles County
197574	Fee-for-Service	1003436064	1003436064	1	2	WS AUDIOLOGY (CALIFORNIA), P	11/12/2020	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7910 FROST ST	420	SAN DIEGO	CA	92123	2771	37	06073	32.80027449	-117.153846	San Diego County
197580	Fee-for-Service	1891025896	1891025896	1	1	WESTFALL, DANIELLE E MD	9/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98345	22	Pathology (M.D. only)	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
197616	Fee-for-Service	1407021421	1407021421	1	1	WALSH MEDICAL GROUP, A PROFE	9/25/2020	305S00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SSIONAL CORPORATION	1110 W LA PALMA AVE	SUITE 6	ANAHEIM	CA	92801	2823	30	06059	33.84712953	-117.9320355	Orange County
197670	Fee-for-Service	1902962400	1902962400	1	1	WESTSIDE COMM MENTAL	7/20/1990	No Taxonomy Provided	NA	None	073	AIDS WAIVER SERVICES	-	-	NOT APPLICABLE	0	In state provider	HLTH CTR- WCAP	1153 OAK ST	None	SAN FRANCISCO	CA	94117	2216	38	06075	37.77299026	-122.4383082	San Francisco County
197684	Fee-for-Service	1265776587	1265776587	1	1	WANG, VICTOR C MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	113969	68	Hematology	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
197716	Fee-for-Service	1720407356	1720407356	1	1	WECHTER, ELIZABETH MD	9/20/2017	363LP0200X	NA	Nurse Practitioner	026	PHYSICIANS	140509	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
197738	Fee-for-Service	1295761005	1295761005	1	1	WATSON, ROBERT W MD	5/8/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
197754	Fee-for-Service	1407901283	1407901283	1	1	WOOD,KELLY E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 MARIO CAPECCHI DR	None	SALT LAKE CITY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
197758	Fee-for-Service	1174565527	1174565527	2	1	WEBMAN, ROBERT M MD	1/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	39792	41	Internal Medicine	0	In state provider	None	3250 LOMITA BLVD	STE 301	TORRANCE	CA	90505	5006	19	06037	33.81253631	-118.3435557	Los Angeles County
197794	Fee-for-Service	1528319506	1528319506	1	1	WAL-MART STORES, INC	12/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8455 ELK GROVE BLVD	None	ELK GROVE	CA	95758	9573	34	06067	38.410209	-121.3915995	Sacramento County
197862	Fee-for-Service	1003436064	1003436064	1	2	WS AUDIOLOGY (CALIFORNIA), P	3/25/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	7910 FROST ST	420	SAN DIEGO	CA	92123	2771	37	06073	32.80027449	-117.153846	San Diego County
197866	Fee-for-Service	1437162856	1437162856	1	1	WALKER, ARMI L MD	7/30/1996	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	64332	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1609 28TH ST	STE A	BAKERSFIELD	CA	93301	1927	15	06029	35.38477422	-119.0203556	Kern County
197894	Fee-for-Service	1629695358	1629695358	1	1	WILLIAMS, DANIEL B NP	9/14/2021	390200000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
197924	Fee-for-Service	1497769012	1497769012	1	1	WANG, ON MD	8/31/1992	208600000X	NA	General Surgery	026	PHYSICIANS	70368	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	# 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
198045	Fee-for-Service	1174565527	1174565527	2	1	WEBMAN, ROBERT M MD	1/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	39792	10	Gastroenterology (M.D. only)	0	In state provider	None	3250 LOMITA BLVD	STE 301	TORRANCE	CA	90505	5006	19	06037	33.81253631	-118.3435557	Los Angeles County
198051	Fee-for-Service	1003436064	1003436064	1	54	WS AUDIOLOGY (CALIFORNIA), P	7/29/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5480 DEWEY	SUITE 110	FAIR OAKS	CA	95628	3156	34	06067	38.66526	-121.3076025	Sacramento County
198077	Fee-for-Service	1679624407	1679624407	1	1	WASHINGTON HOSPTIAL	3/1/1966	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1746	01	06001	37.55769729	-121.9808861	Alameda County
198089	Fee-for-Service	1194793976	1194793976	1	1	WENDT, ALLEN MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53816	40	Pediatrics	0	In state provider	None	1186 LELAND AVE	None	TULARE	CA	93274	2233	54	06107	36.23014473	-119.3277192	Tulare County
198095	Fee-for-Service	1083762900	1083762900	1	1	WANG-O'CONNELL, ESTHER C	3/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86420	08	Family Practice	0	In state provider	MD	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
198097	Fee-for-Service	1578270799	1578270799	1	1	WONG, VIVIAN OT	6/13/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8282 WHITE OAK AVE	107, 108, AND 111	RANCHO CUCAMONGA	CA	91730	7680	36	06071	34.10361339	-117.5644472	San Bernardino County
198118	Fee-for-Service	1710221445	1710221445	1	1	WU, SHARON H MD	5/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122230	22	Pathology (M.D. only)	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
198154	Fee-for-Service	1720427024	1720427024	1	1	WINKELMANN, RICHARD R DO	9/1/2021	207ND0101X	NA	Dermatology	026	PHYSICIANS	17449	None	None	0	In state provider	None	10441 LAKEWOOD BLVD	None	DOWNEY	CA	90241	2744	19	06037	33.94358034	-118.1193714	Los Angeles County
198169	Fee-for-Service	1780926808	1780926808	1	1	WONG, JONATHAN M MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135101	41	Internal Medicine	0	In state provider	None	2340 CLAY ST	3RD FL	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
198192	Fee-for-Service	1508060401	1508060401	1	1	WANG, WILLIAM DO	5/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9985	08	Family Practice	0	In state provider	None	420 W LAS TUNAS DRIVE	None	SAN GABRIEL	CA	91776	1268	19	06037	34.1024295	-118.1052135	Los Angeles County
198237	Fee-for-Service	1194274167	1194274167	2	1	WELIM MD INC	2/11/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	126925	None	None	0	In state provider	None	2026 N IMPERIAL AVE	SUITE D	EL CENTRO	CA	92243	1607	13	06025	32.81256347	-115.5700202	Imperial County
198254	Fee-for-Service	1275572802	1275572802	1	1	WAT, KAREN E MD	7/31/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	37608	30	Radiology	0	In state provider	None	2 W FERN AVE	None	RIVERSIDE	CA	92737	5916	33	06065	33.91784492	-116.9502943	Riverside
198299	Fee-for-Service	1689710048	1689710048	1	1	WINDSOR SKYLINE CARE CTR LLC	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	348 IRIS DR	None	SALINAS	CA	93906	3514	27	06053	36.69347517	-121.6574161	Monterey County
198302	Fee-for-Service	1811367998	1811367998	1	1	WONG, CHRISTABEL P	11/30/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	STE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
198310	Fee-for-Service	1831836618	1831836618	1	1	WINTERS HEALTHCARE FOUNDATIO	5/24/2022	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	172 E GRANT AVE	STE 100	WINTERS	CA	95694	1780	57	06113	38.5264496	-121.9668052	Yolo County
198326	Fee-for-Service	1487682183	1487682183	1	1	WONG, KENNETH C MD	11/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92821	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
198333	Fee-for-Service	1174565527	1174565527	2	1	WEBMAN, ROBERT M MD	1/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	39792	01	General Practice	0	In state provider	None	3250 LOMITA BLVD	STE 301	TORRANCE	CA	90505	5006	19	06037	33.81253631	-118.3435557	Los Angeles County
198340	Fee-for-Service	1003436064	1003436064	1	54	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5480 DEWEY	SUITE 110	FAIR OAKS	CA	95628	3156	34	06067	38.66526	-121.3076025	Sacramento County
198349	Fee-for-Service	1326265919	1326265919	1	1	WEEKES, LAURENCE J MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	28484	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2650 JONES WAY	STE 2	SIMI VALLEY	CA	93065	1204	56	06111	34.28861251	-118.745991	Ventura County
198358	Fee-for-Service	1154447316	1154447316	1	1	WACZEK, ALLISON D NP	11/4/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3609 OCEAN RANCH BLVD	None	OCEANSIDE	CA	92056	2698	37	06073	33.210836	-117.3107856	San Diego County
198365	Fee-for-Service	1679624407	1679624407	1	1	WASHINGTON HOSPTIAL	12/1/1977	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1746	01	06001	37.55769729	-121.9808861	Alameda County
198375	Fee-for-Service	1245263086	1245263086	1	1	WYATT, JOAN M MD	3/3/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	52165	08	Family Practice	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
198387	Fee-for-Service	1871813824	1871813824	1	1	WEBER, MARY	1/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
198391	Fee-for-Service	1407896327	1407896327	1	1	WYATT, LEWIS JR MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	32030	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8631 W 3RD ST	STE 1125E	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
198405	Fee-for-Service	1396725073	1396725073	1	1	WILLIAM W HINCHEY, MD	3/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11212 STATE HIGHWAY 151	None	SAN ANTONIO	TX	78251	4498	00	None	29.46743939	-98.69462674	Bexar County
198464	Fee-for-Service	1801564620	1801564620	1	1	WARNSHUIS, DEVIN T NP	2/8/2024	163WP0808X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
198590	Fee-for-Service	1780621276	1780621276	1	1	WASHINGTON, TARA A MD	5/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88063	78	Neoplastic Diseases/Oncology	0	In state provider	None	36450 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9583	33	06065	33.591168	-117.2367715	Riverside County
198598	Fee-for-Service	1912688946	1912688946	1	1	WOODWARD, ADRIANA M NP	7/19/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
198635	Fee-for-Service	1326265919	1326265919	1	1	WEEKES, LAURENCE J MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	28484	02	General Surgery	0	In state provider	None	2650 JONES WAY	STE 2	SIMI VALLEY	CA	93065	1204	56	06111	34.28861251	-118.745991	Ventura County
198641	Fee-for-Service	1770220055	1770220055	1	1	WINTER, SARAH A	9/2/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
198745	Fee-for-Service	1114968393	1114968393	1	2	WONG, JACQUELINE C MD	2/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	84867	41	Internal Medicine	0	In state provider	None	8035 HILL DR	None	ROSEMEAD	CA	91770	8853	19	06037	34.04567476	-118.0930827	Los Angeles County
198765	Fee-for-Service	1609878115	1609878115	1	1	WOODBURY, THOMAS A DO	8/2/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	5929	08	Family Practice	0	In state provider	None	9089 BASELINE RD	STE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
198773	Fee-for-Service	1578545208	1578545208	1	1	WERNER, TERRY S MD INC	10/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	67230	04	Otology, Laryngology, Rhinology	0	In state provider	None	150 GLASSON WAY	STE B	GRASS VALLEY	CA	95945	5706	29	06057	39.22882551	-121.0470962	Nevada County
198778	Fee-for-Service	1629146949	1629146949	1	1	WALTERS, KIM C MD	8/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82272	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
198795	Fee-for-Service	1992741219	1992741219	1	1	WIEDEMANN, JEFFERSON M	3/24/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	82232	66	Emergency Medicine (Urgent Care)	0	In state provider	MD	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
198798	Fee-for-Service	1699121319	1699121319	1	1	WOLDEYESUS, TEMESGEN MD	6/4/2019	390200000X	NA	Other	026	PHYSICIANS	152723	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
198880	Fee-for-Service	1871097436	1871097436	1	1	WILLIAMS, BRANDON J MD	8/23/2021	207R00000X	NA	Other	026	PHYSICIANS	163743	None	None	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
198900	Fee-for-Service	1528395282	1528395282	1	1	WAI, SHANNON S MD	6/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122459	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
198934	Fee-for-Service	1497079487	1497079487	1	1	WILLIAMS, AMY MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115044	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
198966	Fee-for-Service	1184647091	1184647091	1	1	WILSON, BRENT ALAN MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84254	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
198970	Fee-for-Service	1184102014	1184102014	1	1	WILLIAMS, CHRISTINA K LMFT	6/7/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
199028	Fee-for-Service	1205841574	1205841574	1	1	WALGREEN CO.	12/21/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	830 3RD ST	None	SAN RAFAEL	CA	94901	3302	21	06041	37.97188236	-122.5255096	Marin County
199040	Fee-for-Service	1518491307	1518491307	1	1	WILLIAMS, JAMES MD	9/9/2020	207P00000X	NA	Other	026	PHYSICIANS	157561	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13100 STUDEBAKER ROAD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
199050	Fee-for-Service	1326483363	1326483363	1	1	WOLESKY, CHRISTIANNE M LCSW	9/17/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	854 MAGNOLIA AVE	STE 201	CORONA	CA	92879	3109	33	06065	33.8605591	-117.5513844	Riverside County
199082	Fee-for-Service	1992741219	1992741219	1	1	WIEDEMANN, JEFFERSON M	3/24/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	82232	08	Family Practice	0	In state provider	MD	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
199186	Fee-for-Service	1528395282	1528395282	1	1	WAI, SHANNON S MD	6/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122459	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
199219	Fee-for-Service	1225084312	1225084312	1	1	WEE, LOLITA I CRNA	3/16/2009	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 N ROXBURY DRIVE	SUITE 600	BEVERLY HILLS	CA	90210	4321	19	06037	34.06820793	-118.4070317	Los Angeles County
199228	Fee-for-Service	1801813035	1801813035	1	1	WAL-MART STORES INC	8/20/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL MART PHRMCY 10-5023	1200 HIGHLAND AVE	None	NATIONAL CITY	CA	91950	3541	37	06073	32.67530709	-117.0977171	San Diego County
199232	Fee-for-Service	1003979980	1003979980	1	1	WONG, ANNA PHD	1/15/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
199247	Fee-for-Service	1912403668	1912403668	1	1	WOODSON, DOMINIC DO	8/16/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	17497	20	Orthopedic Surgery	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
199253	Fee-for-Service	1669733812	1669733812	1	1	WONG, LILY W DO	6/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14577	41	Internal Medicine	0	In state provider	None	2501 E CHAPMAN AVE	SUITE 200	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
199269	Fee-for-Service	1396733135	1396733135	1	1	WILLIAMS, ANDREA E MD	9/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	68057	08	Family Practice	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
199327	Fee-for-Service	1114022365	1114022365	1	1	WORLD MARKET ENTRPRS INC	5/19/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	RISING SUN MED SUPPLY	2049 PACIFIC COAST HWY	STE 103	LOMITA	CA	90717	2658	19	06037	33.7895673	-118.3163601	Los Angeles County
199351	Fee-for-Service	1891733788	1891733788	1	1	WEST CONTRA COSTA HEALTHCARE	8/1/2004	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
199403	Fee-for-Service	1902373558	1902373558	1	1	WANG, GRACE H PT	6/18/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
199404	Fee-for-Service	1447332036	1447332036	1	12	WELLSPACE HEALTH	4/8/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5 MEDICAL PLAZA DRIVE	SUITE 170	ROSEVILLE	CA	95661	3037	31	06061	38.76604411	-121.2466761	Placer County
199408	Fee-for-Service	1902275381	1902275381	1	1	WERNICK, OLIVIA Z LCSW	2/15/2022	390200000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
199414	Fee-for-Service	1427371087	1427371087	1	2	WASHINGTON, OMAR R MD	9/1/2024	207P00000X	NA	Other	026	PHYSICIANS	126890	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
199429	Fee-for-Service	1427406792	1427406792	1	1	WAL-MART STORES INC	11/16/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1249 ALLEN RD	None	BAKERSFIELD	CA	93314	9748	15	06029	35.370072	-119.1455585	Kern County
199445	Fee-for-Service	1164637872	1164637872	1	1	WILSON, APRIL E MD	1/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	101649	01	General Practice	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
199457	Fee-for-Service	1366716391	1366716391	1	1	WANG, FENGDAN MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132936	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
199487	Fee-for-Service	1578634549	1578634549	1	1	WEST, NATASHA C MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76884	40	Pediatrics	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
199488	Fee-for-Service	1336367267	1336367267	1	2	WAGER, PAUL P LMFT	11/22/2016	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
199554	Fee-for-Service	1851873293	1851873293	1	1	WATKINS, ALISHA A MD	8/25/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	181637	15	Obstetrics (D.O. only)	0	In state provider	None	501 J ST	None	SACRAMENTO	CA	95814	2325	34	06067	38.582118	-121.499325	Sacramento County
199560	Fee-for-Service	1164272480	1164272480	1	1	WALGREEN CO	1/16/2025	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6140 STONERIDGE MALL RD	STE 180	PLEASANTON	CA	94588	3232	01	06001	37.69767	-121.9231845	Alameda County
199580	Fee-for-Service	1063531291	1063531291	1	1	WARD, ABNER M	1/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	86332	20	Orthopedic Surgery	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
199597	Fee-for-Service	1285808907	1285808907	1	1	WONG, CANDY F M MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109984	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
199601	Fee-for-Service	1851599872	1851599872	1	1	WONG, YOLANDA Y MD	9/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	94449	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
199630	Fee-for-Service	1902211451	1902211451	1	1	WINNIE, KIRSTEN A MD	9/24/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	172054	None	None	0	In state provider	None	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
199640	Fee-for-Service	1891733788	1891733788	1	1	WEST CONTRA COSTA HEALTHCARE	8/1/2004	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
199646	Fee-for-Service	1255866216	1255866216	1	1	WOODS, GABRIELLA DO	2/9/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16754	None	None	0	In state provider	None	1400 E PALOMAR ST	None	CHULA VISTA	CA	91913	1800	37	06073	32.62382113	-116.9960539	San Diego County
199648	Fee-for-Service	1881734788	1881734788	1	1	WATTS, GREGORY M MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	35248	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
199649	Fee-for-Service	1962563627	1962563627	1	1	WIGHT, LINDA C NP	11/8/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
199657	Fee-for-Service	1033223946	1033223946	1	1	WIN, MAUNG-NYEIN MD	11/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92820	None	None	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
199665	Fee-for-Service	1316268477	1316268477	1	1	WONG, MELISSA MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136060	02	General Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	0001	19	06037	34.06373445	-118.443537	Los Angeles County
199666	Fee-for-Service	1235296229	1235296229	1	1	WITTMAN, RICHARD MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79722	None	None	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
199692	Fee-for-Service	1881072346	1881072346	1	1	WANG, CANTY MD	7/22/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	145356	15	Obstetrics (D.O. only)	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
199693	Fee-for-Service	1447332036	1447332036	1	12	WELLSPACE HEALTH	4/8/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5 MEDICAL PLAZA DRIVE	SUITE 170	ROSEVILLE	CA	95661	3037	31	06061	38.76604411	-121.2466761	Placer County
199703	Fee-for-Service	1427371087	1427371087	1	2	WASHINGTON, OMAR R MD	9/1/2024	207P00000X	NA	Other	026	PHYSICIANS	126890	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
199709	Fee-for-Service	1487806857	1487806857	1	1	WARREN, APRIL E OD	1/4/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1234 CHAPMAN AVENUE	STE 201	ORANGE	CA	92868	2863	30	06059	33.78786164	-117.865845	Orange County
199734	Fee-for-Service	1336371400	1336371400	1	1	WHITLOW, SCOTT R MD	3/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
199751	Fee-for-Service	1316083025	1316083025	1	1	WINDSOR EL CAMINO	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CARE CENTER	2540 CARMICHAEL WAY	None	CARMICHAEL	CA	95608	5314	34	06067	38.611062	-121.327011	Sacramento County
199832	Fee-for-Service	1174562631	1174562631	1	1	WEINSTEIN, CHARLES D PHD	10/31/1986	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	15300 VENTURA BLVD	SUITE 400	SHERMAN OAKS	CA	91403	3142	19	06037	34.15387425	-118.4666626	Los Angeles County
199842	Fee-for-Service	1851873293	1851873293	1	1	WATKINS, ALISHA A MD	8/25/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	181637	09	Gynecology (D.O. only)	0	In state provider	None	501 J ST	None	SACRAMENTO	CA	95814	2325	34	06067	38.582118	-121.499325	Sacramento County
199864	Fee-for-Service	1497120653	1497120653	1	1	WESTERN DIAGNOSTIC SERVICES	10/4/2019	207ZP0102X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	LABORATORY, LLC	1414 E MAIN ST	SUITE 102	SANTA MARIA	CA	93454	4813	42	06083	34.95286853	-120.4139295	Santa Barbara County
199885	Fee-for-Service	1285808907	1285808907	1	1	WONG, CANDY F M MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109984	41	Internal Medicine	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
199891	Fee-for-Service	1770580151	1770580151	1	1	WRIGHT, RICHARD F MD	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	39282	06	Cardiovascular Disease (M.D. only)	0	In state provider	#280W	2001 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
199893	Fee-for-Service	1174672885	1174672885	1	1	WERTHEIMER, FIONA B DO	10/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	10827	40	Pediatrics	0	In state provider	None	1200 NORTH STATE ST	None	LOS ANGELES	CA	90033	1083	19	06037	34.05855992	-118.209755	Los Angeles County
199894	Fee-for-Service	1841599156	1841599156	1	1	WHITE, SARAH D CNM	12/2/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	12815 HEACOCK STREET	None	MORENO VALLEY	CA	92553	3116	33	06065	33.934842	-117.2438195	Riverside County
199930	Fee-for-Service	1881734788	1881734788	1	1	WATTS, GREGORY M MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	35248	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
199931	Fee-for-Service	1679985071	1679985071	1	1	WARRICK, KASPER J MD	9/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156491	41	Internal Medicine	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
199967	Fee-for-Service	1750878484	1750878484	1	1	WONG, TSZ HO MD	3/3/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
199980	Fee-for-Service	1881072346	1881072346	1	1	WANG, CANTY MD	7/22/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	145356	09	Gynecology (D.O. only)	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
200025	Fee-for-Service	1386659613	1386659613	1	1	WALGREEN CO	11/9/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19501 BEACH BLVD	None	HUNTINGTON BEACH	CA	92648	2902	30	06059	33.6789	-117.988766	Orange County
200039	Fee-for-Service	1629087887	1629087887	1	1	WHITE, DAVID M	2/28/1992	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10444 SANTA MONICA BLVD	STE 203	LOS ANGELES	CA	90025	5088	19	06037	34.05637794	-118.4252002	Los Angeles County
200137	Fee-for-Service	1548316219	1548316219	1	1	WALTER W STRAUSER, MD, INC	10/28/2021	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	None	None	0	In state provider	None	8765 AERO DRIVE	SUITE 310	SAN DIEGO	CA	92123	1781	37	06073	32.80965252	-117.139383	San Diego County
200138	Fee-for-Service	1033637236	1033637236	1	1	WU, BRIAN MD	9/27/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	159332	None	None	0	In state provider	None	11835 W OLYMPIC BLVD	1265E	LOS ANGELES	CA	90064	5814	19	06037	34.03273663	-118.4516927	Los Angeles County
200165	Fee-for-Service	1053629527	1053629527	1	1	WATSON, JEFFREY B MD	2/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	116367	04	Otology, Laryngology, Rhinology	0	In state provider	None	10121 PINE AVENUE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
200167	Fee-for-Service	1780039644	1780039644	1	1	WANG, ERICA B MD	7/14/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	156279	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
200196	Fee-for-Service	1457308769	1457308769	1	1	WAHLEN, STEVEN A MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	70190	30	Radiology	0	In state provider	None	265 COHASSET RD	STE 140	CHICO	CA	95926	2278	04	06007	39.75090044	-121.8522609	Butte County
200344	Fee-for-Service	1003436064	1003436064	1	15	WS AUDIOLOGY (CALIFORNIA), P	5/7/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1921 DOUGLAS BLVD	106	ROSEVILLE	CA	95661	3817	31	06061	38.74437581	-121.2552522	Placer County
200365	Fee-for-Service	1811196967	1811196967	1	1	WONG, DIXON OD	11/7/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	541 W VALLEY BLVD	None	SAN GABRIEL	CA	91776	3730	19	06037	34.07941179	-118.1077	Los Angeles County
200389	Fee-for-Service	1790064012	1790064012	1	1	WONGTHAVATCHAI, DANIEL D LCS	6/17/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
200420	Fee-for-Service	1235258500	1235258500	1	1	WHEAT, BRIANA LCSW	3/1/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	3001	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
200464	Fee-for-Service	1912438599	1912438599	1	1	WANDELL, GRACE M MD	7/14/2023	390200000X	NA	Other	026	PHYSICIANS	187856	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
200499	Fee-for-Service	1013336817	1013336817	1	1	WANG, HOHUI MD	8/1/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	143806	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
200549	Fee-for-Service	1871907501	1871907501	1	1	WONG, PATRICIA P H MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145163	01	General Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
200551	Fee-for-Service	1790087443	1790087443	1	1	WALGREEN CO	6/17/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2055 N PERRIS BLVD	STE A1	PERRIS	CA	92571	2509	33	06065	33.80930628	-117.2260719	Riverside County
200552	Fee-for-Service	1093943052	1093943052	1	1	WONG, ANNA K MD	5/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99182	22	Pathology (M.D. only)	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
200567	Fee-for-Service	1831423250	1831423250	1	1	WILLIAMS, MATTHEW R MD	6/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109398	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
200571	Fee-for-Service	1114531415	1114531415	1	1	WIND BREEZE HOSPICE INC	10/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5311 TOPANGA CANYON BLVD	STE 311	WOODLAND HILLS	CA	91364	1754	19	06037	34.166313	-118.6059365	Los Angeles County
200575	Fee-for-Service	1629248299	1629248299	1	1	WESTERLING, LAURA N MD	3/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90013	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	#450	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
200630	Fee-for-Service	1003436064	1003436064	1	15	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1921 DOUGLAS BLVD	106	ROSEVILLE	CA	95661	3817	31	06061	38.74437581	-121.2552522	Placer County
200638	Fee-for-Service	1326347725	1326347725	1	1	WERTZ, JENNIFER S MD	5/25/2021	390200000X	NA	Other	026	PHYSICIANS	126153	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
200662	Fee-for-Service	1629498118	1629498118	1	1	WOMENS COMMUNITY CLINIC	8/4/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1833 FILLMORE ST	3RD FL	SAN FRANCISCO	CA	94115	3181	38	06075	37.78652252	-122.4333821	San Francisco County
200718	Fee-for-Service	1780719823	1780719823	1	1	WHALEY, BRADLEY D MD	6/1/1999	207P00000X	NA	Other	026	PHYSICIANS	85157	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
200738	Fee-for-Service	1982998043	1982998043	1	1	WEI, JILL T MD	6/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123524	01	General Practice	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
200772	Fee-for-Service	1124257324	1124257324	1	8	WELLSPACE HEALTH	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7777 SUNRISE BLVD	SUITE 2500	CITRUS HEIGHTS	CA	95610	2372	34	06067	38.706561	-121.2731145	Sacramento County
200794	Fee-for-Service	1437654258	1437654258	1	1	WILLYARD, CHARLES E DO	10/21/2021	207R00000X	NA	Other	026	PHYSICIANS	19161	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
200834	Fee-for-Service	1265694673	1265694673	1	1	WIRJO, JONATHAN DO	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	36	Psychiatry	1	Border provider	None	3006 S MARYLAND PKWY	STE 315	LAS VEGAS	NV	89109	6205	00	None	36.135288	-115.1368705	Clark County
200855	Fee-for-Service	1831423250	1831423250	1	1	WILLIAMS, MATTHEW R MD	6/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109398	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
200874	Fee-for-Service	1114531415	1114531415	1	1	WIND BREEZE HOSPICE INC	10/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5311 TOPANGA CANYON BLVD	STE 311	WOODLAND HILLS	CA	91364	1754	19	06037	34.166313	-118.6059365	Los Angeles County
200973	Fee-for-Service	1548348170	1548348170	1	1	WU, JUN MD	8/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72034	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
200978	Fee-for-Service	1770691644	1770691644	1	1	WALDROP, ANGELA E PHD	1/30/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
201013	Fee-for-Service	1326138710	1326138710	1	1	WEST COAST EYE CARE ASSC	5/31/1991	193400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	6945 EL CAJON BLVD	None	SAN DIEGO	CA	92115	1754	37	06073	32.76862715	-117.048093	San Diego County
201019	Fee-for-Service	1114973898	1114973898	1	1	WILLIAMS, MICHAEL P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 KOOTENAI HEALTH WY	None	COEUR D ALENE	ID	83814	6051	00	None	47.695635	-116.792906	Kootenai County
201061	Fee-for-Service	1124257324	1124257324	1	8	WELLSPACE HEALTH	11/25/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7777 SUNRISE BLVD	SUITE 2500	CITRUS HEIGHTS	CA	95610	2372	34	06067	38.706561	-121.2731145	Sacramento County
201076	Fee-for-Service	1417147422	1417147422	1	1	WILSON, TESHINA N DO	6/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13746	01	General Practice	0	In state provider	None	1301 PINOLE VALLEY ROAD	None	PINOLE	CA	94564	1384	07	06013	37.9991883	-122.2867117	Contra Costa County
201108	Fee-for-Service	1821823212	1821823212	1	1	WAHOME, BENSON CRNA	11/25/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
201138	Fee-for-Service	1801864327	1801864327	1	1	WALLACE, JAMES C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	939 CAROLINE ST	None	PORT ANGELES	WA	98362	3909	00	None	48.11505263	-123.4151177	Clallam County
201206	Fee-for-Service	1952625147	1952625147	1	1	WONG, ROBERT J MD	2/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	110614	41	Internal Medicine	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
201213	Fee-for-Service	1891053625	1891053625	1	1	WESSLER, JEFFREY MD	1/6/2025	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	175435	30	Radiology	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
201230	Fee-for-Service	1447561535	1447561535	1	1	WILSON, ANNA DO PC	5/15/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17564	None	None	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
201291	Fee-for-Service	1972762029	1972762029	1	1	WIN-VROOM, KAREN MD	10/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	127134	02	General Surgery	0	In state provider	None	632 WEST GIBSON ROAD	None	WOODLAND	CA	95695	5131	57	06113	38.66314048	-121.794696	Yolo County
201296	Fee-for-Service	1558492645	1558492645	1	1	WILLIS, JEPHRIE E	4/29/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
201334	Fee-for-Service	1104862556	1104862556	1	1	WEISS, MARTIN H MD	12/28/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	24126	14	Neurological Surgery	0	In state provider	None	1420 SAN PABLO ST	# 103	LOS ANGELES	CA	90089	5364	19	06037	34.06167147	-118.2033258	Los Angeles County
201383	Fee-for-Service	1922166305	1922166305	1	1	WONG, PATRICIA C MD	9/27/2005	207W00000X	NA	Ophthalmology	026	PHYSICIANS	76306	18	Ophthalmology	0	In state provider	None	1515 SCOTT STREET	SUITE 2	SAN FRANCISCO	CA	94115	3511	38	06075	37.78406999	-122.4379366	San Francisco County
201390	Fee-for-Service	1063739175	1063739175	1	1	WANG, MICHAEL J B MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137558	30	Radiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
201394	Fee-for-Service	1316972649	1316972649	1	1	WINSTON, JEFFREY V MD	2/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	49373	18	Ophthalmology	0	In state provider	None	101 LAGUNA ROAD	SUITE C	FULLERTON	CA	92835	3634	30	06059	33.89326085	-117.9300987	Orange County
201426	Fee-for-Service	1477600757	1477600757	1	1	WINKLER, BRIAN L PHD	8/5/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
201458	Fee-for-Service	1851010086	1851010086	1	1	WEBB, TRAVIS PT	3/19/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7033 N FRESNO ST STE 202	None	FRESNO	CA	93720	2976	10	06019	36.838044	-119.7813175	Fresno County
201491	Fee-for-Service	1639787856	1639787856	1	1	WAIYAKI, TERESIAH W	7/30/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	15606 MONTALONE PLACE	None	BAKERSFIELD	CA	93314	8068	15	06029	35.39651148	-119.1751065	Kern County
201581	Fee-for-Service	1588311393	1588311393	1	1	WAHIDI, WAHEED NP	10/4/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
201589	Fee-for-Service	1588869945	1588869945	1	1	WELSBIE, DEREK S MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143481	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
201594	Fee-for-Service	1447332036	1447332036	1	13	WELLSPACE HEALTH	4/8/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5959 GREENBACK LANE	SUITE 500	CITRUS HEIGHTS	CA	95621	4700	34	06067	38.681397	-121.322682	Sacramento County
201614	Fee-for-Service	1609016088	1609016088	1	1	WONG, DENNIS S MD	6/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104251	01	General Practice	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
201635	Fee-for-Service	1891463659	1891463659	1	1	WALNUT PHARMACY LLC	10/15/2021	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10331 W. GOSHEN AVE	UNIT B	VISALIA	CA	93291	9328	54	06107	36.341388	-119.40633	Tulare County
201660	Fee-for-Service	1871141945	1871141945	1	1	WONG, CINDY C CNP	3/23/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10455 S DE ANZA BLVD	None	CUPERTINO	CA	95014	3011	43	06085	37.316601	-122.032407	Santa Clara County
201670	Fee-for-Service	1689741811	1689741811	1	1	WOO, CYNTHIA F MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60887	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
201757	Fee-for-Service	1780173724	1780173724	1	1	WELLBOUND OF EMERYVILLE LLC	12/18/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3 PARKCENTER DRIVE	STE 120	SACRAMENTO	CA	95825	5400	34	06067	38.572632	-121.4154135	Sacramento County
201763	Fee-for-Service	1649505975	1649505975	1	1	WONG, MICHAEL L MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131114	78	Neoplastic Diseases/Oncology	0	In state provider	None	3800 HOMESTEAD ROAD	None	SANTA CLARA	CA	95051	4542	43	06085	37.3377485	-122.001453	Santa Clara County
201780	Fee-for-Service	1639787856	1639787856	1	1	WAIYAKI, TERESIAH W	7/30/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	15606 MONTALONE PLACE	None	BAKERSFIELD	CA	93314	8068	15	06029	35.39651148	-119.1751065	Kern County
201789	Fee-for-Service	1730204884	1730204884	1	2	WINSTON, STEPHEN C PHD	8/15/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	14856	-	NOT APPLICABLE	0	In state provider	None	11600 ELDRIDGE AVE	None	LAKE VIEW TERRACE	CA	91342	6506	19	06037	34.28038404	-118.3838708	Los Angeles County
201796	Fee-for-Service	1356429955	1356429955	1	1	WAGNER, ANDREA M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40213	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
201813	Fee-for-Service	1023543832	1023543832	1	1	WANG, JOCELYN MD	9/1/2023	207L00000X	NA	Other	026	PHYSICIANS	173167	None	None	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
201828	Fee-for-Service	1881690162	1881690162	1	1	WALKER, ROBERT P MD	10/12/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	86380	None	None	0	In state provider	None	2309 ANTONIO AVENUE	None	CAMARILLO	CA	93010	1414	56	06111	34.24435917	-119.0191975	Ventura County
201840	Fee-for-Service	1184101909	1184101909	1	1	WANG, IVY LMFT	3/13/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
201851	Fee-for-Service	1417124124	1417124124	1	1	WILLIAMS, KEVIN G LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	534 B ST	None	SANTA ROSA	CA	95401	5211	49	06097	38.44296	-122.7177585	Sonoma County
201856	Fee-for-Service	1972510451	1972510451	1	1	WEST, PHILLIP N MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	44660	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2415 BATH ST	None	SANTA BARBARA	CA	93105	4324	42	06083	34.43190764	-119.7238799	Santa Barbara County
201879	Fee-for-Service	1912067562	1912067562	1	1	WEI, WEI JANE	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	259 8TH ST	# 201	OAKLAND	CA	94607	4400	01	06001	37.79837815	-122.2693	Alameda County
201881	Fee-for-Service	1447332036	1447332036	1	13	WELLSPACE HEALTH	4/8/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5959 GREENBACK LANE	SUITE 500	CITRUS HEIGHTS	CA	95621	4700	34	06067	38.681397	-121.322682	Sacramento County
201896	Fee-for-Service	1003436064	1003436064	1	69	WS AUDIOLOGY (CALIFORNIA), P	6/5/2024	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3840 VALLEY CENTRE DR	602	SAN DIEGO	CA	92130	3306	37	06073	32.93777252	-117.2318423	San Diego County
201900	Fee-for-Service	1821067935	1821067935	1	1	WAGNER, THAO N MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123521	30	Radiology	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
201924	Fee-for-Service	1811236920	1811236920	1	1	WILSON, PATRICIA T OT	4/11/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
201947	Fee-for-Service	1467530360	1467530360	1	1	WILD, TIMOTHY W MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61573	04	Otology, Laryngology, Rhinology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
202050	Fee-for-Service	1346429537	1346429537	1	2	WOLFE, MARY M MD	10/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96987	02	General Surgery	0	In state provider	None	POST OFFICE BOX 55000	None	FRESNO	CA	93747	5000	10	06019	0	0	None
202052	Fee-for-Service	1891895850	1891895850	1	1	WONG, LENBERT M MD	7/5/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63296	40	Pediatrics	0	In state provider	UCD PROFESSIONAL GROUP	3100 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3866	31	06061	38.74399612	-121.2349547	Placer County
202066	Fee-for-Service	1235392325	1235392325	1	1	WELLNESS PHYSICAL THERAPY CE	7/8/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	NTER	1208 S GARFIELD AVE	None	ALHAMBRA	CA	91801	5036	19	06037	34.0802917	-118.1230178	Los Angeles County
202145	Fee-for-Service	1972510451	1972510451	1	1	WEST, PHILLIP N MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	44660	33	Thoracic Surgery	0	In state provider	None	2415 BATH ST	None	SANTA BARBARA	CA	93105	4324	42	06083	34.43190764	-119.7238799	Santa Barbara County
202178	Fee-for-Service	1851525265	1851525265	1	1	WEISS, NICOLE A MD	8/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137698	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
202185	Fee-for-Service	1003436064	1003436064	1	69	WS AUDIOLOGY (CALIFORNIA), P	6/5/2024	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3840 VALLEY CENTRE DR	602	SAN DIEGO	CA	92130	3306	37	06073	32.93777252	-117.2318423	San Diego County
202233	Fee-for-Service	1124447552	1124447552	1	1	WILES, BRITTANY L MD	11/23/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182428	None	None	0	In state provider	None	3883 AIRWAY DR	202	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
202239	Fee-for-Service	1821301110	1821301110	1	1	WANTUCK, JAMES M MD	12/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117984	41	Internal Medicine	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
202282	Fee-for-Service	1093704603	1093704603	1	1	WIDICO, CORINNE MD	1/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81969	66	Emergency Medicine (Urgent Care)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
202315	Fee-for-Service	1861734436	1861734436	1	1	WAHID, A MD INC APMC	6/27/2016	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	106703	01	General Practice	0	In state provider	None	1108 WARD AVE	BLDG A STE 1	PATTERSON	CA	95363	8529	50	06099	37.48636445	-121.1407911	Stanislaus County
202333	Fee-for-Service	1558541623	1558541623	1	1	WACHSMAN, RICHARD M MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	26231	36	Psychiatry	0	In state provider	None	4150 REGENTS PARK ROW	STE 225	LA JOLLA	CA	92037	9138	37	06073	32.87272099	-117.2175656	San Diego County
202335	Fee-for-Service	1730286527	1730286527	1	1	WILLIAMS, VASHAUN O MD	10/11/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
202410	Fee-for-Service	1922325521	1922325521	1	1	WHANG, DONALD MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118780	41	Internal Medicine	0	In state provider	None	23560 CRENSHAW BLVD	STE 101	TORRANCE	CA	90505	5233	19	06037	33.811677	-118.328042	Los Angeles County
202447	Fee-for-Service	1104864941	1104864941	1	1	WICKHAM, JAMES S MD INC	12/1/2003	207L00000X	NA	Other	026	PHYSICIANS	69601	05	Anesthesiology	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
202469	Fee-for-Service	1336331289	1336331289	1	1	WU, JEFFREY K MD	2/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106273	30	Radiology	0	In state provider	None	1325 E CHURCH ST	STE 301	SANTA MARIA	CA	93454	5915	42	06083	34.95209265	-120.4147348	Santa Barbara County
202479	Fee-for-Service	1447305396	1447305396	1	1	WETZLER, KATHRYN PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
202482	Fee-for-Service	1073528303	1073528303	1	1	WALGREEN CO	8/23/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	37160 47TH ST E	None	PALMDALE	CA	93552	4450	19	06037	34.557426	-118.0452945	Los Angeles County
202536	Fee-for-Service	1013998616	1013998616	1	1	WONG, KIN C MD APC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33946	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	435 ARDEN AVE	STE 310	GLENDALE	CA	91203	4014	19	06037	34.15848148	-118.2628845	Los Angeles County
202619	Fee-for-Service	1215001359	1215001359	1	1	WADDLE, BRIAN J MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68066	02	General Surgery	0	In state provider	None	1595 SOQUEL DR	None	SANTA CRUZ	CA	95065	1719	44	06087	36.98879599	-121.9826354	Santa Cruz County
202667	Fee-for-Service	1194353318	1194353318	1	1	WALLENFELSZ, GRANT M MD	10/1/2024	207P00000X	NA	Other	026	PHYSICIANS	187218	66	Emergency Medicine (Urgent Care)	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
202696	Fee-for-Service	1730237512	1730237512	1	1	WATROUS, EILEEN E MD	11/30/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63863	01	General Practice	0	In state provider	None	1113 ALTA AVE	STE 120	UPLAND	CA	91786	2803	36	06071	34.10824455	-117.6322743	San Bernardino County
202699	Fee-for-Service	1922325521	1922325521	1	1	WHANG, DONALD MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118780	77	Infectious Disease	0	In state provider	None	23560 CRENSHAW BLVD	STE 101	TORRANCE	CA	90505	5233	19	06037	33.811677	-118.328042	Los Angeles County
202729	Fee-for-Service	1235737966	1235737966	1	1	WAGNER, ALICIA M PT	4/19/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
202757	Fee-for-Service	1336331289	1336331289	1	1	WU, JEFFREY K MD	2/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106273	78	Neoplastic Diseases/Oncology	0	In state provider	None	1325 E CHURCH ST	STE 301	SANTA MARIA	CA	93454	5915	42	06083	34.95209265	-120.4147348	Santa Barbara County
202770	Fee-for-Service	1992120034	1992120034	1	1	WARRICK, ALEXANDRA MD	7/15/2021	2081S0010X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	151438	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
202800	Fee-for-Service	1487702395	1487702395	1	1	WHITTAKER, AMY A N DO	11/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8348	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
202825	Fee-for-Service	1013998616	1013998616	1	1	WONG, KIN C MD APC	8/31/2004	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	435 ARDEN AVE	STE 310	GLENDALE	CA	91203	4014	19	06037	34.15848148	-118.2628845	Los Angeles County
202827	Fee-for-Service	1265700066	1265700066	1	1	WAHL, JEANNINE L DO	1/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11712	08	Family Practice	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
202851	Fee-for-Service	1609200526	1609200526	1	1	WHITTAKER, LEAH PSYD	9/26/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	750 B	2870	SAN DIEGO	CA	92101	8114	37	06073	32.71782447	-117.157905	San Diego County
202953	Fee-for-Service	1003436064	1003436064	1	4	WS AUDIOLOGY (CALIFORNIA), P	3/29/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	14845 POMERADO	None	POWAY	CA	92064	2803	37	06073	32.98179708	-117.062216	San Diego County
202987	Fee-for-Service	1043743644	1043743644	1	1	WILLIAMS, AUSTIN K MD	11/16/2020	207P00000X	NA	Other	026	PHYSICIANS	169873	None	None	0	In state provider	None	4929 VAN NUYS BLVD	ATTN: EMERGENCY DEPT	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
202988	Fee-for-Service	1053435099	1053435099	1	1	WOODWARD, STEPHANIE M MD	7/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103828	02	General Surgery	0	In state provider	None	7910 FROST ST	STE 450	SAN DIEGO	CA	92123	2753	37	06073	32.80027449	-117.153846	San Diego County
202995	Fee-for-Service	1477251510	1477251510	1	1	WHITE, ARIANA J BIRTH DOULA	4/28/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
202998	Fee-for-Service	1992923460	1992923460	1	1	WINKLE, PETER J MD	3/31/1993	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	70077	02	General Surgery	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 402	GARDEN GROVE	CA	92843	1903	30	06059	33.77450946	-117.913041	Orange County
203015	Fee-for-Service	1275639965	1275639965	1	1	WEIL, PATRICIA M	12/31/1986	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	457 KNOLLCREST DR	SUITE 130	REDDING	CA	96002	0121	45	06089	40.57256468	-122.3637223	Shasta County
203054	Fee-for-Service	1295800068	1295800068	1	1	WOUND MANAGEMENT OF OKLAHOMA	8/8/2012	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	2840 S UTAH AVE	None	OKLAHOMA CITY	OK	73108	1703	00	None	35.43650243	-97.59364002	Oklahoma County
203058	Fee-for-Service	1215399506	1215399506	1	1	WHIPPLE, MARY T MD	9/15/2021	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
203085	Fee-for-Service	1245985019	1245985019	1	1	WESTMORELAND, LAURELL	12/20/2022	172A00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2520 SEAMIST DR	APT 3	SACRAMENTO	CA	95833	2349	34	06067	38.61225	-121.4939925	Sacramento County
203087	Fee-for-Service	1558948562	1558948562	1	1	WANG, WINNIE W DO	9/25/2024	208M00000X	NA	Other	026	PHYSICIANS	22717	41	Internal Medicine	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
203146	Fee-for-Service	1023051638	1023051638	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	44100 JEFFERSON ST	None	INDIO	CA	92201	2712	33	06065	33.72753404	-116.2687204	Riverside County
203179	Fee-for-Service	1619028008	1619028008	1	1	WILEN, LILLY L MD AMC	6/1/1998	261QM2500X	NA	Other	026	PHYSICIANS	61876	01	General Practice	0	In state provider	NEW CONCEPTS MEDICAL GRP	17075 DEVONSHIRE ST	STE 306	NORTHRIDGE	CA	91325	5417	19	06037	34.25755945	-118.50471	Los Angeles County
203192	Fee-for-Service	1902497175	1902497175	1	1	WRIGHT-GARCIA, ERIKA C LMFT	12/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
203242	Fee-for-Service	1003436064	1003436064	1	4	WS AUDIOLOGY (CALIFORNIA), P	3/29/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	14845 POMERADO	None	POWAY	CA	92064	2803	37	06073	32.98179708	-117.062216	San Diego County
203284	Fee-for-Service	1255508131	1255508131	2	1	WONG, CHARLES D DO	11/1/2021	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	8787	None	None	0	In state provider	None	117 BUNNY AVE	None	SANTA MARIA	CA	93458	2805	42	06083	34.96327701	-120.4368111	Santa Barbara County
203285	Fee-for-Service	1992923460	1992923460	1	1	WINKLE, PETER J MD	3/31/1993	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	70077	10	Gastroenterology (M.D. only)	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 402	GARDEN GROVE	CA	92843	1903	30	06059	33.77450946	-117.913041	Orange County
203372	Fee-for-Service	1396907200	1396907200	1	1	WADE, MARIA A MD	3/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98174	08	Family Practice	0	In state provider	None	3291 LOMA VISTA ROAD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
203380	Fee-for-Service	1841072352	1841072352	1	1	WHITSON, AMADA LCSW	6/13/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	473 CARNEGIE DR	STE 200	SAN BERNARDINO	CA	92408	4201	36	06071	34.06796019	-117.2749922	San Bernardino County
203425	Fee-for-Service	1851926455	1851926455	1	1	WONG, CHRISTINE CCC-SLP	9/15/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
203440	Fee-for-Service	1720542236	1720542236	1	1	WOODLYN HOME HEALTH, INC	6/7/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	728 S HILL ST	STE 605B	LOS ANGELES	CA	90014	2767	19	06037	34.04525076	-118.2550818	Los Angeles County
203443	Fee-for-Service	1831357573	1831357573	1	1	WONG, ALAN K MD	11/6/2008	207L00000X	NA	Other	026	PHYSICIANS	95604	05	Anesthesiology	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
203466	Fee-for-Service	1215446109	1215446109	1	1	WELLBE HOME INC	9/23/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6700 VAN NOORD AVE	None	NORTH HOLLYWOOD	CA	91606	1105	19	06037	34.192161	-118.4147605	Los Angeles County
203565	Fee-for-Service	1275996134	1275996134	1	1	WONG, CHUNG KI DO	9/5/2019	390200000X	NA	Other	026	PHYSICIANS	16864	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
203628	Fee-for-Service	1639345184	1639345184	1	1	WONG, GORDON K MD	6/5/2009	2083P0901X	NA	Adult Primary Care	026	PHYSICIANS	71751	01	General Practice	0	In state provider	None	409 W MAIN STREET	None	ALHAMBRA	CA	91801	3433	19	06037	34.0930305	-118.1314728	Los Angeles County
203661	Fee-for-Service	1730825449	1730825449	1	1	WINKLE, KYLA CRNA	10/18/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
203670	Fee-for-Service	1710595392	1710595392	1	1	WHITE FEATHER PHYSICIANS PC	8/31/2020	207QG0300X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
203731	Fee-for-Service	1104941467	1104941467	1	1	WAHI, DEEPAK MD	6/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101142	41	Internal Medicine	0	In state provider	MD	400 OLD RIVER RD	None	BAKERSFIELD	CA	93311	9781	15	06029	35.351487	-119.1143025	Kern County
203741	Fee-for-Service	1689673212	1689673212	1	1	WADE,DEBRA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 SUNNYVIEW LANE	None	KALISPELL	MT	59901	3129	00	None	48.214773	-114.3236925	Flathead County
203743	Fee-for-Service	1831757830	1831757830	1	1	WELLS, MICHELLE OT	6/23/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
203756	Fee-for-Service	1609883602	1609883602	1	1	WALGREEN CO	10/25/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 W ONTARIO AVE	None	CORONA	CA	92882	5215	33	06065	33.85631483	-117.5699252	Riverside County
203771	Fee-for-Service	1639369002	1639369002	1	1	WHANG, JANET MD	8/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97042	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	4528	19	06037	34.06269295	-118.2030006	Los Angeles County
203901	Fee-for-Service	1972540508	1972540508	1	1	WHITEHURST, RICHARD G DO	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	5849	08	Family Practice	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
203950	Fee-for-Service	1679884472	1679884472	1	1	WEST, DARA M MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137341	13	Neurology (M.D. only)	0	In state provider	None	10243 GENETIC CENTER DR	None	SAN DIEGO	CA	92121	6310	37	06073	32.90618683	-117.1814064	San Diego County
203960	Fee-for-Service	1710595392	1710595392	1	1	WHITE FEATHER PHYSICIANS PC	8/31/2020	207QG0300X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
203972	Fee-for-Service	1346672136	1346672136	1	1	WOLF, ALEXIS S LMFT	10/9/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7 4TH ST	STE 43	PETALUMA	CA	94952	7402	49	06097	38.23300765	-122.640298	Sonoma County
203990	Fee-for-Service	1174141253	1174141253	1	1	WILLIAMS, NEIL P MD	1/22/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
203994	Fee-for-Service	1487709531	1487709531	1	1	WILSON, LYNN E MD	3/20/1986	174400000X	NA	Other	026	PHYSICIANS	17387	20	Orthopedic Surgery	0	In state provider	None	12616 183RD ST	None	CERRITOS	CA	90703	8531	19	06037	33.86578739	-118.0632747	Los Angeles County
204006	Fee-for-Service	1124441399	1124441399	1	1	WALMART STORES INC	4/10/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4651 FIRESTONE BLVD	None	SOUTH GATE	CA	90280	3446	19	06037	33.954822	-118.187595	Los Angeles County
204021	Fee-for-Service	1225458573	1225458573	1	1	WU, MICHAEL D MD	7/31/2019	390200000X	NA	Other	026	PHYSICIANS	138737	05	Anesthesiology	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
204065	Fee-for-Service	1760788566	1760788566	1	1	WRIGHT, MARC E DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	11430	01	General Practice	0	In state provider	None	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
204155	Fee-for-Service	1104805944	1104805944	1	1	WARREN, JOSEPH L. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	22101 MOROSS RD	None	DETROIT	MI	48236	2148	00	None	42.41918818	-82.91538222	Wayne County
204170	Fee-for-Service	1124782461	1124782461	1	1	WHITE, NAOMI L OT	5/9/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41760 IVY ST	SUITE 101	MURRIETA	CA	92562	9416	33	06065	33.55331844	-117.2081759	Riverside County
204193	Fee-for-Service	1972540508	1972540508	1	1	WHITEHURST, RICHARD G DO	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	5849	01	General Practice	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
204203	Fee-for-Service	1164437448	1164437448	1	1	WALGREENS CO.	11/11/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1532 N MAIN ST	None	SALINAS	CA	93906	5101	27	06053	36.71140332	-121.6541379	Monterey County
204237	Fee-for-Service	1679884472	1679884472	1	1	WEST, DARA M MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137341	18	Ophthalmology	0	In state provider	None	10243 GENETIC CENTER DR	None	SAN DIEGO	CA	92121	6310	37	06073	32.90618683	-117.1814064	San Diego County
204249	Fee-for-Service	1306851878	1306851878	1	1	WIEST, PHILLIP W. MD	10/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
204250	Fee-for-Service	1710595392	1710595392	1	1	WHITE FEATHER PHYSICIANS PC	8/31/2020	207QG0300X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
204263	Fee-for-Service	1841336534	1841336534	1	1	WINDSOR COUNTRY DRIVE CARE	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	2500 COUNTRY	None	FREMONT	CA	94536	5356	01	06001	37.5576661	-121.9848358	Alameda County
204269	Fee-for-Service	1679182737	1679182737	1	1	WEBB, VERONICA BIRTH DOULA	4/4/2024	171100000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	29	06057	0	0	None
204270	Fee-for-Service	1164512752	1164512752	1	1	WIGGINS,RICHARD H MD	2/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N MEDICAL DR	None	SALT LAKE CITY	UT	84132	0100	00	None	40.77197161	-111.8352608	Salt Lake County
204281	Fee-for-Service	1003436064	1003436064	1	43	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	5160 VINELAND	SUITE 101C	NORTH HOLLYWOOD	CA	91601	3888	19	06037	34.164126	-118.3702625	Los Angeles County
204282	Fee-for-Service	1316608482	1316608482	1	1	WEBER COUNSELING SERVICES A	2/22/2023	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	LICENSED CLINICAL SOCIAL	765 N MAIN ST	STE #127	CORONA	CA	92880	1440	33	06065	33.892072	-117.5636837	Riverside County
204298	Fee-for-Service	1306127204	1306127204	1	1	WALKER, AMELIA D PHD	10/11/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
204379	Fee-for-Service	1639245806	1639245806	1	1	WILBURN, WANDA MD	3/4/2024	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	84253	None	None	0	In state provider	None	805 E MOUNTAIN VIEW ST	None	BARSTOW	CA	92311	3033	36	06071	34.89343047	-117.0171832	San Bernardino County
204423	Fee-for-Service	1497772719	1497772719	1	1	WAL-MART PHARMACY	7/7/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	10-1992	1540 W FOOTHILL BLVD	None	UPLAND	CA	91786	3653	36	06071	34.10688347	-117.6784002	San Bernardino County
204425	Fee-for-Service	1740272798	1740272798	1	1	WHITE, GREGORY R MD	6/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
204453	Fee-for-Service	1992764294	1992764294	1	1	WANG, DAVID Y MD	12/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84366	02	General Surgery	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
204480	Fee-for-Service	1972540508	1972540508	1	1	WHITEHURST, RICHARD G DO	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	5849	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
204536	Fee-for-Service	1801990841	1801990841	1	1	WERBOFF, LAWRENCE H MD	10/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	34112	34	Urology and Urological Surgery	0	In state provider	None	929 CLAY STREET	SUITE 505	SAN FRANCISCO	CA	94108	1500	38	06075	37.79398652	-122.4083496	San Francisco County
204560	Fee-for-Service	1033567474	1033567474	1	1	WERNER, JESSIE MD	7/9/2020	207P00000X	NA	Other	026	PHYSICIANS	167859	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
204566	Fee-for-Service	1316425028	1316425028	1	1	WEINSTEIN, MAISHA T LMFT	3/17/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	245 FAIRMOUNT AVE	101	OAKLAND	CA	94611	5812	01	06001	37.81783985	-122.2597955	Alameda County
204569	Fee-for-Service	1003436064	1003436064	1	43	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	5160 VINELAND	SUITE 101C	NORTH HOLLYWOOD	CA	91601	3888	19	06037	34.164126	-118.3702625	Los Angeles County
204570	Fee-for-Service	1316608482	1316608482	1	1	WEBER COUNSELING SERVICES A	2/22/2023	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	LICENSED CLINICAL SOCIAL	765 N MAIN ST	STE #127	CORONA	CA	92880	1440	33	06065	33.892072	-117.5636837	Riverside County
204585	Fee-for-Service	1750727301	1750727301	1	1	WHITTINGTON, JOHN E LMFT	5/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
204599	Fee-for-Service	1316921075	1316921075	1	1	WOLLASTON, SEAN J MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63797	41	Internal Medicine	0	In state provider	None	200 MED PLAZA #365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
204648	Fee-for-Service	1699784967	1699784967	1	1	WHEELER, DONALD C MD	6/1/1999	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	62017	01	General Practice	0	In state provider	None	450 GREENFIELD AVE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
204677	Fee-for-Service	1477581627	1477581627	1	1	WILEY CENE, CRYSTAL N	2/6/2023	207R00000X	NA	Other	026	PHYSICIANS	182700	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
204699	Fee-for-Service	1245438985	1245438985	1	1	WONG, PAOLA OD	9/25/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6765 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91606	1614	19	06037	34.19368795	-118.3878213	Los Angeles County
204708	Fee-for-Service	1053301440	1053301440	1	1	WALKER, CARL J III MD	7/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	74666	34	Urology and Urological Surgery	0	In state provider	None	1820 FULLERTON AVE	SUITE 260	CORONA	CA	92881	3101	33	06065	33.858756	-117.5503465	Riverside County
204719	Fee-for-Service	1306853353	1306853353	1	1	WILLIAMSON, MICHAEL MD	7/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
204736	Fee-for-Service	1992764294	1992764294	1	1	WANG, DAVID Y MD	12/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84366	28	Proctology (colon and rectal)	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
204750	Fee-for-Service	1033355425	1033355425	1	1	WESTCARE CALIFORNIA, INC	12/11/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1128 S DAIRY AVENUE	None	CORCORAN	CA	93212	2501	16	06031	36.098622	-119.572089	Kings County
204866	Fee-for-Service	1124199039	1124199039	1	1	WON, DANIEL J MD	2/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	58669	14	Neurological Surgery	0	In state provider	None	1101 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06470063	-117.984656	Los Angeles County
204906	Fee-for-Service	1972651966	1972651966	1	1	WEISZ, JEFFREY A MD	2/1/1983	207RH0000X	NA	Hematology	026	PHYSICIANS	36346	41	Internal Medicine	0	In state provider	CROSSROADS HOSP	6323 WOODMAN AVE	None	VAN NUYS	CA	91401	2346	19	06037	34.18549798	-118.4312916	Los Angeles County
204910	Fee-for-Service	1073721007	1073721007	1	1	WILSON, DAN A LCSW	7/2/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 CLAREMONT AVE	STE 210	STOCKTON	CA	95207	5700	39	06077	37.99861886	-121.3102123	San Joaquin County
204953	Fee-for-Service	1427016625	1427016625	1	1	WOHLMUTH, DAVID E MD	10/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	48991	30	Radiology	0	In state provider	None	10445 BALBOA BLVD	None	GRANADA HILLS	CA	91344	7323	19	06037	34.259094	-118.5023365	Los Angeles County
204954	Fee-for-Service	1417011164	1417011164	1	1	WU, THOMAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
204982	Fee-for-Service	1104808443	1104808443	1	1	WONG, ANTHONY F MD	9/11/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67003	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
204990	Fee-for-Service	1568551968	1568551968	1	1	WEST VALLEY PULMONARY	7/31/1985	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	MED GRP	7320 WOODLAKE AVE	STE 290	WEST HILLS	CA	91307	1401	19	06037	34.20245266	-118.6321273	Los Angeles County
204996	Fee-for-Service	1265621601	1265621601	1	1	WIRSHING, WILLIAM C MD	12/15/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	50986	-	NOT APPLICABLE	0	In state provider	None	1920 MARENGO STREET	None	LOS ANGELES	CA	90033	1317	19	06037	34.05751768	-118.2095235	Los Angeles County
205032	Fee-for-Service	1881873032	1881873032	1	1	WEI, CHAU-PO MD INC	4/13/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	30134	18	Ophthalmology	0	In state provider	None	616 N GARFIELD AVE	SUITE 305	MONTEREY PARK	CA	91754	1101	19	06037	34.06916465	-118.1229039	Los Angeles County
205042	Fee-for-Service	1124657911	1124657911	1	1	WALIA, SHARAN K PT	7/9/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
205053	Fee-for-Service	1396857454	1396857454	1	1	WINSTON, LISA G MD	10/1/2000	207R00000X	NA	Other	026	PHYSICIANS	55752	77	Infectious Disease	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
205065	Fee-for-Service	1417269473	1417269473	1	1	WHITE, LATONYA G MD	4/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116476	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
205102	Fee-for-Service	1336354315	1336354315	1	1	WEAVER, RONALD S MD INC	9/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	30118	41	Internal Medicine	0	In state provider	None	633 AERICK ST	None	INGLEWOOD	CA	90301	1978	19	06037	33.9635805	-118.345563	Los Angeles County
205130	Fee-for-Service	1114944535	1114944535	1	1	WAL-MART STORES, INC	10/24/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101693	2050 W REDLANDS BLVD	None	REDLANDS	CA	92373	6228	36	06071	34.06509	-117.2228535	San Bernardino County
205236	Fee-for-Service	1154485860	1154485860	1	1	WARD, ELIZABETH L MD	12/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108159	36	Psychiatry	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
205249	Fee-for-Service	1497739528	1497739528	1	1	WARE, MICHELE DO	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7566	08	Family Practice	0	In state provider	None	11637 THE PLZ	None	NORWALK	CA	90650	3930	19	06037	33.90431046	-118.0843459	Los Angeles County
205269	Fee-for-Service	1104808443	1104808443	1	1	WONG, ANTHONY F MD	9/11/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67003	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
205273	Fee-for-Service	1982205118	1982205118	1	1	WILLIAMS, SHERAE K CNM	9/17/2021	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
205328	Fee-for-Service	1316953979	1316953979	1	1	WALGREEN CO.	7/9/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 N WINCHESTER BLVD	None	SANTA CLARA	CA	95050	6501	43	06085	37.329138	-121.950268	Santa Clara County
205340	Fee-for-Service	1396857454	1396857454	1	1	WINSTON, LISA G MD	10/1/2000	207R00000X	NA	Other	026	PHYSICIANS	55752	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
205362	Fee-for-Service	1033543939	1033543939	1	1	WILSON, ALISON A DO	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12834	01	General Practice	0	In state provider	None	450 EAST ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
205388	Fee-for-Service	1720045396	1720045396	1	1	WONG, CAROL H MD	9/4/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72280	30	Radiology	0	In state provider	None	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
205402	Fee-for-Service	1134195118	1134195118	1	1	WALI, JYOTIKA L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45629	None	None	0	In state provider	None	1001 E CHAPMAN AVE	STE D	FULLERTON	CA	92831	3811	30	06059	33.87408446	-117.9097875	Orange County
205417	Fee-for-Service	1184663932	1184663932	1	1	WALDMAN, MICHAEL A MD	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	50052	41	Internal Medicine	0	In state provider	None	16300 SAND CANYON AVE	SUITE 311	IRVINE	CA	92618	3703	30	06059	33.66115075	-117.7742405	Orange County
205494	Fee-for-Service	1093899049	1093899049	1	1	WALGREEN CO	11/30/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	308 E PERKINS ST	None	UKIAH	CA	95482	4505	23	06045	39.15067779	-123.2038624	Mendocino County
205522	Fee-for-Service	1144555194	1144555194	1	1	WRENN, STEPHEN J MD	11/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110249	30	Radiology	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
205545	Fee-for-Service	1386263200	1386263200	1	1	WECK, DANIELLE MD	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	192128	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1650 CREEKSIDE DRIVE	None	FOLSOM	CA	95630	3400	34	06067	38.67021	-121.145382	Sacramento County
205584	Fee-for-Service	1871586685	1871586685	1	1	WOOD, DAVID MD	10/2/2023	2085R0204X	NA	Other	026	PHYSICIANS	70599	30	Radiology	0	In state provider	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	6533	09	06017	38.72453536	-120.7921649	El Dorado County
205588	Fee-for-Service	1356496012	1356496012	1	1	WACHSMAN, LAURA MD	10/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	34368	40	Pediatrics	0	In state provider	None	1200 NORTH STATE STREET	None	LOS ANGELES	CA	90033	1083	19	06037	34.05855992	-118.209755	Los Angeles County
205620	Fee-for-Service	1750452702	1750452702	1	1	WATANABE, FREDERICK D	2/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	71639	10	Gastroenterology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
205625	Fee-for-Service	1245464874	1245464874	1	1	WOLPERT, DEBBIE	8/1/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25830 MCBEAN PKWY	None	VALENICIA	CA	91355	2004	19	06037	34.40360638	-118.5522028	Los Angeles County
205627	Fee-for-Service	1174529507	1174529507	1	1	WHITE, STEVEN C MD	12/5/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182649	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
205633	Fee-for-Service	1093786998	1093786998	1	1	WEINRAUB, GLENN M DPM	3/8/2007	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
205691	Fee-for-Service	1063474385	1063474385	1	1	WARDRIP, ERIC A MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	38633	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
205705	Fee-for-Service	1053464099	1053464099	1	1	WONG, FELICIA K MD	10/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111983	36	Psychiatry	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
205742	Fee-for-Service	1255380986	1255380986	1	1	WEN, CHUN-YUEH MD	12/31/1983	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	38188	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2303 17TH ST	None	BAKERSFIELD	CA	93301	3503	15	06029	35.3743245	-119.0285415	Kern County
205763	Fee-for-Service	1679549539	1679549539	1	1	WEINSTEIN, STEVEN R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	19079	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	4201 TORRANCE BLVD	STE 750	TORRANCE	CA	90503	4520	19	06037	33.8375955	-118.358748	Los Angeles County
205766	Fee-for-Service	1255642179	1255642179	1	1	WADIWALA, NICKY M DO	11/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11280	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
205779	Fee-for-Service	1205153772	1205153772	1	1	WOODFIELD, ALONZO S MD	1/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	123307	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
205811	Fee-for-Service	1598908907	1598908907	1	1	WILSON, CHRISTINA A NP	11/28/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
205853	Fee-for-Service	1720899016	1720899016	1	1	WALLACE, DANESHA L BIRTH DOU	2/11/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	15	06029	0	0	None
205870	Fee-for-Service	1598210510	1598210510	1	1	WOO, RENEE L DPM	8/20/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	13690 E 14TH ST	SUITE 220	SAN LEANDRO	CA	94578	2582	01	06001	37.71615361	-122.1438999	Alameda County
205879	Fee-for-Service	1164500260	1164500260	1	1	WALSH, JOHN W MD	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11029	22	Pathology (M.D. only)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
205889	Fee-for-Service	1952437113	1952437113	1	1	WAGMAN, RACHEL B MD	8/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70821	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
205904	Fee-for-Service	1750452702	1750452702	1	1	WATANABE, FREDERICK D	2/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	71639	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
205938	Fee-for-Service	1801075684	1801075684	1	1	WEI, YUN FEI MD	4/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99930	41	Internal Medicine	0	In state provider	None	11480 BROOKSHIRE AVE	STE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
205959	Fee-for-Service	1063774883	1063774883	1	2	WISTAR, EMILY R MD	3/29/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	128587	-	NOT APPLICABLE	0	In state provider	None	1050 WISCONSIN ST	None	SAN FRANCISCO	CA	94107	3328	38	06075	37.7540295	-122.3986796	San Francisco County
205968	Fee-for-Service	1689770687	1689770687	1	1	WINNER, JAY M MD	2/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	71195	08	Family Practice	0	In state provider	None	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	42	06083	34.42967671	-119.7228362	Santa Barbara County
205995	Fee-for-Service	1750496774	1750496774	1	1	WEBER, MIRYAM MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72452	36	Psychiatry	0	In state provider	None	1080 EMELINE AVE	None	SANTA CRUZ	CA	95060	1966	44	06087	36.99191102	-122.0176744	Santa Cruz County
206010	Fee-for-Service	1043383144	1043383144	1	1	WAGNER, PAUL D. MD INC	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77188	41	Internal Medicine	0	In state provider	None	4060 4TH AVE	STE 100	SAN DIEGO	CA	92103	2120	37	06073	32.75053673	-117.1616539	San Diego County
206012	Fee-for-Service	1558590679	1558590679	1	1	WAGNER, JORDAN C DO	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14140	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER COURT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
206049	Fee-for-Service	1679549539	1679549539	1	1	WEINSTEIN, STEVEN R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	19079	01	General Practice	0	In state provider	INC	4201 TORRANCE BLVD	STE 750	TORRANCE	CA	90503	4520	19	06037	33.8375955	-118.358748	Los Angeles County
206053	Fee-for-Service	1194735829	1194735829	1	2	WCHS, INC	3/16/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1021 W LA CADENA DR	None	RIVERSIDE	CA	92501	1413	33	06065	34.00415437	-117.3504456	Riverside County
206058	Fee-for-Service	1720004146	1720004146	1	1	WYATT, RHONDA A MD	11/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	76274	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
206177	Fee-for-Service	1811168990	1811168990	1	1	WILLIAM PATRICK STANFORD MD	2/23/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PHD A PROFESSIONAL MEDIC	855 N FAIRFAX AVE	None	LOS ANGELES	CA	90046	7207	19	06037	34.08672117	-118.3616072	Los Angeles County
206178	Fee-for-Service	1952437113	1952437113	1	1	WAGMAN, RACHEL B MD	8/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70821	67	Endocrinology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
206204	Fee-for-Service	1104084110	1104084110	1	1	WEBB, LAURA M MD	2/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109006	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
206229	Fee-for-Service	1003436064	1003436064	1	9	WS AUDIOLOGY (CALIFORNIA), P	4/16/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3003 LOMA VISTA	C	VENTURA	CA	93003	2935	56	06111	34.27572109	-119.255478	Ventura County
206259	Fee-for-Service	1063454080	1063454080	1	1	WILSON, THOMAS A MD	5/19/2020	2080P0205X	NA	Endocrinology	026	PHYSICIANS	30444	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
206265	Fee-for-Service	1154825347	1154825347	1	1	WEBBER, MEGHAN D MD	7/1/2021	207P00000X	NA	Other	026	PHYSICIANS	165153	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
206299	Fee-for-Service	1043383144	1043383144	1	1	WAGNER, PAUL D. MD INC	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77188	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4060 4TH AVE	STE 100	SAN DIEGO	CA	92103	2120	37	06073	32.75053673	-117.1616539	San Diego County
206340	Fee-for-Service	1598057333	1598057333	1	2	WAI, ANDREW W MD	8/1/2016	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	11175 CAMPUS STREET	CP-11120	LOMA LINDA	CA	92350	1700	36	06071	34.049547	-117.2656245	San Bernardino County
206347	Fee-for-Service	1720004146	1720004146	1	1	WYATT, RHONDA A MD	11/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	76274	42	Nuclear Medicine	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
206366	Fee-for-Service	1679736250	1679736250	1	1	WOLTER, DAVID J LMFT	6/20/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	264 CLOVIS AVE	214	CLOVIS	CA	93612	1115	10	06019	36.8268544	-119.7007055	Fresno County
206371	Fee-for-Service	1235175035	1235175035	1	1	WONGWORAWAT, MONTRI D MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62977	20	Orthopedic Surgery	0	In state provider	None	11370 ANDERSON ST	STE 1500	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
206419	Fee-for-Service	1316444250	1316444250	1	1	WATSON, JESSICA MD	2/27/2022	207R00000X	NA	Other	026	PHYSICIANS	163940	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
206449	Fee-for-Service	1861717605	1861717605	1	2	WESTERN PHYSICAL THERAPY INC	3/22/2019	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	37451 MAIN STREET	SUITE A & B	BURNEY	CA	96013	4372	45	06089	40.89003582	-121.6527704	Shasta County
206474	Fee-for-Service	1194767012	1194767012	1	1	WEISSMAN, ALAN F MD	10/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
206490	Fee-for-Service	1689136293	1689136293	1	1	WARD, DANIEL MD	9/14/2023	207P00000X	NA	Other	026	PHYSICIANS	181025	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
206501	Fee-for-Service	1962439232	1962439232	1	1	WOUND CARE RESOURCES INC	2/24/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	4 NEWBERN HWY	None	YORKVILLE	TN	38389	0009	00	None	36.09997454	-89.12018874	Gibson County
206511	Fee-for-Service	1003436064	1003436064	1	9	WS AUDIOLOGY (CALIFORNIA), P	3/31/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3003 LOMA VISTA	C	VENTURA	CA	93003	2935	56	06111	34.27572109	-119.255478	Ventura County
206550	Fee-for-Service	1063870996	1063870996	1	1	WULSIN, JESSICA LMFT	8/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
206553	Fee-for-Service	1346731767	1346731767	1	1	WIGUNA, JASON S DO	3/1/2022	390200000X	NA	Other	026	PHYSICIANS	19069	None	None	0	In state provider	None	4955 VAN NUYS BLVD	SUITE 308	SHERMAN OAKS	CA	91403	1811	19	06037	34.160805	-118.4487295	Los Angeles County
206587	Fee-for-Service	1619696713	1619696713	1	1	WINN, AMANDA J	10/13/2022	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	3630 ENTERPRISE STREET	None	SAN DIEGO	CA	92110	3212	37	06073	32.74601586	-117.1985439	San Diego County
206602	Fee-for-Service	1518101518	1518101518	1	1	WEYLIE, BRIAN DO	6/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
206617	Fee-for-Service	1295746915	1295746915	1	1	WANG, CLAUDIA MD	10/30/1992	207R00000X	NA	Other	026	PHYSICIANS	68181	41	Internal Medicine	0	In state provider	UCLA CHILDRENS HLTH CTR	200 MEDICAL PLAZA #265	None	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
206622	Fee-for-Service	1811060262	1811060262	1	1	WHITE MEMORIAL GYN OB	1/1/1979	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	1701 CESAR CHAVEZ AVENUE	STE 200 225	LOS ANGELES	CA	90033	6720	19	06037	34.05112725	-118.2173921	Los Angeles County
206625	Fee-for-Service	1194735829	1194735829	1	1	WCHS, INC	10/26/1981	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	RIVERSIDE TREATMENT CTR	1021 W LA CADENA DR	None	RIVERSIDE	CA	92501	1413	33	06065	34.00415437	-117.3504456	Riverside County
206643	Fee-for-Service	1598359002	1598359002	1	1	WELLS, SHARDAE G NP	4/20/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1800 N. WESTERN AVE	SUITE 204	SAN BERNARDINO	CA	92411	1353	36	06071	34.1315778	-117.3182453	San Bernardino County
206659	Fee-for-Service	1235175035	1235175035	1	1	WONGWORAWAT, MONTRI D MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62977	46	Hand Surgery	0	In state provider	None	11370 ANDERSON ST	STE 1500	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
206675	Fee-for-Service	1548920010	1548920010	1	1	WONG, SHERWIN NP	2/9/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25000 AVENUE STANFORD	167	VALENCIA	CA	91355	4553	19	06037	34.43847322	-118.5729968	Los Angeles County
206708	Fee-for-Service	1154336485	1154336485	1	1	WALGREEN CO	10/8/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3005 MIDWAY DR	None	SAN DIEGO	CA	92110	4502	37	06073	32.74999864	-117.2067973	San Diego County
206752	Fee-for-Service	1013440965	1013440965	1	1	WANG, LAWRENCE C DO	6/17/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	19230	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
206783	Fee-for-Service	1235166703	1235166703	1	1	WISE.JAMES N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4020 RICHARDO RD	STE D	NORTH LITTLE ROCK	AR	72117	0000	00	None	34.790652	-92.2123665	Pulaski County
206786	Fee-for-Service	1215028022	1215028022	1	1	WEISS, JENNIFER M MD	8/25/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82273	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
206879	Fee-for-Service	1689694580	1689694580	1	1	WEI, HONGSHENG MD	11/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85829	41	Internal Medicine	0	In state provider	None	650 W DUARTE RD	STE 208	ARCADIA	CA	91007	7642	19	06037	34.12621324	-118.0537434	Los Angeles County
206960	Fee-for-Service	1295837607	1295837607	1	1	WONG, KENLEY	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	402 8TH AVE	STE 203	SAN FRANCISCO	CA	94118	3057	38	06075	37.78061549	-122.4663704	San Francisco County
207011	Fee-for-Service	1720387715	1720387715	1	1	WONG, ANDREA W OD	2/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2880 STORY RD	None	SAN JOSE	CA	95127	3812	43	06085	37.3537019	-121.8227358	Santa Clara County
207014	Fee-for-Service	1306925011	1306925011	1	1	WONG, KAHO MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71826	13	Neurology (M.D. only)	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
207047	Fee-for-Service	1326053695	1326053695	1	1	WALGREEN CO	10/23/1986	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2300 OTIS DR	None	ALAMEDA	CA	94501	5722	01	06001	37.75772853	-122.2487248	Alameda County
207077	Fee-for-Service	1003917485	1003917485	1	1	WALKER, LORRI CNM	2/3/2003	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4650 BARRANCA PKWY	None	IRVINE	CA	92604	4733	30	06059	33.67779305	-117.7991728	Orange County
207096	Fee-for-Service	1265454250	1265454250	1	1	WITCOFF, LAUREN	9/30/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	46484	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
207108	Fee-for-Service	1487815502	1487815502	1	1	WALKER, MARCIA M MD	12/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112356	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
207162	Fee-for-Service	1811346281	1811346281	1	1	WYNGLASS, RANDY LMFT	6/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
207194	Fee-for-Service	1275696544	1275696544	1	2	WENDSCHLAG, SANDRA J	1/17/2020	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	877 W FREMONT AVE	STE I4	SUNNYVALE	CA	94087	2319	43	06085	37.35226149	-122.049297	Santa Clara County
207242	Fee-for-Service	1881743193	1881743193	1	1	WANG, DOROTHY Z OD	1/29/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
207258	Fee-for-Service	1336408707	1336408707	1	1	WU, KENNY K MD	6/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127627	None	None	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
207295	Fee-for-Service	1659720217	1659720217	1	1	WASEEM ALBASHA	4/21/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	14502 W MEEKER BLVD	None	SUN CITY	AZ	85375	5282	00	None	33.660657	-112.3736175	Maricopa County
207367	Fee-for-Service	1629162995	1629162995	1	1	WALLACE, PATRICIA ANN MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73003	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
207409	Fee-for-Service	1982959110	1982959110	1	1	WALLE, NANCY LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	SUITE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
207420	Fee-for-Service	1972546265	1972546265	1	1	WANG, LILY Y MD	3/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83685	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	STE 3150	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
207447	Fee-for-Service	1932542008	1932542008	1	1	WONG, DOROTHY MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113899	22	Pathology (M.D. only)	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
207452	Fee-for-Service	1679531842	1679531842	1	1	WANG, LINDA T MD INC	6/1/2000	207RE0101X	NA	Endocrinology	026	PHYSICIANS	81232	67	Endocrinology	0	In state provider	None	2840 LONG BEACH BLVD	STE 435	LONG BEACH	CA	90806	7514	19	06037	33.808743	-118.189341	Los Angeles County
207508	Fee-for-Service	1982685996	1982685996	1	1	WELLISCH, MARK MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23373	20	Orthopedic Surgery	0	In state provider	None	16311 VENTURA BLVD	STE 800	ENCINO	CA	91436	2140	19	06037	34.15706864	-118.4885978	Los Angeles County
207524	Fee-for-Service	1003436064	1003436064	1	12	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1908 SANTA MONICA BLVD	3	SANTA MONICA	CA	90404	1927	19	06037	34.0281169	-118.480668	Los Angeles County
207546	Fee-for-Service	1760581532	1760581532	1	1	WAIRIMU, KATHLEEN MD PC	7/21/2008	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	-	77	Infectious Disease	1	Border provider	None	1700 BEARDEN DR	None	LAS VEGAS	NV	89106	4107	00	None	0	0	None
207554	Fee-for-Service	1831565670	1831565670	1	1	WU PEDIATRICS CORP	3/15/2016	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	5817 TEMPLE CITY BLVD	None	TEMPLE CITY	CA	91780	2113	19	06037	34.10542561	-118.0606767	Los Angeles County
207556	Fee-for-Service	1003494147	1003494147	1	1	WIMMER, MARJORIE MD	8/12/2024	207R00000X	NA	Other	026	PHYSICIANS	191760	41	Internal Medicine	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
207560	Fee-for-Service	1245383546	1245383546	1	1	WHITE, LINDA A	5/9/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2120 PROFESSIONAL DR	None	ROSEVILLE	CA	95661	3700	31	06061	38.74247397	-121.2508672	Placer County
207649	Fee-for-Service	1578773826	1578773826	1	1	WATANABE, KENJI K MFT	2/17/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45242	-	NOT APPLICABLE	0	In state provider	None	20350 VENTURA BLVD	SUITE 230	WOODLAND HILLS	CA	91364	2487	19	06037	34.16912779	-118.5759948	Los Angeles County
207665	Fee-for-Service	1962566380	1962566380	1	1	WALSH, PATRICK J MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	27968	29	Pulmonary Diseases (M.D. only)	0	In state provider	A MED CORP	15243 VANOWEN ST	STE 411	VAN NUYS	CA	91405	3661	19	06037	34.19394848	-118.4654115	Los Angeles County
207667	Fee-for-Service	1174194849	1174194849	1	1	WILLEY, RACHEL C CNM	12/12/2022	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
207719	Fee-for-Service	1679956809	1679956809	1	1	WARING, MICHAEL DO	5/19/2021	208D00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	18639	-	NOT APPLICABLE	0	In state provider	None	582, 584, 586, 588, & 59	None	CHICO	CA	95926	1817	04	06007	0	0	None
207741	Fee-for-Service	1679531842	1679531842	1	1	WANG, LINDA T MD INC	6/1/2000	207RE0101X	NA	Endocrinology	026	PHYSICIANS	81232	41	Internal Medicine	0	In state provider	None	2840 LONG BEACH BLVD	STE 435	LONG BEACH	CA	90806	7514	19	06037	33.808743	-118.189341	Los Angeles County
207742	Fee-for-Service	1386280899	1386280899	1	2	WESTERN PACIFIC MED-CORP	9/2/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	26921 CROWN VALLEY PARKW	200	MISSION VIEJO	CA	92691	6501	30	06059	33.56301002	-117.6675731	Orange County
207744	Fee-for-Service	1154852572	1154852572	1	1	WHEELER, SARAH MD	8/7/2023	207RC0200X	NA	Other	026	PHYSICIANS	157799	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
207756	Fee-for-Service	1063181089	1063181089	1	1	WHITE, JESIKA LMFT	11/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
207766	Fee-for-Service	1891768388	1891768388	1	1	WATANABE, WILSON T MD	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	3001 SAINT ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
207812	Fee-for-Service	1003436064	1003436064	1	12	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1908 SANTA MONICA BLVD	3	SANTA MONICA	CA	90404	1927	19	06037	34.0281169	-118.480668	Los Angeles County
207836	Fee-for-Service	1598716300	1598716300	1	1	WU, PO-CHIN J MD	8/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85199	05	Anesthesiology	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
207869	Fee-for-Service	1508204504	1508204504	1	1	WONG, SHUCHENG MD	10/29/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	151544	36	Psychiatry	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
207948	Fee-for-Service	1548505621	1548505621	1	1	WELCH, ERICK R CRNA	3/7/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 GREENFIELD AVE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
208014	Fee-for-Service	1740480441	1740480441	1	1	WEE, DANIEL MD	12/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	139388	18	Ophthalmology	0	In state provider	None	1805 N CALIFORNIA ST	STE 101	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
208017	Fee-for-Service	1376779306	1376779306	1	1	WILSON, MICHAEL B MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	107901	08	Family Practice	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
208049	Fee-for-Service	1760508915	1760508915	1	1	WHITE, VERONICA A NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	365 E HILLCREST DR	None	THOUSAND OAKS	CA	91360	5802	56	06111	34.18122452	-118.8704974	Ventura County
208110	Fee-for-Service	1497767396	1497767396	1	1	WOLTERBEEK, MICHAEL DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	STANISLAUS ORTHOP SPORTS	609 E ORANGEBURG AVE	# 201	MODESTO	CA	95350	5580	50	06099	37.66364947	-120.9857985	Stanislaus County
208127	Fee-for-Service	1740262252	1740262252	1	1	WINTHER,JON W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11115 PARKVIEW PLAZA	None	FORT WAYNE	IN	46845	1701	00	None	41.1874757	-85.09943567	Allen County
208134	Fee-for-Service	1861432874	1861432874	1	1	WHITESIDE, PAUL M MD	1/1/1985	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	35353	08	Family Practice	0	In state provider	None	3693 HIGHLAND AVE	STE D	HIGHLAND	CA	92346	2665	36	06071	34.13577432	-117.2070364	San Bernardino County
208196	Fee-for-Service	1356689087	1356689087	1	1	WAL-MART STORES, INC	9/4/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10075 BRUCEVILLE RD	None	ELK GROVE	CA	95757	9501	34	06067	38.391867	-121.4162955	Sacramento County
208225	Fee-for-Service	1407116890	1407116890	1	1	WARD, CARRIE L MD	7/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130663	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
208238	Fee-for-Service	1013934363	1013934363	1	1	WAL-MART STORES, INC	7/16/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101840	1205 S MAIN ST	None	MANTECA	CA	95337	5748	39	06077	37.785528	-121.2185655	San Joaquin County
208249	Fee-for-Service	1508852013	1508852013	1	1	WALL, DANIEL J MD	1/17/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	74764	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
208283	Fee-for-Service	1467056184	1467056184	1	1	WILSON, JODI NP	7/19/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	720 E CARNEGIE DR.	STE 140	SAN BERNARDINO	CA	92408	3516	36	06071	34.06914052	-117.2695442	San Bernardino County
208298	Fee-for-Service	1588647481	1588647481	1	1	WAGUESPACK, ROBERT L MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84995	34	Urology and Urological Surgery	0	In state provider	APC	2201 19TH ST	None	BAKERSFIELD	CA	93301	3608	15	06029	35.37622931	-119.0272609	Kern County
208310	Fee-for-Service	1972702165	1972702165	1	1	WU, SHU P MD	2/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	31440	01	General Practice	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
208312	Fee-for-Service	1619179322	1619179322	1	1	WU, TAI-WEI MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	112473	01	General Practice	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
208433	Fee-for-Service	1770652786	1770652786	1	1	WAITZMAN-YI, JANINE A	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	10430 S DE ANZA BLVD	STE 110	CUPERTINO	CA	95014	3024	43	06085	37.3172651	-122.0321678	Santa Clara County
208464	Fee-for-Service	1679701551	1679701551	1	1	WONG, ERIC MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113827	05	Anesthesiology	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
208475	Fee-for-Service	1447332036	1447332036	1	4	WELLSPACE HEALTH	4/1/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	6879 14TH AVE	BUILDING F1	SACRAMENTO	CA	95820	3431	34	06067	38.541483	-121.4254125	Sacramento County
208526	Fee-for-Service	1003436064	1003436064	1	50	WS AUDIOLOGY (CALIFORNIA), P	7/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	994 EL NORTE PARKWAY	None	ESCONDIDO	CA	92026	3339	37	06073	33.14718269	-117.1067953	San Diego County
208529	Fee-for-Service	1366461832	1366461832	1	1	WACHS, BARTON H MD	11/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	32052	34	Urology and Urological Surgery	0	In state provider	None	701 E 28TH ST	STE 319	LONG BEACH	CA	90806	2783	19	06037	33.80803441	-118.1847137	Los Angeles County
208537	Fee-for-Service	1184651788	1184651788	1	1	WALGREEN CO	10/12/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1280 W FOOTHILL BLVD	None	RIALTO	CA	92376	4686	36	06071	34.10675648	-117.3958515	San Bernardino County
208544	Fee-for-Service	1174086060	1174086060	1	1	WOLFE, MARISSA A MD	3/2/2023	390200000X	NA	Other	026	PHYSICIANS	180629	None	None	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
208551	Fee-for-Service	1225173099	1225173099	1	1	WONG, WENDY B MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68891	78	Neoplastic Diseases/Oncology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
208553	Fee-for-Service	1447420732	1447420732	1	1	WALTER, CHRISTOPHER A DO	3/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	212 ELKS POINT ROAD	STE 200	ZEPHYR COVE	NV	89448	9800	00	None	38.98585115	-119.9417018	Douglas County
208572	Fee-for-Service	1003436064	1003436064	1	38	WS AUDIOLOGY (CALIFORNIA), P	4/21/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	554 E BASELINE RD	None	CLAREMONT	CA	91711	2236	19	06037	34.1215617	-117.7060025	Los Angeles County
208574	Fee-for-Service	1669486999	1669486999	1	1	WALGREEN CO	1/30/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E FOOTHILL BLVD	None	POMONA	CA	91767	1223	19	06037	34.10721485	-117.7372912	Los Angeles County
208581	Fee-for-Service	1144287509	1144287509	1	1	WOLFE, JOHN A.	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	57746	22	Pathology (M.D. only)	0	In state provider	None	COUNTY RD. 99	None	DAVIS	CA	95616	0000	57	06113	38.57575978	-121.7859718	Yolo County
208592	Fee-for-Service	1114999208	1114999208	1	1	WASHINGTON, SHARON D MD	12/1/2001	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	70516	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	632 W 11TH ST	#211	TRACY	CA	95376	3861	39	06077	37.73965648	-121.4352045	San Joaquin County
208594	Fee-for-Service	1316384472	1316384472	1	1	WILSON, DESMOND MD	8/26/2019	207R00000X	NA	Other	026	PHYSICIANS	144081	41	Internal Medicine	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
208642	Fee-for-Service	1720548001	1720548001	1	1	WANG, XINYU	6/24/2024	207RA0201X	NA	Other	026	PHYSICIANS	179145	03	Allergy	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
208655	Fee-for-Service	1083163380	1083163380	1	1	WILCOX, SHELBY NP	2/4/2025	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
208662	Fee-for-Service	1598497323	1598497323	1	1	WALTER, CHARISTELLA NP	3/27/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13200 JAMBOREE RD	None	IRVINE	CA	92602	2307	30	06059	33.726753	-117.785601	Orange County
208679	Fee-for-Service	1386714509	1386714509	1	1	WECHTER, VICTOR MD	9/21/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	25333	18	Ophthalmology	0	In state provider	None	1020 E VISTA WAY	None	VISTA	CA	92084	4602	37	06073	33.21280236	-117.2288363	San Diego County
208709	Fee-for-Service	1295316362	1295316362	1	1	WIN, SU S MD	9/25/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
208727	Fee-for-Service	1134608797	1134608797	1	1	WEINHOUSE, SHARON RCP	10/4/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
208762	Fee-for-Service	1447332036	1447332036	1	4	WELLSPACE HEALTH	4/1/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	6879 14TH AVE	BUILDING F1	SACRAMENTO	CA	95820	3431	34	06067	38.541483	-121.4254125	Sacramento County
208764	Fee-for-Service	1942321138	1942321138	1	1	WILKES, CRAIG A DPM	12/7/2007	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2305 SUNSET BLVD	None	ROCKLIN	CA	95765	4337	31	06061	38.7979323	-121.2667966	Placer County
208813	Fee-for-Service	1003436064	1003436064	1	50	WS AUDIOLOGY (CALIFORNIA), P	7/6/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	994 EL NORTE PARKWAY	None	ESCONDIDO	CA	92026	3339	37	06073	33.14718269	-117.1067953	San Diego County
208840	Fee-for-Service	1225173099	1225173099	1	1	WONG, WENDY B MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68891	68	Hematology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
208860	Fee-for-Service	1003436064	1003436064	1	38	WS AUDIOLOGY (CALIFORNIA), P	4/21/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	554 E BASELINE RD	None	CLAREMONT	CA	91711	2236	19	06037	34.1215617	-117.7060025	Los Angeles County
208888	Fee-for-Service	1851465686	1851465686	1	2	WONG, MATTHEW MD	10/27/2023	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	84553	-	NOT APPLICABLE	0	In state provider	None	2615 BRESLAUER WAY	None	REDDING	CA	96001	4247	45	06089	40.54957365	-122.3807785	Shasta County
208889	Fee-for-Service	1285622662	1285622662	1	1	WEISE, RICHARD A MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	45111	08	Family Practice	0	In state provider	None	11026 VALLEY MALL	None	EL MONTE	CA	91731	2617	19	06037	34.07443752	-118.0342966	Los Angeles County
208917	Fee-for-Service	1871170076	1871170076	1	1	WALTON, REBECCA MD	7/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186718	08	Family Practice	0	In state provider	None	3883 AIRWAY DR	202	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
208918	Fee-for-Service	1982890117	1982890117	1	1	WIEMER, MONICA E MD	5/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100931	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
208927	Fee-for-Service	1013922301	1013922301	1	1	WALGREEN CO	6/15/1982	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1795 E CAPITOL EXPRESSWY	None	SAN JOSE	CA	95121	1561	43	06085	37.30985957	-121.8089013	Santa Clara County
208956	Fee-for-Service	1659594604	1659594604	1	1	WARING, JOHN T MD	1/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109920	05	Anesthesiology	0	In state provider	None	3939 J STREET # 310	None	SACRAMENTO	CA	95819	3666	34	06067	38.570364	-121.4540325	Sacramento County
208962	Fee-for-Service	1659318954	1659318954	1	1	WATKINS, BRENDA L NP	4/22/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
208969	Fee-for-Service	1740654409	1740654409	1	1	WRIGHT, SUSAN LMFT	8/9/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10918 HESPERIA RD	STE B	HESPERIA	CA	92345	2151	36	06071	34.44933232	-117.2964082	San Bernardino County
208982	Fee-for-Service	1780601195	1780601195	1	1	WAL-MART STORES, INC	1/13/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102507	2220 S BRADLEY RD	None	SANTA MARIA	CA	93455	1348	42	06083	34.919901	-120.419163	Santa Barbara County
208990	Fee-for-Service	1528687787	1528687787	1	1	WHITE, NATALIE MD	9/14/2023	390200000X	NA	Other	026	PHYSICIANS	184450	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
209020	Fee-for-Service	1922156918	1922156918	1	1	WYCOFF, ERIN L DO	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	7023	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
209029	Fee-for-Service	1720155617	1720155617	1	1	WOOD, CALVIN E MD	10/10/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67281	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
209050	Fee-for-Service	1881013548	1881013548	1	1	WISE, LEANNA M MD	9/17/2019	207RR0500X	NA	Other	026	PHYSICIANS	137546	83	Rheumatology	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
209068	Fee-for-Service	1093867970	1093867970	1	1	WALKER, ROBERT C DO	12/28/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2075 SAN JOAQUIN HILLS R	None	NEWPORT BEACH	CA	92660	6505	30	06059	33.61676129	-117.869325	Orange County
209101	Fee-for-Service	1982629903	1982629903	1	1	WOHL, IRA LCSW	10/10/2007	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
209128	Fee-for-Service	1225173099	1225173099	1	1	WONG, WENDY B MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68891	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
209146	Fee-for-Service	1245356492	1245356492	1	1	WONG, SERENA S OD	1/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1255 W ARROW HWY	None	SAN DIMAS	CA	91773	2340	19	06037	34.10676133	-117.8312617	Los Angeles County
209231	Fee-for-Service	1710410428	1710410428	1	1	WILLIAMS, KAYLA M MD	8/7/2023	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	187867	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
209236	Fee-for-Service	1477519734	1477519734	1	1	WONG, JAMES M MD	8/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89320	01	General Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
209262	Fee-for-Service	1497881197	1497881197	1	1	WAX, VIVIKA S NP	10/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
209277	Fee-for-Service	1114932209	1114932209	1	1	WALGREEN COMPANY	2/27/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8005 EL CAMINO REAL	None	ATASCADERO	CA	93422	5211	40	06079	35.47712859	-120.6559822	San Luis Obispo County
209336	Fee-for-Service	1720520141	1720520141	1	1	WOMEN'S CENTER FOR UROGYNECO	1/25/2021	2088F0040X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	LOGY & ROBOTIC SURGERY I	520 SUPERIOR AVE	STE 200	NEWPORT BEACH	CA	92663	3642	30	06059	33.628914	-117.9276525	Orange County
209347	Fee-for-Service	1336279157	1336279157	1	1	WEAVER, KENT AU	1/8/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	26726 CROWN VALLEY PKWY	STE 210	MISSION VIEJO	CA	92691	8006	30	06059	33.56385623	-117.6639538	Orange County
209349	Fee-for-Service	1811083819	1811083819	1	1	WENG, CHRISTIANA Y MD	9/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89701	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
209350	Fee-for-Service	1518903012	1518903012	1	1	WESTENDORF, ELAINE S LCSW	2/18/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5025 HAMPTON CT	None	GRANITE BAY	CA	95746	6686	31	06061	38.72208227	-121.2074196	Placer County
209506	Fee-for-Service	1447299649	1447299649	1	1	WESLEY MEDICAL CENTER	8/15/2000	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	550 N HILLSIDE ST	None	WICHITA	KS	67214	4976	00	None	37.695312	-97.29903348	Sedgwick County
209574	Fee-for-Service	1609895358	1609895358	1	1	WU, NANCY MD	1/18/2024	207ZP0102X	NA	Other	026	PHYSICIANS	64787	None	None	0	In state provider	None	438 W LAS TUNAS DR	None	SAN GABRIEL	CA	91776	0000	19	06037	34.10243051	-118.105902	Los Angeles County
209588	Fee-for-Service	1619031481	1619031481	1	1	WINTERS, GLORIA L LMFT	8/20/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18919 NORDHOFF ST	STE 4C	NORTHRIDGE	CA	91324	3726	19	06037	34.23552853	-118.5456555	Los Angeles County
209592	Fee-for-Service	1053453951	1053453951	2	1	WESTMED AMBULANCE INC	11/17/2017	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2020 S CENTRAL AVE	None	COMPTON	CA	90220	5302	19	06037	33.875037	-118.248623	Los Angeles County
209763	Fee-for-Service	1326053653	1326053653	1	1	WALGREEN CO	3/11/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5328 W CYPRESS AVE	None	VISALIA	CA	93277	8337	54	06107	36.324882	-119.3503545	Tulare County
209791	Fee-for-Service	1447299649	1447299649	1	1	WESLEY MEDICAL CENTER	8/15/2000	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	550 N HILLSIDE ST	None	WICHITA	KS	67214	4976	00	None	37.695312	-97.29903348	Sedgwick County
209822	Fee-for-Service	1063781359	1063781359	1	1	WHITE, REBA J PHD	10/22/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
209942	Fee-for-Service	1962474387	1962474387	1	1	WESTERN STATES HOME HEALTH	1/22/2002	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE AGENCY	5777 W CENTURY BLVD	SUITE 610	LOS ANGELES	CA	90045	5600	19	06037	33.94561146	-118.382661	Los Angeles County
209978	Fee-for-Service	1003436064	1003436064	1	46	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 ELLSWORTH AVENUE	711	SAN MATEO	CA	94401	3939	41	06081	37.56665635	-122.3247743	San Mateo County
210001	Fee-for-Service	1548404494	1548404494	1	1	WU, JAMES J MD	10/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113791	08	Family Practice	0	In state provider	None	3883 AIRWAY DR	#202	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
210064	Fee-for-Service	1407888944	1407888944	1	1	WENG, MODERN DO	11/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10477	01	General Practice	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
210069	Fee-for-Service	1659485589	1659485589	1	2	WHITTIER INTERNAL MEDICINE A	12/22/2020	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ND NEPHROLOGY MEDICAL GR	14350 WHITTIER BLVD	SUITE 101	WHITTIER	CA	90605	2164	19	06037	33.95501294	-118.0185665	Los Angeles County
210076	Fee-for-Service	1841359403	1841359403	1	1	WADHWA, JASVINDAR K MD	10/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	32262	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
210094	Fee-for-Service	1376956706	1376956706	1	1	WREN, ANA V A PHD	5/11/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
210122	Fee-for-Service	1427685734	1427685734	1	1	WALLACE, ELLEN MD	10/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191094	None	None	0	In state provider	None	500 SAN PABLO AVE	None	ALBANY	CA	94706	1127	01	06001	37.89781848	-122.3014067	Alameda County
210132	Fee-for-Service	1841246568	1841246568	1	1	WATROUS, DANIEL A MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55060	83	Rheumatology	0	In state provider	None	5315 W HILLSDALE AVE	None	VISALIA	CA	93291	5118	54	06107	36.329229	-119.3500755	Tulare County
210146	Fee-for-Service	1003436064	1003436064	1	8	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1801 ROMNEYA	SUITE 605	ANAHEIM	CA	92801	1830	30	06059	33.8506615	-117.946413	Orange County
210163	Fee-for-Service	1043552771	1043552771	1	1	WATERHOUSE, EMILY G MD	7/10/2020	207ZP0102X	NA	Other	026	PHYSICIANS	136936	22	Pathology (M.D. only)	0	In state provider	None	SANTA BARBARA COTTAGE	PUEBOL AT BATH STREET	SANTA BARBARA	CA	93102	0689	42	06083	34.42507224	-119.7015833	Santa Barbara County
210185	Fee-for-Service	1326574120	1326574120	1	1	WEISS, JOSEPH A PT	1/22/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
210256	Fee-for-Service	1821062027	1821062027	1	1	WIDGER, JUDY A MD	5/12/2004	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	80051	08	Family Practice	0	In state provider	None	1375 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3382	49	06097	38.627145	-122.863779	Sonoma County
210265	Fee-for-Service	1003436064	1003436064	1	46	WS AUDIOLOGY (CALIFORNIA), P	9/17/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	100 ELLSWORTH AVENUE	711	SAN MATEO	CA	94401	3939	41	06081	37.56665635	-122.3247743	San Mateo County
210269	Fee-for-Service	1134862238	1134862238	1	1	WOODARD, CALVIN MD	7/11/2024	390200000X	NA	Other	026	PHYSICIANS	190921	66	Emergency Medicine (Urgent Care)	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
210291	Fee-for-Service	1902906977	1902906977	1	1	WORLEY, DUANE A MD	5/8/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86503	08	Family Practice	0	In state provider	None	685 TWELVE BRIDGES DR	None	LINCOLN	CA	95648	8689	31	06061	38.85108687	-121.2886018	Placer County
210319	Fee-for-Service	1932467362	1932467362	1	1	WHITTAKER, LATASHA R LMFT	1/27/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
210340	Fee-for-Service	1497289524	1497289524	1	1	WRIGHT, RICHARD S DC	7/19/2018	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1775 HARRISON AVE	None	EUREKA	CA	95501	1338	12	06023	40.79191911	-124.1395817	Humboldt County
210419	Fee-for-Service	1841246568	1841246568	1	1	WATROUS, DANIEL A MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55060	41	Internal Medicine	0	In state provider	None	5315 W HILLSDALE AVE	None	VISALIA	CA	93291	5118	54	06107	36.329229	-119.3500755	Tulare County
210436	Fee-for-Service	1003436064	1003436064	1	8	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1801 ROMNEYA	SUITE 605	ANAHEIM	CA	92801	1830	30	06059	33.8506615	-117.946413	Orange County
210449	Fee-for-Service	1427165067	1427165067	1	1	WEINSTEIN, MICHAEL S MD	7/6/2016	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	88894	25	Physical Medicine and Rehabilitation	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
210461	Fee-for-Service	1851827315	1851827315	1	1	WELCH, MORGAN A	8/31/2022	207L00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
210506	Fee-for-Service	1043237464	1043237464	1	1	WAL-MART PHRMCY 10-1832	9/25/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101832	31033 DATE PALM DR	None	CATHEDRAL CITY	CA	62934	0000	33	06065	33.822396	-116.4583055	Riverside County
210558	Fee-for-Service	1750352761	1750352761	1	1	WHITE, ANDREW A MD	1/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	80018	03	Allergy	0	In state provider	None	15004 INNOVATION DR	None	SAN DIEGO	CA	92128	3491	37	06073	32.98890466	-117.0770231	San Diego County
210567	Fee-for-Service	1376557439	1376557439	1	1	WEEKS, JONATHAN C MD	3/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104384	None	None	0	In state provider	None	3200 21ST STREET	SUITE 301	BAKERSFIELD	CA	93301	3108	15	06029	35.37823652	-119.0379645	Kern County
210573	Fee-for-Service	1699138420	1699138420	1	1	WATKINS, RHONDA A MD	8/10/2020	2080S0010X	NA	Orthopedic Surgery	026	PHYSICIANS	157623	40	Pediatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
210580	Fee-for-Service	1548233349	1548233349	1	1	WILLIAMS, SYMPHOROSA MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74881	30	Radiology	0	In state provider	None	4601 TELEPHONE RD	STE 101	VENTURA	CA	93003	5671	56	06111	34.25783504	-119.2351187	Ventura County
210594	Fee-for-Service	1255955233	1255955233	1	1	WILLIAMSON, JESSICA L CNP	10/12/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
210630	Fee-for-Service	1205027018	1205027018	1	1	WEGER, LAUREN M MD	3/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	94311	40	Pediatrics	0	In state provider	None	725 WELCH ROAD MC: 5500	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
210632	Fee-for-Service	1487352233	1487352233	1	1	WALJI, NIKHITA CNP	3/23/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2900 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2730	19	06037	33.896799	-118.3959415	Los Angeles County
210667	Fee-for-Service	1508125857	1508125857	1	1	WOJTAL, NICOLE M MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129721	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
210686	Fee-for-Service	1104395938	1104395938	1	1	WENG, DANIEL J MD	4/25/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	25	Physical Medicine and Rehabilitation	0	In state provider	None	1225 15TH ST	2100	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
210723	Fee-for-Service	1447712906	1447712906	1	1	WONG, CARMEN DPM	6/10/2022	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
210743	Fee-for-Service	1942476064	1942476064	1	1	WALSH, EILEEN P CNP	11/12/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	434 S SAN VINCENTE BLVD	STE 100	LOS ANGELES	CA	90048	4108	19	06037	34.07053591	-118.375828	Los Angeles County
210779	Fee-for-Service	1518604024	1518604024	2	1	WESTMINSTER TERRACE LLC	2/4/2025	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7571 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	8606	30	06059	33.75919048	-117.9976455	Orange County
210781	Fee-for-Service	1710931076	1710931076	1	1	WILSON, ROGER W MD	12/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	22782	20	Orthopedic Surgery	0	In state provider	None	1140 W LA VETA AVE	STE 860	ORANGE	CA	92868	4218	30	06059	33.7802984	-117.8651669	Orange County
210799	Fee-for-Service	1114697349	1114697349	1	1	WHEELER-HAGGART, LISA CRNA	5/3/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
210898	Fee-for-Service	1457445678	1457445678	1	1	WILSON, ERIKA K MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64786	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2632 E WASHINGTON BLVD	None	PASADENA	CA	91107	1411	19	06037	34.1691255	-118.096119	Los Angeles County
210916	Fee-for-Service	1376779066	1376779066	1	1	WILLIAMS, KERRY M CNP	4/28/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1981 N BROADWAY	STE 190	WALNUT CREEK	CA	94596	3671	07	06013	37.90582392	-122.0613697	Contra Costa County
210974	Fee-for-Service	1649718446	1649718446	1	1	WRIGHT, CARIE A NP	3/15/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
211002	Fee-for-Service	1578502191	1578502191	1	1	WALLACE, ERIC W MD	6/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85195	30	Radiology	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
211020	Fee-for-Service	1184011074	1184011074	1	1	WAGONER, JACQUELYNN M DO	9/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15405	40	Pediatrics	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
211043	Fee-for-Service	1669765590	1669765590	1	1	WILLIAMS, STEPHANIE PHD	10/26/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
211053	Fee-for-Service	1912314287	1912314287	1	1	WARD, SHAWNA M NP	1/9/2023	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
211063	Fee-for-Service	1952328270	1952328270	1	1	WAL-MART STORES, INC	4/19/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101917	170 TOWN CENTER PKWY	None	SANTEE	CA	92071	5801	37	06073	32.84159782	-116.9885467	San Diego County
211066	Fee-for-Service	1548290778	1548290778	1	1	WALKER, JAMES D MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
211076	Fee-for-Service	1336219468	1336219468	1	1	WANG, CATHERINE M MD	4/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	72030	01	General Practice	0	In state provider	None	2621 SHADELANDS DR	None	WALNUT CREEK	CA	94598	2512	07	06013	37.92734436	-122.0231145	Contra Costa County
211166	Fee-for-Service	1770710022	1770710022	1	1	WOO, JESSE MD	7/16/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162865	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1818 N ORANGE GROVE AVE	None	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
211186	Fee-for-Service	1043237456	1043237456	1	1	WAL-MART STORES, INC	1/15/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-1588	15272 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	8766	36	06071	34.473366	-117.330966	San Bernardino County
211218	Fee-for-Service	1427476555	1427476555	1	1	WEE, DAVID MD	4/20/2018	207R00000X	NA	Other	026	PHYSICIANS	139633	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
211279	Fee-for-Service	1306942644	1306942644	1	1	WANG, YUBAO MD	12/23/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	149361	41	Internal Medicine	0	In state provider	None	2675 PLEASANT HILL	None	PLEASANT HILL	CA	94523	2033	07	06013	37.95521179	-122.0898401	Contra Costa County
211312	Fee-for-Service	1215039516	1215039516	1	1	WILSON, CHARLES MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	665 WINTER ST	None	SALEM	OR	97301	3919	00	None	44.933211	-123.0355125	Marion County
211354	Fee-for-Service	1700058294	1700058294	1	1	WISE, KAREN C PSYD	2/24/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
211361	Fee-for-Service	1013035252	1013035252	1	1	WOODEN, FEEBY	8/19/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	334 VIA VERA CRUZ	SUITE 207	SAN MARCOS	CA	92078	2635	37	06073	33.13698477	-117.1888034	San Diego County
211375	Fee-for-Service	1710357579	1710357579	1	1	WU, PEI-CHI DO APC	11/28/2016	261QP2300X	NA	Other	026	PHYSICIANS	10943	08	Family Practice	0	In state provider	None	2020 S BREA CANYON ROAD	SUITE A1	DIAMOND BAR	CA	91765	4012	19	06037	33.9852146	-117.8449156	Los Angeles County
211472	Fee-for-Service	1982058566	1982058566	1	1	WANG, DEBRA B MD	7/31/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	150587	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
211530	Fee-for-Service	1467423046	1467423046	1	1	WALTRIP, STEVEN J MD	5/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70446	25	Physical Medicine and Rehabilitation	0	In state provider	None	150 N ROBERTSON BLVD	SUITE 300	BEVERLY HILLS	CA	90211	2145	19	06037	34.06812722	-118.3837146	Los Angeles County
211536	Fee-for-Service	1235300989	1235300989	1	1	WANG, TOMMY J MD	7/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97518	40	Pediatrics	0	In state provider	None	101 THE CITY DRIVE S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
211541	Fee-for-Service	1992725949	1992725949	1	1	WIESE, HARRY C MD	4/28/1999	207L00000X	NA	Other	026	PHYSICIANS	53163	05	Anesthesiology	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
211564	Fee-for-Service	1316952641	1316952641	1	1	WALGREENS CO	6/1/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4520 BALFOUR RD	None	BRENTWOOD	CA	94513	1529	07	06013	37.92552452	-121.6954215	Contra Costa County
211567	Fee-for-Service	1306942644	1306942644	1	1	WANG, YUBAO MD	12/23/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	149361	68	Hematology	0	In state provider	None	2675 PLEASANT HILL	None	PLEASANT HILL	CA	94523	2033	07	06013	37.95521179	-122.0898401	Contra Costa County
211584	Fee-for-Service	1396241543	1396241543	1	1	WATERSTONE, ANNA M MD	12/30/2022	207P00000X	NA	Other	026	PHYSICIANS	163610	None	None	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
211588	Fee-for-Service	1528065216	1528065216	1	1	WOODING, LENORE G MD INC	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	36360	41	Internal Medicine	0	In state provider	None	254 COHASSET RD	STE 10	CHICO	CA	95926	2210	04	06007	39.75189732	-121.8525897	Butte County
211598	Fee-for-Service	1386800795	1386800795	1	1	WEISS, CRYSTAL CO	8/28/2008	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	WEISS, CRYSTAL CO	1929 W VISTA WAY	#A	VISTA	CA	92083	6018	37	06073	33.18658664	-117.2829247	San Diego County
211606	Fee-for-Service	1891223343	1891223343	1	1	WHITTINGTON, COURTNEY	5/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR	SUITE #230	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
211666	Fee-for-Service	1194807941	1194807941	1	1	WEST POINT PHYSICAL THERAPY	1/21/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	CENTER	1115 W AVENUE M14	# C	PALMDALE	CA	93551	1407	19	06037	34.63305646	-118.1505735	Los Angeles County
211682	Fee-for-Service	1164024394	1164024394	1	1	WILLIAM F. KIVETT MD INC.	4/23/2021	2086S0122X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	1140 SONOMA AVE.	SUITE 1A	SANTA ROSA	CA	95405	4817	49	06097	38.440458	-122.699502	Sonoma County
211714	Fee-for-Service	1114075181	1114075181	1	1	WONG, CHRISTINE M MD	12/1/1997	208600000X	NA	General Surgery	026	PHYSICIANS	83853	01	General Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
211761	Fee-for-Service	1982058566	1982058566	1	1	WANG, DEBRA B MD	7/31/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	150587	09	Gynecology (D.O. only)	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
211788	Fee-for-Service	1568535771	1568535771	1	1	WEBER, JOSEPH G MD	8/8/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	78368	05	Anesthesiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
211798	Fee-for-Service	1538521760	1538521760	1	1	WILKINSON, ARIANA MD	6/13/2019	207R00000X	NA	Other	026	PHYSICIANS	155893	41	Internal Medicine	0	In state provider	None	1245 16TH ST	STE 204	SANTA MONICA	CA	90404	1240	19	06037	34.02726451	-118.4857138	Los Angeles County
211877	Fee-for-Service	1528065216	1528065216	1	1	WOODING, LENORE G MD INC	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	36360	03	Allergy	0	In state provider	None	254 COHASSET RD	STE 10	CHICO	CA	95926	2210	04	06007	39.75189732	-121.8525897	Butte County
211880	Fee-for-Service	1629169230	1629169230	1	1	WEINER, MICHAEL S MD INC	3/13/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	36357	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	125 E BARSTOW AVE	STE 137	FRESNO	CA	93710	5020	10	06019	36.81570455	-119.787651	Fresno County
211943	Fee-for-Service	1063774883	1063774883	1	1	WISTAR, EMILY R MD	4/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128587	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
211994	Fee-for-Service	1508266396	1508266396	1	1	WEST PICO TERRACE HEALTHCARE	10/11/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	& WELLNESS CENTRE, LP	6070 W PICO BLVD	None	LOS ANGELES	CA	90035	2647	19	06037	34.05264718	-118.3727441	Los Angeles County
211997	Fee-for-Service	1669542007	1669542007	1	1	WOLFF, GEORGE P	1/30/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
212049	Fee-for-Service	1982058566	1982058566	1	1	WANG, DEBRA B MD	7/31/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	150587	15	Obstetrics (D.O. only)	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
212061	Fee-for-Service	1386887362	1386887362	1	1	WILLIAMS, RACHAEL Y MD	6/17/2019	208600000X	NA	General Surgery	026	PHYSICIANS	159969	02	General Surgery	0	In state provider	None	7325 MEDICAL CENTER DR	STE 200	WEST HILLS	CA	91307	4108	19	06037	34.20369349	-118.629837	Los Angeles County
212122	Fee-for-Service	1336367267	1336367267	1	1	WAGER, PAUL P LMFT	11/22/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	38677	-	NOT APPLICABLE	0	In state provider	None	5600 RICKENBACKER ROAD	2A/B	BELL	CA	90201	6425	19	06037	33.98966197	-118.1648431	Los Angeles County
212172	Fee-for-Service	1124257324	1124257324	1	10	WELLSPACE HEALTH	6/22/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	10423 OLD PLACERVILLE RD	SUITE A	SACRAMENTO	CA	95827	2508	34	06067	38.570382	-121.3075395	Sacramento County
212219	Fee-for-Service	1902433394	1902433394	1	1	WANG, JENNIFER MD	10/23/2023	207R00000X	NA	Other	026	PHYSICIANS	186074	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
212224	Fee-for-Service	1811376908	1811376908	1	1	WASHINGTON, VANCE M MD	8/4/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187365	None	None	0	In state provider	None	4323 W RIVERSIDE DRIVE	None	BURBANK	CA	91505	4044	19	06037	34.15223748	-118.347426	Los Angeles County
212226	Fee-for-Service	1588609572	1588609572	1	1	WOO, JEAN M MD	4/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	51082	40	Pediatrics	0	In state provider	C B O VALLEJO	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
212298	Fee-for-Service	1659436186	1659436186	1	1	WU, JOSEPH C MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66551	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1127 WILSHIRE BLVD	STE 600	LOS ANGELES	CA	90017	3907	19	06037	34.05270508	-118.2641005	Los Angeles County
212346	Fee-for-Service	1578730719	1578730719	1	1	WOODRUFF CARE HOME	10/3/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	16409 WOODRUFF AVENUE	None	BELLFLOWER	CA	90706	4911	19	06037	33.884964	-118.1173665	Los Angeles County
212413	Fee-for-Service	1689714701	1689714701	1	1	WELTY, JENNIFER M LCSW	6/1/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
212429	Fee-for-Service	1184629701	1184629701	1	1	WELLMAN, RICHARD W MD	4/28/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	48681	None	None	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
212440	Fee-for-Service	1427064005	1427064005	1	1	WALGREEN CO.	5/31/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1160 BROADWAY	None	BURLINGAME	CA	94010	3422	41	06081	37.58671897	-122.364233	San Mateo County
212452	Fee-for-Service	1134353949	1134353949	1	1	WONG, PRISCILLA H MD	4/26/2019	207K00000X	NA	Other	026	PHYSICIANS	159362	03	Allergy	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
212456	Fee-for-Service	1124257324	1124257324	1	10	WELLSPACE HEALTH	4/8/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	10423 OLD PLACERVILLE RD	SUITE A	SACRAMENTO	CA	95827	2508	34	06067	38.570382	-121.3075395	Sacramento County
212488	Fee-for-Service	1548426018	1548426018	1	1	WONG, JASON C MD	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107426	78	Neoplastic Diseases/Oncology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
212502	Fee-for-Service	1356710685	1356710685	1	1	WILBUR, LAURA L LMFT	6/1/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
212509	Fee-for-Service	1790893378	1790893378	1	1	WALASEK, ALINA E MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78763	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
212546	Fee-for-Service	1659765618	1659765618	1	2	WILBON, ETISHA LMFT	10/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
212589	Fee-for-Service	1659436186	1659436186	1	1	WU, JOSEPH C MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66551	41	Internal Medicine	0	In state provider	None	1127 WILSHIRE BLVD	STE 600	LOS ANGELES	CA	90017	3907	19	06037	34.05270508	-118.2641005	Los Angeles County
212612	Fee-for-Service	1568584159	1568584159	1	1	WANG, VINCENT Y MD	6/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	94626	14	Neurological Surgery	0	In state provider	None	1001 POTRERO AVE	RM 4M39	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
212684	Fee-for-Service	1457428674	1457428674	1	1	WANG, JIM C MD	3/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79074	18	Ophthalmology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
212686	Fee-for-Service	1740237163	1740237163	1	1	WONG, ALAN K MD	6/1/1999	208800000X	NA	Other	026	PHYSICIANS	50541	None	None	0	In state provider	None	1061 E MAIN ST	STE 203	GRASS VALLEY	CA	95945	5724	29	06057	39.22945852	-121.0502754	Nevada County
212699	Fee-for-Service	1417921412	1417921412	1	1	WU, WENWEI MD	12/21/2018	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
212717	Fee-for-Service	1750735767	1750735767	1	1	WONG, KATHERINE MD	6/16/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	152688	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
212726	Fee-for-Service	1134146558	1134146558	1	1	WAL-MART STORES, INC	9/9/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1231 SO.SANDERSON AVE	None	HEMET	CA	92545	9046	33	06065	33.726375	-117.0099135	Riverside County
212741	Fee-for-Service	1134353949	1134353949	1	1	WONG, PRISCILLA H MD	4/26/2019	207K00000X	NA	Other	026	PHYSICIANS	159362	40	Pediatrics	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
212746	Fee-for-Service	1124257324	1124257324	1	10	WELLSPACE HEALTH	4/8/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	10423 OLD PLACERVILLE RD	SUITE A	SACRAMENTO	CA	95827	2508	34	06067	38.570382	-121.3075395	Sacramento County
212747	Fee-for-Service	1912920836	1912920836	1	1	WOODSON, LEILANI K M MD	2/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77130	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2683 PACIFIC AVE	STE A	LONG BEACH	CA	90806	2610	19	06037	33.805926	-118.193738	Los Angeles County
212758	Fee-for-Service	1831173855	1831173855	1	1	WIDMAN, ELISABETH R MD	11/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	46518	08	Family Practice	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
212773	Fee-for-Service	1548426018	1548426018	1	1	WONG, JASON C MD	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107426	30	Radiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
212785	Fee-for-Service	1164717740	1164717740	1	1	WEINER, JASON J MD	6/10/2021	207RR0500X	NA	Other	026	PHYSICIANS	171534	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
212868	Fee-for-Service	1346252574	1346252574	1	1	WILTSE, LISE R MD	8/24/2004	207L00000X	NA	Other	026	PHYSICIANS	80621	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
212873	Fee-for-Service	1386834745	1386834745	1	2	WATSON, DENEEN L LMFT	6/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1902 ORANGE TREE LN	SUITE 200	REDLANDS	CA	92374	2888	36	06071	34.06785293	-117.2179967	San Bernardino County
212879	Fee-for-Service	1073946489	1073946489	1	1	WALGREEN CO	11/22/2013	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	301 UNIVERSITY AVE	None	SAN DIEGO	CA	92103	3008	37	06073	32.74824655	-117.162423	San Diego County
212890	Fee-for-Service	1295745073	1295745073	1	1	WEST, DARREN R MD	1/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
212912	Fee-for-Service	1578887105	1578887105	1	1	WOLFE, LAURA H MD	2/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	77679	36	Psychiatry	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
212952	Fee-for-Service	1194100156	1194100156	1	1	WELL NOW PHYSICIANS PC	7/15/2016	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7777 EDINGER AVE	STE 110	HUNTINGTON BEACH	CA	92647	8688	30	06059	33.733026	-117.994401	Orange County
213031	Fee-for-Service	1396828687	1396828687	1	1	WALSH, KATHLEEN S	2/8/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	555 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
213129	Fee-for-Service	1700822426	1700822426	1	1	WALD, SAMUEL H MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68889	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
213131	Fee-for-Service	1124601950	1124601950	1	1	WONG, THEODORE A CRNA	8/20/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
213147	Fee-for-Service	1104867498	1104867498	2	1	WILER, JENNIFER L MD	4/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
213182	Fee-for-Service	1548291081	1548291081	1	1	WILSON, STEVEN MD	1/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	46504	08	Family Practice	0	In state provider	None	245 TERRACINA BLVD	STE 106C	REDLANDS	CA	92373	4899	36	06071	34.03858912	-117.2066515	San Bernardino County
213251	Fee-for-Service	1346325362	1346325362	1	1	WILLIAMS, HIRAM J MD	10/1/2007	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	58977	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1500-30 S OLIVE ST	None	LOS ANGELES	CA	90015	3023	19	06037	34.03568676	-118.2649769	Los Angeles County
213261	Fee-for-Service	1114371549	1114371549	1	1	WI, MATTHEW MD	7/19/2021	163WG0000X	NA	Other	026	PHYSICIANS	163012	None	None	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	19	06037	34.28200485	-118.4030797	Los Angeles County
213289	Fee-for-Service	1104820950	1104820950	1	1	WANG, MICHAEL OD	7/18/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9727 ELK GROVE FLORIN RD	STE 190	ELK GROVE	CA	95624	2267	34	06067	38.404503	-121.370994	Sacramento County
213318	Fee-for-Service	1902984636	1902984636	1	1	WHITING, GARY W MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	58809	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
213325	Fee-for-Service	1366746224	1366746224	1	1	WONG, MONA M	11/10/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
213341	Fee-for-Service	1760409783	1760409783	1	1	WESTERN SURGICAL GROUP	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	1	Border provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
213359	Fee-for-Service	1902298656	1902298656	1	1	WATSON, COURTNEY LMFT	12/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	298 GRAND AVE	STE 100	OAKLAND	CA	94610	4797	01	06001	37.80909278	-122.2574153	Alameda County
213406	Fee-for-Service	1821331299	1821331299	1	1	WONG, SAMANTHA Y S MD	8/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	134675	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
213472	Fee-for-Service	1831169143	1831169143	1	1	WANG, ANNABEL K MD	2/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52657	13	Neurology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
213478	Fee-for-Service	1760239529	1760239529	1	1	WATTS, CARLY E	8/5/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
213494	Fee-for-Service	1053771071	1053771071	1	1	WOODLAND CHIROPRACTIC AND WE	6/16/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	LLNESS	1100 MAIN ST	SUITE 100	WOODLAND	CA	95695	3514	57	06113	38.67737354	-121.766454	Yolo County
213497	Fee-for-Service	1356368583	1356368583	1	1	WAL-MART STORES, INC	12/22/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHAR 10-5139	235 E DORSET DR	None	DIXON	CA	95620	9232	48	06095	38.47186094	-121.8186909	Solano County
213550	Fee-for-Service	1891941738	1891941738	1	1	WALGREEN CO	10/22/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6100 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2923	19	06037	33.984981	-118.2251735	Los Angeles County
213602	Fee-for-Service	1427620194	1427620194	1	1	WENGER, KELLY CCC-SLP	11/6/2024	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1317 OAKDALE ROAD	#1110 OFFICE 106	MODESTO	CA	95355	3361	50	06099	37.662489	-120.957588	Stanislaus County
213610	Fee-for-Service	1093306748	1093306748	1	1	WEI, ANGIE	9/13/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4339 E MORADA LN STE 150	150	STOCKTON	CA	95212	1634	39	06077	38.039067	-121.259493	San Joaquin County
213636	Fee-for-Service	1427117001	1427117001	1	1	WONG, JOHN MD	1/1/1982	207W00000X	NA	Ophthalmology	026	PHYSICIANS	39213	18	Ophthalmology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
213669	Fee-for-Service	1043746373	1043746373	1	1	WONG, TERRENCE S MD	6/7/2024	207R00000X	NA	Other	026	PHYSICIANS	166391	41	Internal Medicine	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
213698	Fee-for-Service	1922001346	1922001346	2	1	WIJESINGHE, M N MD	12/10/2013	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	33740	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1025 S ANAHEIM BLVD	None	ANAHEIM	CA	92805	5806	30	06059	33.81994338	-117.9087416	Orange County
213721	Fee-for-Service	1548243504	1548243504	1	1	WASHOFSKY, RICHARD A MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80244	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
213748	Fee-for-Service	1922260520	1922260520	1	1	WANG, CHIA CHING J MD	4/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119101	68	Hematology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
213759	Fee-for-Service	1205137981	1205137981	1	1	WAN, TAMMY S P MD	3/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119071	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
213782	Fee-for-Service	1497772800	1497772800	1	1	WAL-MART STORES INC.	9/15/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-2527	951 AVENIDA PICO	None	SAN CLEMENTE	CA	92673	3908	30	06059	33.45413381	-117.6050011	Orange County
213790	Fee-for-Service	1811904626	1811904626	1	1	WAITS, KEVIN A DO	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	7514	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2430 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4356	52	06103	40.14832201	-122.2216203	Tehama County
213815	Fee-for-Service	1063916286	1063916286	1	1	WU, CONNIE K MD	7/3/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	163614	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
213825	Fee-for-Service	1326164369	1326164369	1	1	WARD, DEANNA M MD	9/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	101196	40	Pediatrics	0	In state provider	None	3100 TELEGRAPH AVE	STE 2109	OAKLAND	CA	94609	3210	01	06001	37.82037533	-122.2667839	Alameda County
213837	Fee-for-Service	1720140973	1720140973	1	1	WARREN, LAURA L CNM	4/27/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
213845	Fee-for-Service	1235660887	1235660887	1	1	WEBSTER, LUKE MD	7/13/2020	208M00000X	NA	Other	026	PHYSICIANS	159228	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
213854	Fee-for-Service	1205972908	1205972908	1	1	WALKER, WESLEY C MD	5/1/1998	174400000X	NA	Other	026	PHYSICIANS	33878	34	Urology and Urological Surgery	0	In state provider	None	1001 E LATHAM AVE	STE A	HEMET	CA	92543	4435	33	06065	33.74937254	-116.961804	Riverside County
213872	Fee-for-Service	1699744813	1699744813	1	1	WASEF, EVA S MD	4/24/2014	207ZP0105X	NA	Other	026	PHYSICIANS	34605	01	General Practice	0	In state provider	None	150 PIONEER LN	None	BISHOP	CA	93514	2556	14	06027	37.36193834	-118.4073304	Inyo County
213896	Fee-for-Service	1831116185	1831116185	1	1	WAL-MART STORES, INC	1/14/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102523	2595 E IMPERIAL HWY	None	BREA	CA	92821	6129	30	06059	33.913458	-117.865269	Orange County
213902	Fee-for-Service	1437921459	1437921459	1	1	WONG, MAYBELLE NP	11/17/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
213971	Fee-for-Service	1629191366	1629191366	1	1	WESTERVELT, LANI G LMFT	7/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21 N EL CIRCULO AVE	None	PATTERSON	CA	95363	2535	50	06099	37.47121868	-121.1322863	Stanislaus County
214027	Fee-for-Service	1932586302	1932586302	1	1	WILSON, CAMERON MD INC	1/6/2016	193400000X	NA	Other	026	PHYSICIANS	121921	34	Urology and Urological Surgery	0	In state provider	None	8851 CENTER DR	STE 208	LA MESA	CA	91942	3189	37	06073	32.78189749	-117.0075062	San Diego County
214038	Fee-for-Service	1922260520	1922260520	1	1	WANG, CHIA CHING J MD	4/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119101	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
214073	Fee-for-Service	1801951900	1801951900	1	1	WARNER, MARK L PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
214113	Fee-for-Service	1326164369	1326164369	1	1	WARD, DEANNA M MD	9/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	101196	41	Internal Medicine	0	In state provider	None	3100 TELEGRAPH AVE	STE 2109	OAKLAND	CA	94609	3210	01	06001	37.82037533	-122.2667839	Alameda County
214181	Fee-for-Service	1639504962	1639504962	1	1	WAHLGREN, REBECCA E	10/22/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7999 GATEWAY BLVD	SUITE 200	NEWARK	CA	94560	1188	01	06001	37.53814232	-122.0629661	Alameda County
214313	Fee-for-Service	1043387574	1043387574	1	1	WOMENS HEALTH & PREGNANCY	4/30/1992	174400000X	NA	Other	026	PHYSICIANS	28470	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	CARE MEDICAL	440 GREENFIELD AVE	STE D	HANFORD	CA	93230	3568	16	06031	36.32904	-119.6582155	Kings County
214326	Fee-for-Service	1598394876	1598394876	1	1	WALTERS, CAITLYN D DO	7/27/2023	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
214369	Fee-for-Service	1487677886	1487677886	1	1	WAGHRAY, AMIT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	250 E DUNLAP AVE	None	PHOENIX	AZ	85020	2825	00	None	33.568947	-112.0712985	Maricopa County
214431	Fee-for-Service	1841259694	1841259694	1	1	WEINBERG, RICHARD A	10/15/1993	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1351 E SPRUCE AVE	None	FRESNO	CA	93720	3342	10	06019	36.84136088	-119.7588077	Fresno County
214443	Fee-for-Service	1609058973	1609058973	1	1	WANG, TINA C MD	4/11/2008	207P00000X	NA	Other	026	PHYSICIANS	103116	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	54	06107	36.327888	-119.294919	Tulare County
214447	Fee-for-Service	1033315403	1033315403	1	1	WONG, SHUK HAN T MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126069	01	General Practice	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
214510	Fee-for-Service	1679887343	1679887343	1	1	WOODEN-XENOS, AJA N PSYD	1/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
214511	Fee-for-Service	1760456768	1760456768	1	1	WONG, LIAM DO	6/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	9039	05	Anesthesiology	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
214525	Fee-for-Service	1578630489	1578630489	1	1	WEXLER, ANDREW M MD	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	41919	24	Plastic Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
214556	Fee-for-Service	1932738515	1932738515	1	1	WANG, EDMUND DO	6/17/2024	207L00000X	NA	Other	026	PHYSICIANS	21397	05	Anesthesiology	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
214557	Fee-for-Service	1154870301	1154870301	1	1	WILLIAMS, JOHN E T CRNA	1/26/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVENUE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
214582	Fee-for-Service	1740295013	1740295013	1	1	WALGREEN CO.	7/15/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	42010 WASHINGTON ST	None	INDIO	CA	92203	9610	33	06065	33.743034	-116.303752	Riverside County
214591	Fee-for-Service	1962651778	1962651778	1	1	WILLIAMS, ADREE N CRNA	2/22/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
214651	Fee-for-Service	1922494020	1922494020	1	2	WU, DEREK B MD	10/1/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	171943	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
214737	Fee-for-Service	1033315403	1033315403	1	1	WONG, SHUK HAN T MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126069	41	Internal Medicine	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
214757	Fee-for-Service	1669540803	1669540803	2	1	WALNUT VILLAGE PHARMACY, INC	9/7/2012	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4840 IRVINE BLVD	STE. 103	IRVINE	CA	92620	1962	30	06059	33.71307939	-117.7592612	Orange County
214792	Fee-for-Service	1841233947	1841233947	1	1	WEINSTEIN, GEOFFREY D MD	4/5/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54109	30	Radiology	0	In state provider	None	555 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
214811	Fee-for-Service	1003436064	1003436064	1	5	WS AUDIOLOGY (CALIFORNIA), P	3/26/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1611 S MELROSE DRIVE	F	VISTA	CA	92081	5407	37	06073	33.16662307	-117.2471325	San Diego County
214812	Fee-for-Service	1003811803	1003811803	1	1	WATERS, ERICA R MD	11/18/2009	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	91419	40	Pediatrics	0	In state provider	None	89 W MARCH LANE	STE 1	STOCKTON	CA	95207	2723	39	06077	37.9950695	-121.307499	San Joaquin County
214821	Fee-for-Service	1033272521	1033272521	1	1	WOMENS TOTAL CARE MEDICAL	6/1/2000	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	44407	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	CLINIC INC	314 W JUNIPERO ST	None	SANTA BARBARA	CA	93105	4305	42	06083	34.43103031	-119.7236859	Santa Barbara County
214837	Fee-for-Service	1891873980	1891873980	1	1	WEISS, MADELYN R MD	8/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	46626	40	Pediatrics	0	In state provider	None	7601 STONERIDGE DR	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
214852	Fee-for-Service	1356497226	1356497226	1	1	WELTY, PETER MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	43081	40	Pediatrics	0	In state provider	None	2921 REDONDO AVE	None	LONG BEACH	CA	90806	2415	19	06037	33.808185	-118.1513675	Los Angeles County
214866	Fee-for-Service	1336122134	1336122134	1	1	WONG, LORI	12/30/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
214880	Fee-for-Service	1538584693	1538584693	1	1	WILBUR, KATHRYN C LCSW	4/4/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	334 SHAW AVE	SUITE 100	CLOVIS	CA	93612	3839	10	06019	36.80839352	-119.7049776	Fresno County
214944	Fee-for-Service	1356363725	1356363725	1	1	WONG, STEVEN CHING-SUNG	5/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90357	41	Internal Medicine	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
214957	Fee-for-Service	1194040063	1194040063	1	1	WILKES, MICHAEL S MD	11/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	64198	41	Internal Medicine	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
215030	Fee-for-Service	1699949883	1699949883	1	1	WESLEY, LETTA D	5/21/2008	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1800 28TH ST	None	SACRAMENTO	CA	95816	7310	34	06067	38.564892	-121.4734095	Sacramento County
215045	Fee-for-Service	1760497853	1760497853	1	1	WALGREEN CO	2/10/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7878 CRESCENT AVE	None	BUENA PARK	CA	90620	3950	30	06059	33.83935387	-117.9959161	Orange County
215056	Fee-for-Service	1174611917	1174611917	1	1	WEY, JACLYN C MD	10/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84965	20	Orthopedic Surgery	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
215079	Fee-for-Service	1841233947	1841233947	1	1	WEINSTEIN, GEOFFREY D MD	4/5/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54109	78	Neoplastic Diseases/Oncology	0	In state provider	None	555 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
215178	Fee-for-Service	1528183761	1528183761	1	1	WANG, KEVIN C MD	8/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98026	None	None	0	In state provider	None	1701 DIVISADERO STREET	None	SAN FRANCISCO	CA	94115	3011	38	06075	37.78553106	-122.4399475	San Francisco County
215187	Fee-for-Service	1285920934	1285920934	1	2	WINKLER, KATHRIN LMFT	9/27/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2900 BRISTOL ST	J206	COSTA MESA	CA	92626	7921	30	06059	33.67689875	-117.8872016	Orange County
215211	Fee-for-Service	1942434527	1942434527	1	1	WALGREENS CO	9/2/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #09532	4050 SUNRISE BLVD	None	RANCHO CORDOVA	CA	95742	7338	34	06067	38.555946	-121.2435855	Sacramento County
215212	Fee-for-Service	1407979891	1407979891	1	1	WOODS, CELIA M	12/3/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	87778	-	NOT APPLICABLE	0	In state provider	None	3150 E LOS ANGELES AVE	None	SIMI VALLEY	CA	93065	3940	56	06111	34.2716367	-118.7360247	Ventura County
215219	Fee-for-Service	1003436064	1003436064	1	70	WS AUDIOLOGY (CALIFORNIA), P	9/23/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7251 WARNER AVE	STE A	HUNTINGTON BEACH	CA	92647	5491	30	06059	33.71569644	-118.0024271	Orange County
215249	Fee-for-Service	1679749964	1679749964	1	1	WORSHAM, ANTHONY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
215287	Fee-for-Service	1831119403	1831119403	1	2	WADA, SCOTT J MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	54251	-	NOT APPLICABLE	0	In state provider	None	1915 D STREET	None	ANTIOCH	CA	94509	2571	07	06013	38.0038299	-121.8099949	Contra Costa County
215321	Fee-for-Service	1841214376	1841214376	1	1	WONG, CYNTHIA J MD	7/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91426	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
215348	Fee-for-Service	1700897394	1700897394	1	1	WHITNEY, ANTHONY M MD	10/1/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	73583	08	Family Practice	0	In state provider	None	2201 MISSION AVE	None	OCEANSIDE	CA	92054	2328	37	06073	33.20742226	-117.3612486	San Diego County
215379	Fee-for-Service	1245643758	1245643758	1	1	WESTOX LABS LLC	6/19/2018	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	18102 SKY PARK SOUTH	BLDG 52 SUITE E	IRVINE	CA	92614	6531	30	06059	33.68753661	-117.8594875	Orange County
215412	Fee-for-Service	1841205119	1841205119	1	1	WALGREEN CO	11/8/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 MCHENRY AVE	None	MODESTO	CA	95350	5439	50	06099	37.659177	-120.9938755	Stanislaus County
215414	Fee-for-Service	1336124346	1336124346	1	1	WEISS, ROBERT HENRY MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	55307	45	Nephrology (Renal-Kidney)	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
215452	Fee-for-Service	1144247560	1144247560	1	1	WAL-MART STORES, INC	7/16/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2601 FASHION PL	None	BAKERSFIELD	CA	93306	3027	15	06029	35.3908146	-118.961799	Kern County
215491	Fee-for-Service	1699964122	1699964122	1	1	WU, IRENE I MD	6/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102000	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
215495	Fee-for-Service	1194741363	1194741363	1	1	WAN, PAULINE S LCSW	6/12/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1732 FILLMORE ST	None	SAN FRANCISCO	CA	94115	3130	38	06075	37.78566226	-122.4331577	San Francisco County
215504	Fee-for-Service	1003436064	1003436064	1	70	WS AUDIOLOGY (CALIFORNIA), P	9/23/2024	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	7251 WARNER AVE	STE A	HUNTINGTON BEACH	CA	92647	5491	30	06059	33.71569644	-118.0024271	Orange County
215558	Fee-for-Service	1124033402	1124033402	1	1	WALGREEN CO.	5/5/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	34503 YUCAIPA BLVD	None	YUCAIPA	CA	92399	4129	36	06071	34.03384253	-117.051417	San Bernardino County
215607	Fee-for-Service	1841214376	1841214376	1	1	WONG, CYNTHIA J MD	7/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91426	45	Nephrology (Renal-Kidney)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
215636	Fee-for-Service	1588380075	1588380075	1	1	WENDY WANG M D INC	3/24/2023	261QP2300X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	223 N GARFIELD AVE	STE 200	MONTEREY PARK	CA	91754	1700	19	06037	34.0646166	-118.1228948	Los Angeles County
215667	Fee-for-Service	1831752641	1831752641	1	1	WONG, JORDAN A MD	9/30/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	179631	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
215668	Fee-for-Service	1154554871	1154554871	1	1	WANG, REGINA M MD	10/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109828	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
215704	Fee-for-Service	1083117261	1083117261	1	1	WOOD, CARLA DO	7/19/2024	390200000X	NA	Other	026	PHYSICIANS	19773	13	Neurology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
215714	Fee-for-Service	1568508505	1568508505	1	1	WONG, DANIEL CRNA	3/1/2006	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
215718	Fee-for-Service	1649367491	1649367491	1	2	WOO, RICHARD A DPM	3/1/1998	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2299 POST ST	STE 304	SAN FRANCISCO	CA	94115	3474	38	06075	37.78434298	-122.4392033	San Francisco County
215731	Fee-for-Service	1235367327	1235367327	1	1	WITHERSPOON, PAULA V MD	3/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139073	03	Allergy	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
215805	Fee-for-Service	1417248097	1417248097	1	1	WANG, DORIS D MD	9/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122689	14	Neurological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
215809	Fee-for-Service	1447661996	1447661996	1	1	WARRITAY, OLAYINKA K MD	10/11/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	149212	08	Family Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
215903	Fee-for-Service	1639140296	1639140296	1	1	WEIS, PETER J MD	4/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	76040	83	Rheumatology	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
215933	Fee-for-Service	1679695134	1679695134	1	1	WATTS, PAMELA J	6/15/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10992 SAN DIEGO MISSION	None	SAN DIEGO	CA	92108	2417	37	06073	32.78503881	-117.1020911	San Diego County
215963	Fee-for-Service	1437490372	1437490372	1	1	WEI, JOYCE A OD	1/8/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	365 E HILLCREST DR	None	THOUSAND OAKS	CA	91360	5802	56	06111	34.18122452	-118.8704974	Ventura County
215996	Fee-for-Service	1154344984	1154344984	1	1	WAT, PAMELA J	10/31/1990	207ZP0105X	NA	Other	026	PHYSICIANS	60753	22	Pathology (M.D. only)	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
216009	Fee-for-Service	1275536930	1275536930	1	1	WILKEN, TIMOTHY MD	12/14/2018	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	24579	01	General Practice	0	In state provider	None	3130 DEL MONTE BLVD	None	MARINA	CA	93933	3047	27	06053	36.68590557	-121.8010492	Monterey County
216028	Fee-for-Service	1699135558	1699135558	1	1	WATSON, MARGO F PHD	3/30/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	SUITE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
216045	Fee-for-Service	1780612101	1780612101	1	1	WEEKS, RUSSELL S MD	2/8/2015	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	19422	04	Otology, Laryngology, Rhinology	0	In state provider	None	6645 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.7772577	-117.0575222	San Diego County
216072	Fee-for-Service	1770844227	1770844227	1	1	WALGREEN CO	8/6/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3131 W. HAMMER LN	None	STOCKTON	CA	95209	2747	39	06077	38.02143649	-121.3555455	San Joaquin County
216081	Fee-for-Service	1326255183	1326255183	1	1	WEINMAN, MICHAL S	6/12/2007	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1340 LAKE BLVD	None	DAVIS	CA	95616	2619	57	06113	38.55491538	-121.7876886	Yolo County
216088	Fee-for-Service	1356684948	1356684948	1	1	WANG, TONY R MD	7/10/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	169010	14	Neurological Surgery	0	In state provider	None	300 STEIN PLAZA	STE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
216091	Fee-for-Service	1134216252	1134216252	1	1	WILLIAMS, KENT C	7/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	2	Out of state provider	None	700 CHILDRENS DRIVE	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
216102	Fee-for-Service	1497718704	1497718704	1	1	WASPE, LAWRENCE E MD	10/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	57417	None	None	0	In state provider	None	1401 SPANOS CT	STE 203	MODESTO	CA	95355	2813	50	06099	37.66975543	-120.9724048	Stanislaus County
216120	Fee-for-Service	1871684837	1871684837	1	1	WORTMAN, WILLIAM J MD	12/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	37929	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	0000	19	06037	34.133598	-118.1534895	Los Angeles County
216166	Fee-for-Service	1639140296	1639140296	1	1	WEIS, PETER J MD	4/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	76040	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
216207	Fee-for-Service	1376832550	1376832550	1	1	WALDMAN, SARAH E MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125365	77	Infectious Disease	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
216343	Fee-for-Service	1083811467	1083811467	1	1	WALSWORTH, MATTHEW K MD	6/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119553	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
216357	Fee-for-Service	1003436064	1003436064	1	59	WS AUDIOLOGY (CALIFORNIA), P	7/28/2022	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	24981 DANA POINT HARBOR	SUITE E130	DANA POINT	CA	92629	2931	30	06059	33.4625874	-117.6947412	Orange County
216375	Fee-for-Service	1760929210	1760929210	1	1	WAY, BRENDA J LMFT	4/23/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	26639 VALLEY CENTER DR	STE 109	SANTA CLARITA	CA	91351	2368	19	06037	34.42178843	-118.5049314	Los Angeles County
216397	Fee-for-Service	1205922952	1205922952	1	1	WU, WENDY D MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74303	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
216412	Fee-for-Service	1710257357	1710257357	1	1	WELCH, PATRICK D DO	7/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12154	01	General Practice	0	In state provider	None	901 OAK PARK BLVD	SUITE 101	PISMO BEACH	CA	93449	3409	40	06079	35.13460775	-120.6050814	San Luis Obispo County
216418	Fee-for-Service	1043772940	1043772940	1	1	WANG, EMILY MD	10/18/2023	207L00000X	NA	Other	026	PHYSICIANS	184301	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
216433	Fee-for-Service	1114933785	1114933785	1	1	WALGREEN CO	1/16/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1570 W CAMPBELL AVE	None	CAMPBELL	CA	95008	1528	43	06085	37.28601044	-121.9775527	Santa Clara County
216450	Fee-for-Service	1912242975	1912242975	1	1	WALLACE, JOSEPHINE P LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	78374	-	NOT APPLICABLE	0	In state provider	None	1625 W OLYMPIC BLVD	SUITE 600	LOS ANGELES	CA	90015	3809	19	06037	34.04957404	-118.2750068	Los Angeles County
216452	Fee-for-Service	1144990797	1144990797	1	1	WHITE, AMY LCSW	7/8/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
216479	Fee-for-Service	1336167808	1336167808	1	1	WAL-MART STORE INC	10/7/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-1805	79295 HIGHWAY 111	None	LA QUINTA	CA	92253	2060	33	06065	33.703668	-116.281116	Riverside County
216485	Fee-for-Service	1992966105	1992966105	1	1	WALBOLT, THOMAS DO	9/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10110	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
216498	Fee-for-Service	1376832550	1376832550	1	1	WALDMAN, SARAH E MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125365	41	Internal Medicine	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
216508	Fee-for-Service	1124257324	1124257324	1	7	WELLSPACE HEALTH	11/2/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3415 MLK JR BLVD	None	SACRAMENTO	CA	95817	3648	34	06067	38.54376	-121.4644095	Sacramento County
216556	Fee-for-Service	1831209998	1831209998	1	1	WIN, KHIN M MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64463	41	Internal Medicine	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
216625	Fee-for-Service	1861417206	1861417206	1	1	WING, RONALD H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	24826	08	Family Practice	0	In state provider	None	4849 VAN NUYS BLVD	STE 105	SHERMAN OAKS	CA	91403	2121	19	06037	34.159113	-118.4487465	Los Angeles County
216632	Fee-for-Service	1528132842	1528132842	1	1	WONG, CHRISTINA M MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94143	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	95020	7303	41	06081	37.48948529	-122.2232468	San Mateo County
216646	Fee-for-Service	1003436064	1003436064	1	59	WS AUDIOLOGY (CALIFORNIA), P	2/11/2022	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	24981 DANA POINT HARBOR	SUITE E130	DANA POINT	CA	92629	2931	30	06059	33.4625874	-117.6947412	Orange County
216648	Fee-for-Service	1437499654	1437499654	1	1	WALTHERS, MARY V LMFT	7/24/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
216673	Fee-for-Service	1154387843	1154387843	1	1	WITKIN-LUPO, MARCY A PHD	3/7/2001	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3435 BRANDYWINE ST	None	SAN DIEGO	CA	92117	5605	37	06073	32.80600728	-117.2095256	San Diego County
216681	Fee-for-Service	1083926919	1083926919	1	1	WYMAN, THEODORE E MD	12/31/2018	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	104884	01	General Practice	0	In state provider	None	264 N HIGHLAND SPRINGS A	STE 5A	BANNING	CA	92220	3083	33	06065	33.93063	-116.946864	Riverside County
216691	Fee-for-Service	1588789846	1588789846	1	1	WADHWANI, SWATI MD	9/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1707 W CHARLESTON BLVD	STE 230	LAS VEGAS	NV	89102	2353	00	None	36.15879353	-115.1643015	Clark County
216740	Fee-for-Service	1700803939	1700803939	1	1	WAL-MART STORES, INC	4/27/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHAR 10-5075	3405 MARRON RD	None	OCEANSIDE	CA	92056	4673	37	06073	33.17785335	-117.2977901	San Diego County
216741	Fee-for-Service	1912900739	1912900739	1	1	WILDENBERG, HOPE A MD	4/8/2003	193200000X	NA	Other	026	PHYSICIANS	83457	08	Family Practice	0	In state provider	None	1041 N CHINA LAKE BLVD	STE B	RIDGECREST	CA	93555	3183	15	06029	35.63953945	-117.669891	Kern County
216786	Fee-for-Service	1245347467	1245347467	1	1	WIEDMAN, MARTHA MD	2/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	56421	None	None	0	In state provider	None	5000 SAN BERNARDINO ST	None	MONTCLAIR	CA	91763	2326	36	06071	34.07768647	-117.6957498	San Bernardino County
216795	Fee-for-Service	1124257324	1124257324	1	7	WELLSPACE HEALTH	11/2/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3415 MLK JR BLVD	None	SACRAMENTO	CA	95817	3648	34	06067	38.54376	-121.4644095	Sacramento County
216812	Fee-for-Service	1811069180	1811069180	1	1	WILLIAMS, SARAH M LMFT	9/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2601 E MAIN ST	None	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
216818	Fee-for-Service	1982879524	1982879524	1	1	WALDAU, BEN MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121095	14	Neurological Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
216821	Fee-for-Service	1417149089	1417149089	1	1	WALGREEN CO.	12/27/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1236 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	5311	36	06071	34.122087	-117.278816	San Bernardino County
216841	Fee-for-Service	1437314416	1437314416	1	1	WILKINS, TIMOTHY J LMFT	3/5/2021	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
216845	Fee-for-Service	1841659570	1841659570	1	1	WILSON, LINDSAY M	3/5/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2357 W MARCH LN	None	STOCKTON	CA	95207	5239	39	06077	37.985458	-121.336447	San Joaquin County
216848	Fee-for-Service	1417476557	1417476557	1	2	WAGSTAFF, AMANDA E PHD	3/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
216859	Fee-for-Service	1598844623	1598844623	1	1	WILSON, PAUL MD	10/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	65421	36	Psychiatry	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
216878	Fee-for-Service	1497097018	1497097018	1	1	WANG, PATRICIA MD	10/21/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
216896	Fee-for-Service	1568778124	1568778124	1	1	WALDMAN, HADAR H MD	11/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125810	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8635 W 3RD ST	None	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
216903	Fee-for-Service	1003436064	1003436064	1	47	WS AUDIOLOGY (CALIFORNIA), P	5/17/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	936 N WESTERN AVENUE	SUITE 270	SAN PEDRO	CA	90732	2427	19	06037	33.75111361	-118.3090432	Los Angeles County
216925	Fee-for-Service	1134172547	1134172547	1	1	WEINGARTEN, KARL E MD	12/21/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	80449	30	Radiology	0	In state provider	None	12620 MONTE VISTA RD	STE A	POWAY	CA	92064	2531	37	06073	32.99536145	-117.056826	San Diego County
216934	Fee-for-Service	1003436064	1003436064	1	30	WS AUDIOLOGY (CALIFORNIA), P	8/16/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	8066 -8068 LA MESA BLVD	None	LA MESA	CA	91942	0335	37	06073	32.7634053	-117.0232104	San Diego County
216936	Fee-for-Service	1003436064	1003436064	1	62	WS AUDIOLOGY (CALIFORNIA), P	7/19/2022	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1601 W 17TH ST	UNIT E2	SANTA ANA	CA	92706	0000	30	06059	33.7600735	-117.890325	Orange County
217006	Fee-for-Service	1285130724	1285130724	1	1	WILES, CONNOR MD	8/14/2023	208600000X	NA	General Surgery	026	PHYSICIANS	174969	None	None	0	In state provider	None	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
217029	Fee-for-Service	1912900739	1912900739	1	1	WILDENBERG, HOPE A MD	4/8/2003	193200000X	NA	Other	026	PHYSICIANS	83457	01	General Practice	0	In state provider	None	1041 N CHINA LAKE BLVD	STE B	RIDGECREST	CA	93555	3183	15	06029	35.63953945	-117.669891	Kern County
217038	Fee-for-Service	1831618370	1831618370	1	2	WISNER, MADELEINE J	1/23/2023	176B00000X	NA	Licensed Midwife	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
217083	Fee-for-Service	1730475435	1730475435	1	1	WALGREEN CO	9/21/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12574 LIMONITE AVE	None	EASTVALE	CA	91752	3684	33	06065	33.97513715	-117.5575964	Riverside County
217088	Fee-for-Service	1932441151	1932441151	1	1	WILCOX, CHAD S MD	5/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154807	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
217169	Fee-for-Service	1417959065	1417959065	1	1	WERBEL,GORDON B MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1800 TREE LANE ROAD	STE #330	SNELLVILLE	GA	30078	4200	00	None	33.87804062	-84.01796269	Gwinnett County
217217	Fee-for-Service	1073194932	1073194932	1	1	WENG, JOYCE H	10/19/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
217222	Fee-for-Service	1356623789	1356623789	1	1	WATTERSON, DARLA E NP	8/8/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
217224	Fee-for-Service	1003436064	1003436064	1	30	WS AUDIOLOGY (CALIFORNIA), P	5/13/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	8066 -8068 LA MESA BLVD	None	LA MESA	CA	91942	0335	37	06073	32.7634053	-117.0232104	San Diego County
217225	Fee-for-Service	1003436064	1003436064	1	62	WS AUDIOLOGY (CALIFORNIA), P	7/19/2022	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1601 W 17TH ST	UNIT E2	SANTA ANA	CA	92706	0000	30	06059	33.7600735	-117.890325	Orange County
217268	Fee-for-Service	1578829669	1578829669	1	1	WILLIAMS, DANIELLE MD	1/11/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	192474	None	None	0	In state provider	None	19111 TOWN CENTER DR	None	APPLE VALLEY	CA	92308	8989	36	06071	34.46573149	-117.2467156	San Bernardino County
217300	Fee-for-Service	1871579458	1871579458	1	1	WHEELOCK, VICKI L MD	1/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	54731	13	Neurology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
217307	Fee-for-Service	1548576952	1548576952	1	1	WALGREEN CO	2/14/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	444 W F ST	None	OAKDALE	CA	95361	3837	50	06099	37.76415497	-120.8530102	Stanislaus County
217314	Fee-for-Service	1205929254	1205929254	1	1	WYATT, ALANA SUE PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10811 WASHINGTON BLVD	STE 280	CULVER CITY	CA	90232	3653	19	06037	34.01517469	-118.4073731	Los Angeles County
217344	Fee-for-Service	1114212917	1114212917	1	1	WHITE VANGOMPEL, EMILY C MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123564	01	General Practice	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
217400	Fee-for-Service	1235334228	1235334228	1	1	WONG, STEWART C MD	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98757	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
217423	Fee-for-Service	1295962173	1295962173	1	1	WAYMAN, KENNETH L MD	1/28/2023	207LP3000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
217433	Fee-for-Service	1639271471	1639271471	1	1	WEST, ROBERT B MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74675	22	Pathology (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
217437	Fee-for-Service	1063245629	1063245629	1	1	WIER, DHWANI	10/10/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15260 VENTURA BLVD	1200	SHERMAN OAKS	CA	91403	5307	19	06037	34.15370926	-118.4656644	Los Angeles County
217467	Fee-for-Service	1346215100	1346215100	1	1	WANG, JING C MD	12/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76004	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
217471	Fee-for-Service	1881868164	1881868164	1	1	WOODLAND EMERGENCY	7/1/2008	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PHYSICIANS MED GROUP INC	1325 COTTONWOOD ST	None	WOODLAND	CA	95695	5131	57	06113	38.664027	-121.7933505	Yolo County
217586	Fee-for-Service	1003436064	1003436064	1	45	WS AUDIOLOGY (CALIFORNIA), P	7/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	18220 YORBA LINDA BLVD	SUITE 312	YORBA LINDA	CA	92886	4057	30	06059	33.88842824	-117.8154698	Orange County
217588	Fee-for-Service	1104652015	1104652015	1	1	WAGNER, CASSIDY PT	2/16/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	137 S LAS POSAS RD	STE 254	SAN MARCOS	CA	92078	2475	37	06073	33.14138594	-117.1924065	San Diego County
217660	Fee-for-Service	1750312997	1750312997	2	1	WELLSTAR NORTH FULTON	2/19/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	3000 HOSPITAL BLVD	None	ROSWELL	GA	30076	4915	00	None	34.06240607	-84.32060774	Fulton County
217694	Fee-for-Service	1366766834	1366766834	1	1	WAUNG, MAGGIE W MD	5/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119495	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
217699	Fee-for-Service	1558160556	1558160556	1	1	WILLIAMS, NICOLE	3/28/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
217707	Fee-for-Service	1093793184	1093793184	1	1	WU, WENDY H	6/27/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	223 N GARFIELD AVE	STE 102	MONTEREY PARK	CA	91754	1700	19	06037	34.0646166	-118.1228948	Los Angeles County
217736	Fee-for-Service	1316970031	1316970031	1	1	WORKMAN, THEODORE E	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65834	None	None	0	In state provider	None	2111 AIRPARK DR	None	REDDING	CA	96001	2433	45	06089	40.57502348	-122.4048036	Shasta County
217765	Fee-for-Service	1174563662	1174563662	1	1	WASHINGTON UNIVERSITY	5/9/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	2	Out of state provider	None	1 CHILDRENS PLACE	None	ST LOUIS	MO	63110	1002	00	None	38.63728519	-90.26492064	St. Louis city
217778	Fee-for-Service	1851007843	1851007843	1	1	WHITMIRE, JOZELLE LCSW	12/28/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	206 W. FOURTH ST.	401	SANTA ANA	CA	92701	4631	30	06059	33.74798439	-117.8690056	Orange County
217826	Fee-for-Service	1982607503	1982607503	1	1	WROBEL, LANCE J MD	11/27/1985	174400000X	NA	Other	026	PHYSICIANS	26153	20	Orthopedic Surgery	0	In state provider	None	27856 PUERTA REAL STE 22	None	MISSION VIEJO	CA	92675	0000	30	06059	33.56849493	-117.6696298	Orange County
217873	Fee-for-Service	1003436064	1003436064	1	45	WS AUDIOLOGY (CALIFORNIA), P	7/6/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	18220 YORBA LINDA BLVD	SUITE 312	YORBA LINDA	CA	92886	4057	30	06059	33.88842824	-117.8154698	Orange County
217946	Fee-for-Service	1750312997	1750312997	2	1	WELLSTAR NORTH FULTON	2/19/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	3000 HOSPITAL BLVD	None	ROSWELL	GA	30076	4915	00	None	34.06240607	-84.32060774	Fulton County
218009	Fee-for-Service	1700046778	1700046778	1	1	WONG, RITA LPCC	12/21/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
218012	Fee-for-Service	1659485589	1659485589	1	1	WHITTIER INTERNAL MEDICINE A	1/25/1985	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NEPROLOGY MED GRP	12462 PUTNAM ST	STE 506	WHITTIER	CA	90602	1002	19	06037	33.9709236	-118.0460596	Los Angeles County
218076	Fee-for-Service	1184829145	1184829145	1	1	WILSON, EMMA H PHD	1/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
218093	Fee-for-Service	1013124072	1013124072	1	1	WELL AND FIT ADULT DAY	3/21/2003	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER INC	105 MERCURY CIRCLE	None	POMONA	CA	91768	3211	19	06037	34.05629499	-117.8024713	Los Angeles County
218100	Fee-for-Service	1861443434	1861443434	1	1	WASHINGTON TOWNSHIP	9/6/2006	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	HOSPITAL DEVELOPMENT COR	39141 CIVIC CENTER DR	STE 120	FREMONT	CA	94538	5831	01	06001	37.55436307	-121.9764708	Alameda County
218124	Fee-for-Service	1326065731	1326065731	1	1	WAL-MART STORES INC	11/20/1990	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2150 N WATERMAN AVE	None	EL CENTRO	CA	92243	1605	13	06025	32.813424	-115.577343	Imperial County
218141	Fee-for-Service	1396110961	1396110961	1	1	WHEELER, JOSEPH H LMFT	8/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3434 MENDOCINO AVE	A	SANTA ROSA	CA	95403	2274	49	06097	38.472156	-122.7241935	Sonoma County
218155	Fee-for-Service	1144436262	1144436262	1	1	WADELL, CHAD A MD	8/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94723	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
218179	Fee-for-Service	1821331992	1821331992	1	2	WANG, YUNZU M MD	7/30/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	132450	68	Hematology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
218285	Fee-for-Service	1922111863	1922111863	1	1	WANG, MARILENE B MD	7/30/1991	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	60942	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
218289	Fee-for-Service	1043418957	1043418957	1	1	WHITE, ELIZABETH B LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
218332	Fee-for-Service	1417311010	1417311010	1	1	WU, EVAN MD	7/19/2019	207P00000X	NA	Other	026	PHYSICIANS	152953	None	None	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
218352	Fee-for-Service	1306983812	1306983812	1	1	WESTMINSTER MEDICAL OFFICE I	8/29/2008	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NC	13671 BEACH BLVD	STE A	WESTMINSTER	CA	92683	3200	30	06059	33.76360126	-117.9900561	Orange County
218402	Fee-for-Service	1326254624	1326254624	3	1	WHITE, PAUL A MD	6/18/2019	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	99179	09	Gynecology (D.O. only)	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
218416	Fee-for-Service	1083601330	1083601330	1	1	WESTERN MISSOURI MED CTR	7/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	403 BURKARTH RD	None	WARRENSBURG	MO	64093	3101	00	None	38.76599368	-93.72375583	Johnson County
218422	Fee-for-Service	1356857528	1356857528	1	1	WEI, ERIC MD	1/3/2025	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	188879	84	Surgery-Head and Neck	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
218423	Fee-for-Service	1497190086	1497190086	1	1	WEINSTEIN, JESSICA L MD	6/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147189	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
218442	Fee-for-Service	1144436262	1144436262	1	1	WADELL, CHAD A MD	8/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94723	01	General Practice	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
218443	Fee-for-Service	1982782751	1982782751	1	1	WING, JERELD H MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66051	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
218467	Fee-for-Service	1821331992	1821331992	1	2	WANG, YUNZU M MD	7/30/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	132450	40	Pediatrics	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
218489	Fee-for-Service	1003875816	1003875816	1	1	WEINBERG, RICHARD A MD	5/24/1995	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	34355	04	Otology, Laryngology, Rhinology	0	In state provider	None	1351 E SPRUCE AVE	None	FRESNO	CA	93720	3342	10	06019	36.84136088	-119.7588077	Fresno County
218497	Fee-for-Service	1366513541	1366513541	1	1	WEI, MEI FANG AC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3860 CONVOY ST	STE 119	SAN DIEGO	CA	92111	3748	37	06073	32.8147535	-117.1534579	San Diego County
218530	Fee-for-Service	1083978498	1083978498	1	1	WANG, KAREN MD	12/4/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	150137	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2400 SAMARITAN DR	STE 105	SAN JOSE	CA	95124	3910	43	06085	37.25103365	-121.9442147	Santa Clara County
218611	Fee-for-Service	1467062505	1467062505	1	1	WHITTLE, TAYLOR PT	1/3/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25467 MEDICAL CENTER DR	100	MURRIETA	CA	92562	1501	33	06065	33.55711632	-117.1860368	Riverside County
218650	Fee-for-Service	1548674369	1548674369	1	1	WALIA, PALUK MD	1/28/2022	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	159948	None	None	0	In state provider	None	8631 W THIRD STREET	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
218668	Fee-for-Service	1588008981	1588008981	1	1	WRIGHT, MELISSA A LMFT	1/5/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
218689	Fee-for-Service	1326254624	1326254624	3	1	WHITE, PAUL A MD	6/18/2019	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	99179	15	Obstetrics (D.O. only)	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
218698	Fee-for-Service	1174824841	1174824841	1	1	WU, JUSTIN DO	4/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	11281	83	Rheumatology	0	In state provider	None	5451 LA PALMA AVE	SUITE 25	LA PALMA	CA	90623	5451	30	06059	33.84643146	-118.038843	Orange County
218701	Fee-for-Service	1982233649	1982233649	1	1	WU, JONATHAN G DO	2/22/2024	208M00000X	NA	Other	026	PHYSICIANS	20120	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
218760	Fee-for-Service	1003436064	1003436064	1	33	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	2654 GRIFFITH PARK	None	LOS ANGELES	CA	90039	2520	19	06037	34.10657797	-118.2720979	Los Angeles County
218776	Fee-for-Service	1902917503	1902917503	1	1	WUN, CINDY S MD	7/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72936	25	Physical Medicine and Rehabilitation	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
218820	Fee-for-Service	1730267469	1730267469	1	1	WALTER, ANDREW J MD	6/16/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	74934	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
218834	Fee-for-Service	1992101497	1992101497	1	1	WEBER, TAMARA LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1320 STANDIFORD AVE	STE 5	MODESTO	CA	95350	0726	50	06099	37.68934252	-121.0140405	Stanislaus County
218845	Fee-for-Service	1225044886	1225044886	1	1	WALGREENS CO.	2/25/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 S RIVERSIDE AVE	None	RIALTO	CA	92376	7028	36	06071	34.09069396	-117.3703752	San Bernardino County
218887	Fee-for-Service	1639307341	1639307341	1	1	WOODS, CAROLINE E MD	1/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121132	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
218888	Fee-for-Service	1982102869	1982102869	1	1	WATT, JONEE LCSW	1/29/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	637 E ALBERTONI ST	STE 104	CARSON	CA	90746	1543	19	06037	33.87193192	-118.2647009	Los Angeles County
218902	Fee-for-Service	1285016634	1285016634	1	1	WAGNER, ARIEL E MD	11/2/2017	390200000X	NA	Other	026	PHYSICIANS	144187	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
218907	Fee-for-Service	1881768653	1881768653	1	1	WATSON, LUKE R MD	8/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	60383	22	Pathology (M.D. only)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
218949	Fee-for-Service	1972685949	1972685949	1	1	WONG, WADE MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	3872	30	Radiology	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
218955	Fee-for-Service	1548945280	1548945280	1	1	WELL HEALTH SERVICES INC.	1/22/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	553 N WESTLAWN AVE	None	FRESNO	CA	93723	9624	10	06019	36.744705	-119.9517965	Fresno County
218985	Fee-for-Service	1922186741	1922186741	1	1	WILKES, KENNETH R MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	58353	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
218986	Fee-for-Service	1174824841	1174824841	1	1	WU, JUSTIN DO	4/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	11281	41	Internal Medicine	0	In state provider	None	5451 LA PALMA AVE	SUITE 25	LA PALMA	CA	90623	5451	30	06059	33.84643146	-118.038843	Orange County
219021	Fee-for-Service	1033538608	1033538608	1	1	WARSHESKI, STEPHANIE J MD	3/8/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	121952	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
219040	Fee-for-Service	1861019564	1861019564	1	1	WANGSNES, NOLAN D NP	8/17/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
219050	Fee-for-Service	1467630764	1467630764	1	1	WESTERN HEALTH RESOURCES	1/1/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	100 SAN HEDRIN CIRCLE	None	WILLITS	CA	95490	8753	23	06045	39.390957	-123.3361455	Mendocino County
219057	Fee-for-Service	1003436064	1003436064	1	33	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	2654 GRIFFITH PARK	None	LOS ANGELES	CA	90039	2520	19	06037	34.10657797	-118.2720979	Los Angeles County
219075	Fee-for-Service	1235951765	1235951765	1	1	WOODS, IRIE	2/22/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	39	06077	0	0	None
219143	Fee-for-Service	1023266202	1023266202	1	1	WELSH, BRITT K LCSW	10/9/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
219154	Fee-for-Service	1174554497	1174554497	1	1	WANG, SHING-CHIA CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	5814 TEMPLE CITY BLVD	None	TEMPLE CITY	CA	91780	2112	19	06037	34.10537289	-118.0605683	Los Angeles County
219198	Fee-for-Service	1265645691	1265645691	1	1	WARD, KIMBERLY A LCSW	6/17/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2460 W 3RD ST	220	SANTA ROSA	CA	95401	6408	49	06097	38.437731	-122.7692385	Sonoma County
219226	Fee-for-Service	1164419784	1164419784	1	1	WEISER, BARBARA MD	2/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	43348	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
219236	Fee-for-Service	1972685949	1972685949	1	1	WONG, WADE MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	3872	01	General Practice	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
219265	Fee-for-Service	1841340452	1841340452	1	1	WITLIN, STEVEN N MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	18702	41	Internal Medicine	0	In state provider	None	10100 CULVER BLVD	STE A	CULVER CITY	CA	90232	3175	19	06037	34.01935201	-118.3979919	Los Angeles County
219273	Fee-for-Service	1861752172	1861752172	1	1	WU, YOU M MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130748	41	Internal Medicine	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
219304	Fee-for-Service	1730596495	1730596495	1	1	WOGU & WOGU NEUROSURGICAL AN	10/4/2019	207T00000X	NA	General Surgery	026	PHYSICIANS	None	84	Surgery-Head and Neck	0	In state provider	D SPINE SERVICES INC	620 CALIFORNIA BLVD	SUITE J	SAN LUIS OBISPO	CA	93401	2598	40	06079	35.28923398	-120.6579938	San Luis Obispo County
219320	Fee-for-Service	1003436064	1003436064	1	10	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	1268 S LA CIENEGA BLVD	None	LOS ANGELES	CA	90035	2548	19	06037	34.05353604	-118.3761483	Los Angeles County
219327	Fee-for-Service	1851966717	1851966717	1	1	WONG, MEI M LCSW	2/4/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
219330	Fee-for-Service	1003887993	1003887993	1	1	WARREN, JAMES T MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74956	40	Pediatrics	0	In state provider	None	160 E ARTESIA ST	STE 150	POMONA	CA	91767	2994	19	06037	34.07556833	-117.7507835	Los Angeles County
219336	Fee-for-Service	1881135457	1881135457	1	1	WESTERN PHYSICAL THERAPY INC	5/30/2017	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	50 NUGGET LANE	STE A	WEAVERVILLE	CA	96093	2120	53	06105	40.72205851	-122.9293599	Trinity County
219365	Fee-for-Service	1659469526	1659469526	1	1	WECHSLER, ERIC A MD	7/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84767	41	Internal Medicine	0	In state provider	None	3300 E SOUTH ST	STE 110	LONG BEACH	CA	90805	4550	19	06037	33.86018093	-118.1537163	Los Angeles County
219384	Fee-for-Service	1003574120	1003574120	1	1	WILKEY, TAYLOR PT	3/28/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1350 O STREET	201	FRESNO	CA	93721	1828	10	06019	36.74132042	-119.7891324	Fresno County
219418	Fee-for-Service	1225561939	1225561939	1	1	WILLIAMSON, TYLER R MD	7/20/2022	390200000X	NA	Other	026	PHYSICIANS	177935	None	None	0	In state provider	None	1139 THIRD STREET	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
219453	Fee-for-Service	1164666848	1164666848	1	1	WADHWANI, ZINAIDA MD	1/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133213	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
219458	Fee-for-Service	1932126281	1932126281	1	1	WAL-MART STORES, INC	5/21/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101756	17151 FOOTHILL BLVD	None	FONTANA	CA	92335	9046	36	06071	34.1065495	-117.4306635	San Bernardino County
219469	Fee-for-Service	1205241148	1205241148	1	1	WILDER, INGA MD	5/6/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	138883	None	None	0	In state provider	None	451 W GONZALES RD	STE 230	OXNARD	CA	93036	0719	56	06111	34.21921445	-119.1816945	Ventura County
219521	Fee-for-Service	1891722120	1891722120	1	1	WOLCOTT, PATRICK MD	8/31/1988	174400000X	NA	Other	026	PHYSICIANS	55463	41	Internal Medicine	0	In state provider	None	9850 GENESEE AVE	STE 780	LA JOLLA	CA	92037	1232	37	06073	32.882913	-117.226341	San Diego County
219559	Fee-for-Service	1467707968	1467707968	1	1	WAGNER, LORI V	3/18/2013	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
219576	Fee-for-Service	1407418791	1407418791	1	1	WIEGERS, JEFFREY MD	2/26/2024	207L00000X	NA	Other	026	PHYSICIANS	181657	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
219594	Fee-for-Service	1730596495	1730596495	1	1	WOGU & WOGU NEUROSURGICAL AN	10/4/2019	207T00000X	NA	General Surgery	026	PHYSICIANS	None	33	Thoracic Surgery	0	In state provider	D SPINE SERVICES INC	620 CALIFORNIA BLVD	SUITE J	SAN LUIS OBISPO	CA	93401	2598	40	06079	35.28923398	-120.6579938	San Luis Obispo County
219607	Fee-for-Service	1467597815	1467597815	1	1	WOLMAN, CAROL S MD	11/29/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	17507	None	None	0	In state provider	None	406 41ST ST	None	OAKLAND	CA	94609	2511	01	06001	37.82935145	-122.2600713	Alameda County
219608	Fee-for-Service	1003436064	1003436064	1	10	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	1268 S LA CIENEGA BLVD	None	LOS ANGELES	CA	90035	2548	19	06037	34.05353604	-118.3761483	Los Angeles County
219620	Fee-for-Service	1346498201	1346498201	1	1	WALKER, ERIC J DC	7/7/2020	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3015 CALLOWAY DR	STE D6	BAKERSFIELD	CA	93312	2658	15	06029	35.38792975	-119.1100752	Kern County
219644	Fee-for-Service	1881955342	1881955342	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	30491 AVENIDA DE LAS FLO	None	RANCHO SANTA MARG	CA	92688	3923	30	06059	33.64094653	-117.5998308	Orange County
219654	Fee-for-Service	1659469526	1659469526	1	1	WECHSLER, ERIC A MD	7/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84767	45	Nephrology (Renal-Kidney)	0	In state provider	None	3300 E SOUTH ST	STE 110	LONG BEACH	CA	90805	4550	19	06037	33.86018093	-118.1537163	Los Angeles County
219804	Fee-for-Service	1063726057	1063726057	1	1	WAYNE LEE CHRISTENSEN	11/10/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	TAYLOR MARKETING SERVICE	6380 TUPELO DRIVE	SUITE 4	CITRUS HEIGHTS	CA	95621	1762	34	06067	38.704131	-121.314798	Sacramento County
219810	Fee-for-Service	1881773810	1881773810	1	1	WADLINGTON, STACY M PHD	1/16/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
219812	Fee-for-Service	1891722120	1891722120	1	1	WOLCOTT, PATRICK MD	8/31/1988	174400000X	NA	Other	026	PHYSICIANS	55463	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	9850 GENESEE AVE	STE 780	LA JOLLA	CA	92037	1232	37	06073	32.882913	-117.226341	San Diego County
219824	Fee-for-Service	1790777852	1790777852	1	1	WINETZ, JAN A MD	3/1/1984	207RN0300X	NA	Nephrology	026	PHYSICIANS	41245	01	General Practice	0	In state provider	None	2505 SAMARITAN DR	STE 405	SAN JOSE	CA	95124	4013	43	06085	37.25111447	-121.9483395	Santa Clara County
219855	Fee-for-Service	1710075411	1710075411	1	1	WOLFE, PHILLIP A MD	4/1/1999	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	83272	10	Gastroenterology (M.D. only)	0	In state provider	None	5575 W LAS POSITAS BLVD	STE 320	PLEASANTON	CA	94588	5804	01	06001	37.69214859	-121.8796532	Alameda County
219879	Fee-for-Service	1225091945	1225091945	1	1	WOLIN, ELY A MD	12/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139651	42	Nuclear Medicine	0	In state provider	None	3161 L STREET	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
219880	Fee-for-Service	1770102204	1770102204	1	1	WONG, CHRISTOPHER W MD	6/6/2023	207P00000X	NA	Other	026	PHYSICIANS	184900	None	None	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
219890	Fee-for-Service	1588670731	1588670731	1	1	WEIST, DAVID J MD PC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51285	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
219970	Fee-for-Service	1053607879	1053607879	1	1	WALLMAN, MEGHAN M MD	10/29/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162238	15	Obstetrics (D.O. only)	0	In state provider	None	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	42	06083	34.42967671	-119.7228362	Santa Barbara County
219984	Fee-for-Service	1538811922	1538811922	1	1	WECARE HEALTH LLC	6/14/2024	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	1190 W 6TH ST	None	CORONA	CA	92882	3133	33	06065	33.87754974	-117.5868611	Riverside County
219993	Fee-for-Service	1497760771	1497760771	1	1	WALGREEN CO	12/13/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1528 E. FREMONT ST	None	STOCKTON	CA	95205	2639	39	06077	37.96089072	-121.2718644	San Joaquin County
220097	Fee-for-Service	1891722120	1891722120	1	1	WOLCOTT, PATRICK MD	8/31/1988	174400000X	NA	Other	026	PHYSICIANS	55463	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9850 GENESEE AVE	STE 780	LA JOLLA	CA	92037	1232	37	06073	32.882913	-117.226341	San Diego County
220110	Fee-for-Service	1790777852	1790777852	1	1	WINETZ, JAN A MD	3/1/1984	207RN0300X	NA	Nephrology	026	PHYSICIANS	41245	41	Internal Medicine	0	In state provider	None	2505 SAMARITAN DR	STE 405	SAN JOSE	CA	95124	4013	43	06085	37.25111447	-121.9483395	Santa Clara County
220125	Fee-for-Service	1962733022	1962733022	1	1	WATTS HEALTHCARE CORPORATION	5/2/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	8005 S FIGUEROA ST	None	LOS ANGELES	CA	90003	2720	19	06037	33.966369	-118.2827465	Los Angeles County
220142	Fee-for-Service	1710075411	1710075411	1	1	WOLFE, PHILLIP A MD	4/1/1999	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	83272	41	Internal Medicine	0	In state provider	None	5575 W LAS POSITAS BLVD	STE 320	PLEASANTON	CA	94588	5804	01	06001	37.69214859	-121.8796532	Alameda County
220154	Fee-for-Service	1851318190	1851318190	1	1	WAL-MART STORE, INC	1/10/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHMCY 10-1692	1120 S MOUNT VERNON AVE	None	COLTON	CA	92324	4220	36	06071	34.049673	-117.3067155	San Bernardino County
220165	Fee-for-Service	1437354081	1437354081	1	1	WEI, DAVID A MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112876	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4383	01	06001	37.63347961	-122.0897735	Alameda County
220191	Fee-for-Service	1760718944	1760718944	1	1	WIITA, ARUN P MD	10/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115177	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
220195	Fee-for-Service	1831535236	1831535236	1	1	WILLIS, MACEY L LMFT	12/17/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	STE 201	NORWALK	CA	90650	9323	19	06037	33.90523023	-118.0681168	Los Angeles County
220203	Fee-for-Service	1972922094	1972922094	1	1	WAL-MART STORES, INC	6/18/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	25755 BARTON ROAD	None	LOMA LINDA	CA	92354	3812	36	06071	34.04826462	-117.2422457	San Bernardino County
220253	Fee-for-Service	1417244591	1417244591	1	1	WATKINS, FRED M MD	11/17/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	117467	01	General Practice	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
220289	Fee-for-Service	1144209222	1144209222	1	1	WANKEL, ALBERT J MD	1/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89182	02	General Surgery	0	In state provider	None	5196 HILL RD EAST	SUITE 300	SANTA ROSA	CA	95401	0000	49	06097	38.47501678	-122.8650455	Sonoma County
220302	Fee-for-Service	1457186371	1457186371	1	1	WHOLE SYSTEMS LEARNING	9/27/2024	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	161 W. VICTORIA STREET	SUITE 255	LONG BEACH	CA	90805	2175	19	06037	33.86489618	-118.2026866	Los Angeles County
220314	Fee-for-Service	1982037859	1982037859	1	1	WAVE IMAGING LLC	2/27/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	3300 WEST COAST HWY	STE B	NEWPORT BEACH	CA	92663	4026	30	06059	33.62136043	-117.9274297	Orange County
220328	Fee-for-Service	1790045292	1790045292	1	3	WECARE PHARMACEUTICAL SERVIC	9/6/2024	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2121 N D STREET	None	SAN BERNARDINO	CA	92405	3915	36	06071	34.13517012	-117.2918777	San Bernardino County
220331	Fee-for-Service	1487806550	1487806550	1	1	WHITE, SHARON	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
220359	Fee-for-Service	1003436064	1003436064	1	73	WS AUDIOLOGY (CALIFORNIA), P	3/13/2025	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	21787 VENTURA BLVD	None	WOODLAND HILLS	CA	91364	1835	19	06037	34.16845346	-118.602765	Los Angeles County
220428	Fee-for-Service	1730266362	1730266362	1	1	WANG, SUNNY MD	2/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	87068	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
220449	Fee-for-Service	1558449157	1558449157	1	1	WONG, CORINNE MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78813	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
220482	Fee-for-Service	1831501089	1831501089	1	1	WHITE, COURTNEY K MD	6/23/2020	208600000X	NA	General Surgery	026	PHYSICIANS	145761	02	General Surgery	0	In state provider	None	121 SOTOYOME ST	None	SANTA ROSA	CA	95405	4823	49	06097	38.44224	-122.70195	Sonoma County
220583	Fee-for-Service	1780442954	1780442954	1	1	WALK WITH HARMONY FAMILY COU	9/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NSELING SERVICES, INC.	6777 N. WILLOW AVE.	None	FRESNO	CA	93710	9371	10	06019	36.83465436	-119.7311422	Fresno County
220613	Fee-for-Service	1801451000	1801451000	1	1	WIXSON, MOLLY LMFT	9/10/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
220651	Fee-for-Service	1609287127	1609287127	1	1	WAL-MART STORES, INC	6/12/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1804 E ASHLAN AVE	None	FRESNO	CA	93726	3807	10	06019	36.792711	-119.789226	Fresno County
220663	Fee-for-Service	1447265731	1447265731	1	1	WALGREEN CO.	10/5/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	610 E NEES AVE	None	FRESNO	CA	93720	2198	10	06019	36.8520345	-119.773917	Fresno County
220672	Fee-for-Service	1447310404	1447310404	1	1	WATKINS, SUSAN	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
220699	Fee-for-Service	1750886248	1750886248	1	1	WANG, DANNY H DPM	9/1/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1700 CESAR E CHAVEZ AVE	STE 2200	LOS ANGELES	CA	90033	2476	19	06037	34.05101259	-118.217259	Los Angeles County
220716	Fee-for-Service	1730266362	1730266362	1	1	WANG, SUNNY MD	2/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	87068	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
220727	Fee-for-Service	1194783530	1194783530	1	1	WALKER, BRADLEY S MD	1/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73117	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 W E ST	None	TEHACHAPI	CA	93561	1607	15	06029	35.13009994	-118.4488237	Kern County
220785	Fee-for-Service	1700329687	1700329687	1	1	WALKER, KATHRYN NP	7/25/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
220819	Fee-for-Service	1649529926	1649529926	1	1	WIECHEC, JESSICA N PHD	10/6/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
220840	Fee-for-Service	1114124096	1114124096	1	1	WOO, MICHELLE K	5/3/2011	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
220850	Fee-for-Service	1134201171	1134201171	1	1	WIDMAN, RONALD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5301 E GRANT RD	None	TUCSON	AZ	85712	2805	00	None	32.252391	-110.8790055	Pima County
220855	Fee-for-Service	1073619896	1073619896	1	1	WEST, DAVID P OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1183 E FOOTHILL BLVD	None	UPLAND	CA	91786	9999	36	06071	34.10724648	-117.6359175	San Bernardino County
220900	Fee-for-Service	1215288105	1215288105	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	421 W ESPLANADE DR	None	OXNARD	CA	93036	1298	56	06111	34.2364863	-119.1784188	Ventura County
220909	Fee-for-Service	1417943184	1417943184	1	1	WENDER, RONALD H MD	6/23/1992	207L00000X	NA	Other	026	PHYSICIANS	25970	05	Anesthesiology	0	In state provider	None	11601 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2907	19	06037	34.04458879	-118.4542015	Los Angeles County
220921	Fee-for-Service	1255424297	1255424297	1	1	WONG, GARY H MD	11/30/1987	207R00000X	NA	Other	026	PHYSICIANS	58745	01	General Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
220954	Fee-for-Service	1003436064	1003436064	1	56	WS AUDIOLOGY (CALIFORNIA), P	8/9/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3920 GRAND	SUITE E	CHINO	CA	91710	5484	36	06071	33.99859228	-117.7190491	San Bernardino County
220977	Fee-for-Service	1649317462	1649317462	1	1	WIKKELING, DAKARI LCSW	7/23/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
220982	Fee-for-Service	1831300284	1831300284	1	1	WONG, PETER L MD	9/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	112472	02	General Surgery	0	In state provider	None	520 WEST I STREET	None	LOS BANOS	CA	93635	3419	24	06047	37.06346603	-120.8593647	Merced County
221003	Fee-for-Service	1417051657	1417051657	1	1	WONG, VINCENT W MD	7/31/1991	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	950 STOCKTON ST	STE 202	SAN FRANCISCO	CA	94108	1619	38	06075	37.79469747	-122.4079497	San Francisco County
221014	Fee-for-Service	1194783530	1194783530	1	1	WALKER, BRADLEY S MD	1/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73117	08	Family Practice	0	In state provider	None	115 W E ST	None	TEHACHAPI	CA	93561	1607	15	06029	35.13009994	-118.4488237	Kern County
221166	Fee-for-Service	1407053366	1407053366	1	1	WHITNEY, SUSAN E LMFT	8/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
221191	Fee-for-Service	1598052953	1598052953	1	1	WILLIAMS, JASON P MD	2/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123159	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
221196	Fee-for-Service	1023411642	1023411642	1	1	WAT, MARISSA L CRNA	5/6/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
221215	Fee-for-Service	1457061863	1457061863	1	1	WAX, NADINE K LCSW	5/19/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
221225	Fee-for-Service	1063472827	1063472827	1	1	WANG, YAN MD	2/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76292	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
221233	Fee-for-Service	1861140832	1861140832	1	1	WE CARE FOR YOU TRANSPORT	3/29/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2879 SHIELDS LN	None	FORTUNA	CA	95540	3241	12	06023	40.57632969	-124.1344989	Humboldt County
221367	Fee-for-Service	1982686432	1982686432	1	1	WOLPAW, ELEANORE MD	11/30/1982	207R00000X	NA	Other	026	PHYSICIANS	39053	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
221429	Fee-for-Service	1225126444	1225126444	1	1	WEISS, NOAH D MD	12/31/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	70397	None	None	0	In state provider	None	100 ROWLAND WAY	SUITE 200	NOVATO	CA	94945	5011	21	06041	38.09698106	-122.5587348	Marin County
221439	Fee-for-Service	1144784158	1144784158	1	1	WILLIS, DALYNNE S NP	11/1/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2825 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	6039	34	06067	38.570805	-121.4696385	Sacramento County
221449	Fee-for-Service	1013060268	1013060268	1	1	WALKER, MARY E LMFT	12/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
221451	Fee-for-Service	1023470317	1023470317	1	1	WHITNEY, MALINDA D NP	9/20/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
221486	Fee-for-Service	1336373992	1336373992	1	1	WEERAHANDI, HIMALI M MD	11/3/2022	208M00000X	NA	Other	026	PHYSICIANS	178975	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
221509	Fee-for-Service	1750918306	1750918306	1	1	WESTERMAN, VERONICA E NP	7/27/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
221529	Fee-for-Service	1992806962	1992806962	1	1	WISE, KRISTIN PT	6/20/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	42	06083	34.45144647	-119.7604485	Santa Barbara County
221597	Fee-for-Service	1952475550	1952475550	1	1	WEISSHAAR, DANA M MD	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	75915	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
221607	Fee-for-Service	1598250219	1598250219	1	1	WHISLER, EMILY DO	9/27/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	19623	36	Psychiatry	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
221666	Fee-for-Service	1003997024	1003997024	1	1	WANG, CHRISTINE M MD	8/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	91525	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
221692	Fee-for-Service	1265536601	1265536601	1	1	WOLOSIN, JAMES D MD	10/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	51643	01	General Practice	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
221720	Fee-for-Service	1609165299	1609165299	1	1	WHATLEY, SARA D DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	12381	01	General Practice	0	In state provider	None	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
221740	Fee-for-Service	1518996602	1518996602	1	1	WIAN, DEBORAH L	5/2/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
221765	Fee-for-Service	1609961739	1609961739	1	1	WIRYAWAN, BUDI MD	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136504	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
221811	Fee-for-Service	1346349347	1346349347	1	1	WARD, BETH E MD	7/1/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	79562	40	Pediatrics	0	In state provider	None	3133 PROFESSIONAL DR	STE 20	AUBURN	CA	95603	2463	31	06061	38.9412	-121.100888	Placer County
221822	Fee-for-Service	1265655203	1265655203	1	1	WINSTON, DREW J MD	11/30/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	34770	41	Internal Medicine	0	In state provider	None	13351 RIVERSIDE DR	STE D	SHERMAN OAKS	CA	91423	2542	19	06037	34.15764051	-118.4235165	Los Angeles County
221874	Fee-for-Service	1861551467	1861551467	1	1	WONG, PAUL J MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	48411	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
221879	Fee-for-Service	1740273697	1740273697	1	1	WORLD WIDE MEDICAL SERVICES	12/21/2015	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	INC	8508 BENJAMIN RD	SUITE D	TAMPA	FL	33634	1421	00	None	28.02746646	-82.5397335	Hillsborough County
221888	Fee-for-Service	1336534940	1336534940	1	1	WORRALL, DOUGLAS M MD	8/28/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	167505	84	Surgery-Head and Neck	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
221956	Fee-for-Service	1134318454	1134318454	1	1	WOLF, TERRI JANE	12/1/2007	163WH0200X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1916 MAXSON ST	None	OCEANSIDE	CA	92054	3417	37	06073	33.19979146	-117.36216	San Diego County
221974	Fee-for-Service	1194206177	1194206177	1	1	WAASDORP, SUSAN LCSW	4/8/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
221978	Fee-for-Service	1265536601	1265536601	1	1	WOLOSIN, JAMES D MD	10/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	51643	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
222021	Fee-for-Service	1932193596	1932193596	1	1	WILLIAMS, CHRISTOPHER MD	2/13/2023	207RH0002X	NA	Adult Primary Care	026	PHYSICIANS	143116	None	None	0	In state provider	None	1221 E SPRUCE AVE	None	FRESNO	CA	93720	3374	10	06019	36.84197867	-119.761714	Fresno County
222053	Fee-for-Service	1609874510	1609874510	1	1	WIRTH, STEVEN C MD	1/1/2001	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79607	08	Family Practice	0	In state provider	None	721 S DORA ST	None	UKIAH	CA	95482	5301	23	06045	39.14429382	-123.2111557	Mendocino County
222059	Fee-for-Service	1972526457	1972526457	1	1	WU, SIDNEY S MD	7/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78985	41	Internal Medicine	0	In state provider	None	245 TERRACINA BLVD	STE 207A	REDLANDS	CA	92373	4869	36	06071	34.03858912	-117.2066515	San Bernardino County
222093	Fee-for-Service	1326143322	1326143322	1	1	WU, PETER C MD	3/25/1999	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	72283	41	Internal Medicine	0	In state provider	None	1740 FRUITRIDGE RD	None	SACRAMENTO	CA	95822	3037	34	06067	38.524374	-121.498542	Sacramento County
222112	Fee-for-Service	1336728658	1336728658	1	1	WIBOWO, MELISSA MD	5/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	183198	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
222121	Fee-for-Service	1528012168	1528012168	1	1	WISHON RAD MED GRP INC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SPLIT RADIOLOGY	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
222124	Fee-for-Service	1366974305	1366974305	1	1	WU, JULIE J MD	8/26/2021	208M00000X	NA	Other	026	PHYSICIANS	172955	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
222162	Fee-for-Service	1861551467	1861551467	1	1	WONG, PAUL J MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	48411	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
222176	Fee-for-Service	1033164389	1033164389	1	1	WAYNE STRAUSS MD	6/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1111 NE 99TH AVE	STE 200	PORTLAND	OR	97220	9442	00	None	45.53099912	-122.562389	Multnomah County
222206	Fee-for-Service	1336546829	1336546829	1	1	WESTCARE CALIFORNIA, INC	12/5/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1259 N 13TH AVE	ROOMS 203,209,210,306	HANFORD	CA	93230	9219	16	06031	36.33158355	-119.6909109	Kings County
222244	Fee-for-Service	1134318454	1134318454	1	1	WOLF, TERRI JANE	12/1/2007	163WH0200X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1916 MAXSON ST	None	OCEANSIDE	CA	92054	3417	37	06073	33.19979146	-117.36216	San Diego County
222258	Fee-for-Service	1467787911	1467787911	1	1	WEI, JENNIE C MD	4/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112698	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
222269	Fee-for-Service	1568406536	1568406536	1	1	WHITE COUNTY MED CTR	8/9/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3214 EAST RACE AVE	None	SEARCY	AR	72143	4810	00	None	35.251299	-91.697913	White County
222304	Fee-for-Service	1447375480	1447375480	1	1	WRIGHT, RICHARD J MD	9/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122402	04	Otology, Laryngology, Rhinology	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
222335	Fee-for-Service	1609874510	1609874510	1	1	WIRTH, STEVEN C MD	1/1/2001	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79607	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	721 S DORA ST	None	UKIAH	CA	95482	5301	23	06045	39.14429382	-123.2111557	Mendocino County
222347	Fee-for-Service	1972526457	1972526457	1	1	WU, SIDNEY S MD	7/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78985	40	Pediatrics	0	In state provider	None	245 TERRACINA BLVD	STE 207A	REDLANDS	CA	92373	4869	36	06071	34.03858912	-117.2066515	San Bernardino County
222361	Fee-for-Service	1619130994	1619130994	1	1	WEISSMAN, JEFFREY S MD	8/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103001	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
222373	Fee-for-Service	1538174826	1538174826	1	1	WALGREEN CO.	9/28/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2627 PACIFIC AVE	None	LONG BEACH	CA	90806	2610	19	06037	33.80511396	-118.1937379	Los Angeles County
222383	Fee-for-Service	1326054701	1326054701	1	1	WALGREEN CO.	9/17/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7299 LAGUNA BLVD	None	ELK GROVE	CA	95758	5059	34	06067	38.424105	-121.418532	Sacramento County
222393	Fee-for-Service	1134234289	1134234289	1	1	WATSON, DANIEL L PHD	4/30/1991	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	73567 FRED WARING DR	None	PALM DESERT	CA	92260	2573	33	06065	33.72875053	-116.3812905	Riverside County
222436	Fee-for-Service	1023372752	1023372752	1	1	WUSSLER, JILL M LCSW	5/12/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	624 W 9TH ST	103	SAN PEDRO	CA	90731	3158	19	06037	33.73607853	-118.290789	Los Angeles County
222442	Fee-for-Service	1275562878	1275562878	1	1	WOODBURY, JOHN B II DO	6/15/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	5306	08	Family Practice	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4932	39	06077	37.80110374	-121.1974853	San Joaquin County
222474	Fee-for-Service	1235127457	1235127457	1	1	WARD, JAMES M MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53117	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
222544	Fee-for-Service	1598705212	1598705212	1	1	WALDMAN, STEPHANIE	8/24/2004	207L00000X	NA	Other	026	PHYSICIANS	62793	05	Anesthesiology	0	In state provider	None	301 N NEWPORT BLVD	None	NEWPORT BEACH	CA	92663	4120	30	06059	33.6242782	-117.9284249	Orange County
222560	Fee-for-Service	1568406536	1568406536	1	1	WHITE COUNTY MED CTR	8/9/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3214 EAST RACE AVE	None	SEARCY	AR	72143	4810	00	None	35.251299	-91.697913	White County
222607	Fee-for-Service	1508240771	1508240771	1	1	WILHELMI, BREANNA	4/2/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
222626	Fee-for-Service	1609874510	1609874510	1	1	WIRTH, STEVEN C MD	1/1/2001	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79607	01	General Practice	0	In state provider	None	721 S DORA ST	None	UKIAH	CA	95482	5301	23	06045	39.14429382	-123.2111557	Mendocino County
222655	Fee-for-Service	1285863613	1285863613	1	1	WILLIAMS, JOSHUA J PHD	9/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
222671	Fee-for-Service	1215357223	1215357223	1	1	WU, MELANIE DO	11/26/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	14385	None	None	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
222679	Fee-for-Service	1487926275	1487926275	1	1	WILLMAN, JESSICA P LCSW	10/28/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15 ILAHEE	STE 150	CHICO	CA	95973	7205	04	06007	39.75224248	-121.8701858	Butte County
222683	Fee-for-Service	1700994498	1700994498	1	1	WYATT, GAIL E PHD	6/28/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
222712	Fee-for-Service	1982638037	1982638037	1	1	WASSERSTROM,ROBERT MD	11/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 POLELINE RD WEST	None	TWIN FALLS	ID	83301	5801	00	None	42.5915786	-114.4956223	Twin Falls County
222730	Fee-for-Service	1073531356	1073531356	1	1	WOOLF, MURRAY A MD	8/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	40159	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1710 PENNSYLVANIA AVE	STE D	FAIRFIELD	CA	94533	3549	48	06095	38.260476	-122.0498715	Solano County
222731	Fee-for-Service	1275562878	1275562878	1	1	WOODBURY, JOHN B II DO	6/15/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	5306	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4932	39	06077	37.80110374	-121.1974853	San Joaquin County
222750	Fee-for-Service	1942442611	1942442611	1	1	WHITLEY, BRIAN T LMFT	2/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1001 DOVE ST	SUITE 180	NEWPORT BEACH	CA	92660	2816	30	06059	33.65946971	-117.8644015	Orange County
222771	Fee-for-Service	1205147113	1205147113	1	1	WERTZ, DIANA L MD	3/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119989	36	Psychiatry	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
222829	Fee-for-Service	1508398926	1508398926	1	1	WANG, JUSTIN MD	6/8/2021	207L00000X	NA	Other	026	PHYSICIANS	157032	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
222864	Fee-for-Service	1194855148	1194855148	1	1	WEIL, MONICA L PHD	10/14/2011	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4419 VAN NUYS BLVD	STE 409	SHERMAN OAKS	CA	91403	5745	19	06037	34.151697	-118.448716	Los Angeles County
222894	Fee-for-Service	1922166305	1922166305	1	2	WONG, PATRICIA C MD	5/1/1995	207W00000X	NA	Ophthalmology	026	PHYSICIANS	76306	18	Ophthalmology	0	In state provider	None	491 30TH ST	STE 103	OAKLAND	CA	94609	3235	01	06001	37.81935528	-122.2667902	Alameda County
222923	Fee-for-Service	1952342693	1952342693	1	2	WONG, DARRYL S MD	3/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	70557	07	Dermatology	0	In state provider	None	3629 VISTA WAY	None	OCEANSIDE	CA	92056	4522	37	06073	33.1814285	-117.3093613	San Diego County
222963	Fee-for-Service	1902197114	1902197114	1	1	WILLIS, TAIA L LMFT	1/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	777 DAVIS ST	None	SAN LEANDRO	CA	94577	6923	01	06001	37.72317409	-122.162925	Alameda County
223020	Fee-for-Service	1073531356	1073531356	1	1	WOOLF, MURRAY A MD	8/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	40159	04	Otology, Laryngology, Rhinology	0	In state provider	None	1710 PENNSYLVANIA AVE	STE D	FAIRFIELD	CA	94533	3549	48	06095	38.260476	-122.0498715	Solano County
223038	Fee-for-Service	1063402816	1063402816	1	1	WEXMAN, MARK P MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	46721	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4141 GEARY BLVD	RM 322	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
223047	Fee-for-Service	1073876090	1073876090	1	1	WILL, MICHAEL L MD	10/24/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	136246	08	Family Practice	0	In state provider	None	42575 WASHINGTON ST	None	PALM DESERT	CA	92211	8850	33	06065	33.739767	-116.3039465	Riverside County
223048	Fee-for-Service	1780655852	1780655852	1	1	WESTERMEYER, ROBERT R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	400 W 16TH ST	None	PUEBLO	CO	81003	2745	00	None	38.28171999	-104.6119963	Pueblo County
223078	Fee-for-Service	1649323957	1649323957	1	1	WONG, VICTOR J OD	10/16/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
223108	Fee-for-Service	1679063499	1679063499	1	1	WALKER, LINDSAY B MD	10/15/2021	207P00000X	NA	Other	026	PHYSICIANS	174467	None	None	0	In state provider	None	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
223131	Fee-for-Service	1538254339	1538254339	1	1	WEHNER, JOHN H MD	12/1/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	66620	03	Allergy	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
223151	Fee-for-Service	1073003273	1073003273	1	1	WU, MENGJIE MD	1/9/2024	207L00000X	NA	Other	026	PHYSICIANS	184959	None	None	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
223175	Fee-for-Service	1831305242	1831305242	1	1	WILES, STACEY D MD	1/27/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	93227	40	Pediatrics	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
223246	Fee-for-Service	1164058046	1164058046	1	1	WELLSPECT INC	4/8/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1235 FRIENDSHIP RD	SUITE 205	BRASELTON	GA	30517	5626	00	None	34.12177834	-83.82913044	Hall County
223264	Fee-for-Service	1972526457	1972526457	1	2	WU, SIDNEY S MD	1/1/2005	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	11175 CAMPUS ST COLEMAN	PAVILION RM A1121	LOMA LINDA	CA	92354	1700	36	06071	34.05060717	-117.2656018	San Bernardino County
223304	Fee-for-Service	1871844472	1871844472	1	1	WEEMS, UR A LCSW	9/19/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	572 RIO LINDO AVE.	203	CHICO	CA	95926	1851	04	06007	39.75508407	-121.8487933	Butte County
223313	Fee-for-Service	1366039034	1366039034	1	1	WELFARE HOME HEALTH INC	8/16/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14349 VICTORY BLVD	STE 205B	VAN NUYS	CA	91401	1950	19	06037	34.18669646	-118.4460435	Los Angeles County
223314	Fee-for-Service	1356346597	1356346597	1	1	WILLE, CATHERINE A MD	12/21/2011	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	43660	08	Family Practice	0	In state provider	None	4011 N FRESNO ST	STE 101	FRESNO	CA	93726	4028	10	06019	36.79061495	-119.7814544	Fresno County
223316	Fee-for-Service	1003436064	1003436064	1	77	WS AUDIOLOGY (CALIFORNIA), P	11/26/2024	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	2514 JAMACHA RD	501	EL CAJON	CA	92019	6313	37	06073	32.74460454	-116.930348	San Diego County
223338	Fee-for-Service	1518972892	1518972892	1	1	WALGREEN CO	2/10/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1833 N MILPITAS BLVD	None	MILPITAS	CA	95035	2734	43	06085	37.45652323	-121.9113373	Santa Clara County
223382	Fee-for-Service	1942978044	1942978044	1	1	WILLSMORE, SUSAN H LCSW	10/8/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
223443	Fee-for-Service	1477651842	1477651842	1	1	WOO, MARLYN S MD	12/4/1997	2080P0214X	NA	Pulmonology	026	PHYSICIANS	43254	78	Neoplastic Diseases/Oncology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
223466	Fee-for-Service	1356554448	1356554448	1	1	WU, YU-FEI F MD	2/8/2015	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	69605	40	Pediatrics	0	In state provider	None	12444 WASHINGTON BLVD	None	WHITTIER	CA	90602	1005	19	06037	33.96757592	-118.046351	Los Angeles County
223546	Fee-for-Service	1558381822	1558381822	1	1	WALLACE, SCOTT C MD	9/20/2013	207LP3000X	NA	Other	026	PHYSICIANS	115766	05	Anesthesiology	0	In state provider	None	1415 ROSS AVENUE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
223549	Fee-for-Service	1104456391	1104456391	1	1	WESTERN HEALTH RESOURCES	8/1/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	20100 CEDAR ROAD NORTH	None	SONORA	CA	95370	5925	55	06109	37.98700879	-120.3663189	Tuolumne County
223570	Fee-for-Service	1356365290	1356365290	1	1	WONG, HUBERT E MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73672	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	# A108	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
223604	Fee-for-Service	1295952919	1295952919	1	1	WILSON, ARIEL CRNA	7/19/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
223607	Fee-for-Service	1003436064	1003436064	1	77	WS AUDIOLOGY (CALIFORNIA), P	11/26/2024	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	2514 JAMACHA RD	501	EL CAJON	CA	92019	6313	37	06073	32.74460454	-116.930348	San Diego County
223609	Fee-for-Service	1114932480	1114932480	1	1	WALGREEN CO.	1/28/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1661 W FLORIDA AVE	None	HEMET	CA	92543	3818	33	06065	33.74737153	-116.988629	Riverside County
223611	Fee-for-Service	1366460586	1366460586	1	1	WOODS, ROGER P	3/31/1991	2084N0400X	NA	Neurology	026	PHYSICIANS	62794	13	Neurology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
223618	Fee-for-Service	1154562957	1154562957	1	1	WIN, YIN L MD	12/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107903	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
223625	Fee-for-Service	1003436064	1003436064	1	61	WS AUDIOLOGY (CALIFORNIA), P	4/26/2022	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	23521 PASEO DE VALENCIA	SUITE 302A	LAGUNA HILLS	CA	92653	3107	30	06059	33.61113028	-117.7126684	Orange County
223671	Fee-for-Service	1669931754	1669931754	1	1	WOLBERT, JONATHAN G DO	10/7/2024	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	22773	25	Physical Medicine and Rehabilitation	0	In state provider	None	2120 PROFESSIONAL DR	None	ROSEVILLE	CA	95661	3700	31	06061	38.74247397	-121.2508672	Placer County
223721	Fee-for-Service	1871657197	1871657197	1	1	WINKELMANN, MICHAEL MD	8/26/2019	207P00000X	NA	Other	026	PHYSICIANS	156346	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 N NAME UNO	None	GILROY	CA	95020	3528	43	06085	37.03498475	-121.5729235	Santa Clara County
223732	Fee-for-Service	1477651842	1477651842	1	1	WOO, MARLYN S MD	12/4/1997	2080P0214X	NA	Pulmonology	026	PHYSICIANS	43254	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
223747	Fee-for-Service	1285774182	1285774182	1	1	WIEDMAN, TULLY R MD	2/23/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35371	08	Family Practice	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
223749	Fee-for-Service	1174986574	1174986574	1	1	WANG, CHRISTOPHER MD	5/10/2021	207R00000X	NA	Other	026	PHYSICIANS	161055	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
223758	Fee-for-Service	1023034725	1023034725	1	1	WILSON, DOUGLAS L MD	9/8/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	81870	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
223769	Fee-for-Service	1104002351	1104002351	1	1	WARING, STACEY A PSYD	10/18/2018	103TF0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4300 LONG BEACH BLVD	STE 340	LONG BEACH	CA	90807	2011	19	06037	33.83662572	-118.1900605	Los Angeles County
223824	Fee-for-Service	1528164753	1528164753	1	1	WILLIAMS, JEFFREY K MD	11/30/1990	174400000X	NA	Other	026	PHYSICIANS	59161	41	Internal Medicine	0	In state provider	None	1901 4TH AVE	STE 100	SAN DIEGO	CA	92101	2381	37	06073	32.72528373	-117.1611335	San Diego County
223836	Fee-for-Service	1104456391	1104456391	1	1	WESTERN HEALTH RESOURCES	8/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	20100 CEDAR ROAD NORTH	None	SONORA	CA	95370	5925	55	06109	37.98700879	-120.3663189	Tuolumne County
223887	Fee-for-Service	1962061648	1962061648	2	1	WALNUT CREEK RX LLC	6/9/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	112 LA CASA VIA	# 100	WALNUT CREEK	CA	94598	3091	07	06013	37.91229899	-122.0423696	Contra Costa County
223915	Fee-for-Service	1003436064	1003436064	1	61	WS AUDIOLOGY (CALIFORNIA), P	4/26/2022	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	23521 PASEO DE VALENCIA	SUITE 302A	LAGUNA HILLS	CA	92653	3107	30	06059	33.61113028	-117.7126684	Orange County
223918	Fee-for-Service	1003436064	1003436064	1	19	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	301 ALESSANDRO	SUITE 3C	RIVERSIDE	CA	92508	2486	33	06065	33.914196	-117.3287655	Riverside County
223971	Fee-for-Service	1063008274	1063008274	1	1	WONG, LIANNA OT	6/28/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1055 E COLORADO BLVD	STE 500	PASADENA	CA	91106	2380	19	06037	34.14595648	-118.1287575	Los Angeles County
223972	Fee-for-Service	1124414198	1124414198	1	1	WANG, DAVID WEI MD INC	2/12/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	37520	40	Pediatrics	0	In state provider	None	210 N GARFIELD AVE	STE 300	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
224006	Fee-for-Service	1528312055	1528312055	1	1	WANG, SHIH-YEE M MD	5/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	123522	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
224023	Fee-for-Service	1710995840	1710995840	1	1	WESTERN PHYSICAL THERAPY	11/9/2007	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	THERAPY	10255 LIVE OAK BLVD	None	LIVE OAK	CA	95953	2015	51	06101	39.28004385	-121.661271	Sutter County
224034	Fee-for-Service	1285774182	1285774182	1	1	WIEDMAN, TULLY R MD	2/23/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35371	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
224111	Fee-for-Service	1528164753	1528164753	1	1	WILLIAMS, JEFFREY K MD	11/30/1990	174400000X	NA	Other	026	PHYSICIANS	59161	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1901 4TH AVE	STE 100	SAN DIEGO	CA	92101	2381	37	06073	32.72528373	-117.1611335	San Diego County
224128	Fee-for-Service	1891722120	1891722120	1	2	WOLCOTT, PATRICK MD	8/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	55463	41	Internal Medicine	0	In state provider	None	790 W ORANGE AVE	STE C	EL CENTRO	CA	92243	3274	13	06025	32.7888123	-115.5609792	Imperial County
224208	Fee-for-Service	1003436064	1003436064	1	19	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	301 ALESSANDRO	SUITE 3C	RIVERSIDE	CA	92508	2486	33	06065	33.914196	-117.3287655	Riverside County
224267	Fee-for-Service	1740347061	1740347061	1	1	WAL-MART STORES INC	1/17/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM #10-5154	1827 WALNUT GROVE BLVD	None	ROSEMEAD	CA	91770	0000	19	06037	34.050339	-118.0842885	Los Angeles County
224281	Fee-for-Service	1003889890	1003889890	1	1	WESTFALL, CHRISTOPHER R. MD	2/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
224333	Fee-for-Service	1275720633	1275720633	1	1	WEST, JERRIN M MD	6/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96699	05	Anesthesiology	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
224334	Fee-for-Service	1922074954	1922074954	1	1	WRIGHT, JOAN F MD	1/1/1995	2082S0105X	NA	General Surgery	026	PHYSICIANS	43295	46	Hand Surgery	0	In state provider	None	2400 S FLOWER STREET	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
224373	Fee-for-Service	1831536358	1831536358	1	1	WILKINSON, AMANDA F LPCC	8/13/2020	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2960 CAMINO DIABLO	105	WALNUT CREEK	CA	94597	3988	07	06013	37.89859467	-122.0843018	Contra Costa County
224401	Fee-for-Service	1528164753	1528164753	1	1	WILLIAMS, JEFFREY K MD	11/30/1990	174400000X	NA	Other	026	PHYSICIANS	59161	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1901 4TH AVE	STE 100	SAN DIEGO	CA	92101	2381	37	06073	32.72528373	-117.1611335	San Diego County
224417	Fee-for-Service	1861572679	1861572679	1	1	WATSON, DAVID L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
224451	Fee-for-Service	1932425006	1932425006	1	1	WAGUESPACK, DIA R	7/19/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	6410 FANNIN STREET	SUITE 1500	HOUSTON	TX	77030	5306	00	None	29.71419639	-95.39755562	Harris County
224453	Fee-for-Service	1760580427	1760580427	1	1	WYNKOOP, WALKER MD	11/19/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	87898	None	None	0	In state provider	None	807 ILLINOIS AVENUE	None	LOS BANOS	CA	93635	3512	24	06047	37.064394	-120.857788	Merced County
224473	Fee-for-Service	1003436064	1003436064	1	57	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	C	24352 ROCKFIELD	None	LAKE FOREST	CA	92630	4742	30	06059	33.61599427	-117.7037904	Orange County
224600	Fee-for-Service	1710076740	1710076740	1	1	WONG, JAMES T OD	12/16/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9449 IMPERIAL HWY	None	DOWNEY	CA	90242	2814	19	06037	33.91714048	-118.1262915	Los Angeles County
224660	Fee-for-Service	1407988272	1407988272	1	1	WOO, DAVID H MD	5/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95998	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
224691	Fee-for-Service	1306331129	1306331129	1	1	WINDSOR, NOELLE L DO	8/24/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17988	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
224741	Fee-for-Service	1306832571	1306832571	2	1	WADE, GARY L MD	7/15/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	44010	30	Radiology	0	In state provider	None	444 BRUCE ST	None	YREKA	CA	96097	3450	47	06093	41.71863548	-122.6458755	Siskiyou County
224757	Fee-for-Service	1104831296	1104831296	1	1	WALGREEN CO	8/19/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1334 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3356	19	06037	33.89171781	-118.2990832	Los Angeles County
224761	Fee-for-Service	1003436064	1003436064	1	57	WS AUDIOLOGY (CALIFORNIA), P	5/20/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	C	24352 ROCKFIELD	None	LAKE FOREST	CA	92630	4742	30	06059	33.61599427	-117.7037904	Orange County
224767	Fee-for-Service	1558685537	1558685537	1	1	WALKER, ANGELA M MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128712	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
224772	Fee-for-Service	1487689329	1487689329	1	1	WALDMAN, ROBERT P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	49826	45	Nephrology (Renal-Kidney)	0	In state provider	None	4644 LINCOLN BLVD	STE 540	MARINA DEL REY	CA	90292	6391	19	06037	33.98210351	-118.4405172	Los Angeles County
224803	Fee-for-Service	1548445521	1548445521	1	1	WENG, JIAXIONG MD INC	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70965	41	Internal Medicine	0	In state provider	None	624 W DUARTE RD	STE 106	ARCADIA	CA	91007	9255	19	06037	34.12637452	-118.0527313	Los Angeles County
224823	Fee-for-Service	1649285917	1649285917	1	1	WALGREEN CO.	3/14/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY ST	None	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
224843	Fee-for-Service	1144303801	1144303801	1	1	WONG, STEPHEN K	9/30/1988	207W00000X	NA	Ophthalmology	026	PHYSICIANS	40039	None	None	0	In state provider	None	1 SCRIPPS DRIVE	SUITE 303	SACRAMENTO	CA	95825	6206	34	06067	38.573181	-121.4118135	Sacramento County
224847	Fee-for-Service	1407838980	1407838980	1	1	WANG, SHU-MING MD	11/4/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81646	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
224863	Fee-for-Service	1639440357	1639440357	1	1	WOOLLEY, DALE W	1/30/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
224920	Fee-for-Service	1205901642	1205901642	1	1	WANG, ZHENG	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65385	None	None	0	In state provider	None	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	33	06065	33.89552551	-117.186021	Riverside County
224974	Fee-for-Service	1598715062	1598715062	1	1	WANG, LYNN MD	10/3/2008	207RN0300X	NA	Nephrology	026	PHYSICIANS	74029	45	Nephrology (Renal-Kidney)	0	In state provider	None	500 N GARFIELD AVE	STE 102	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
224996	Fee-for-Service	1013968247	1013968247	1	1	WALKER, CRAIG W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
225072	Fee-for-Service	1780262154	1780262154	1	1	WANG, ANDY MD	10/1/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	555 TACHEVAH DR	SUITE 2E-107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
225076	Fee-for-Service	1750544755	1750544755	1	1	WADE, MATTHEW W MD	3/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107728	18	Ophthalmology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
225077	Fee-for-Service	1700402237	1700402237	1	1	WOODLAND CARE PHARMACY & MED	8/18/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	23 MAIN ST	None	WINTERS	CA	95694	1722	57	06113	38.52163272	-121.9695765	Yolo County
225104	Fee-for-Service	1548756364	1548756364	1	1	WEK, HILARY L OT	2/26/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2201 E 4TH ST	None	SANTA ANA	CA	92705	3804	30	06059	33.74828847	-117.8360595	Orange County
225110	Fee-for-Service	1962498550	1962498550	1	1	WRIGHT, ROBERT S MD	3/8/2005	207RP1001X	NA	Pulmonology	026	PHYSICIANS	37447	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2403 CASTILLO ST	STE 206	SANTA BARBARA	CA	93105	5316	42	06083	34.43053648	-119.7243139	Santa Barbara County
225173	Fee-for-Service	1538519244	1538519244	1	1	WICKLAND, SHEA B MD	8/7/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184135	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
225184	Fee-for-Service	1780762559	1780762559	1	1	WIESNER, STEVEN L MD	5/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	70746	01	General Practice	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
225209	Fee-for-Service	1700064722	1700064722	1	1	WELTER, BARBARA J	9/23/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
225264	Fee-for-Service	1598715062	1598715062	1	1	WANG, LYNN MD	10/3/2008	207RN0300X	NA	Nephrology	026	PHYSICIANS	74029	41	Internal Medicine	0	In state provider	None	500 N GARFIELD AVE	STE 102	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
225267	Fee-for-Service	1144853060	1144853060	1	1	WELLSPACE HEALTH	4/23/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ARMACY	2425 ALHAMBRA BLVD	None	SACRAMENTO	CA	95817	1110	34	06067	38.55627	-121.471875	Sacramento County
225290	Fee-for-Service	1154369130	1154369130	1	1	WATERS, RICHARD E MD	4/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90380	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	415 E HARDING WAY	STE D	STOCKTON	CA	95204	6118	39	06077	37.96819912	-121.2900761	San Joaquin County
225295	Fee-for-Service	1568575959	1568575959	1	1	WILLIAMS, ANDREW S MD	1/27/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	45 CASTRO ST	STE 318	SAN FRANCISCO	CA	94114	1019	38	06075	37.76829732	-122.4357056	San Francisco County
225339	Fee-for-Service	1669254504	1669254504	1	1	WAVE'S EMBRACE DOULA SERVICE	10/18/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	50	06099	0	0	None
225340	Fee-for-Service	1275657231	1275657231	1	1	WRIGHT, BRENT DOUGLAS MD	8/1/1999	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	67482	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	205 SOUTH ST	None	FORT BRAGG	CA	95437	5540	23	06045	39.43009931	-123.8032471	Mendocino County
225360	Fee-for-Service	1710278544	1710278544	1	1	WONG, EILEEN C MD	8/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123035	25	Physical Medicine and Rehabilitation	0	In state provider	None	1500 E CHEVY CHASE DRIVE	SUITE 401	GLENDALE	CA	91206	4191	19	06037	34.15201194	-118.2322051	Los Angeles County
225370	Fee-for-Service	1942467451	1942467451	1	1	WU, YI- PO MD MPH	1/3/1984	207R00000X	NA	Other	026	PHYSICIANS	40605	41	Internal Medicine	0	In state provider	INC	645 W HARDING WAY	STE 15	STOCKTON	CA	95204	5688	39	06077	37.96586464	-121.3036751	San Joaquin County
225398	Fee-for-Service	1962498550	1962498550	1	1	WRIGHT, ROBERT S MD	3/8/2005	207RP1001X	NA	Pulmonology	026	PHYSICIANS	37447	41	Internal Medicine	0	In state provider	None	2403 CASTILLO ST	STE 206	SANTA BARBARA	CA	93105	5316	42	06083	34.43053648	-119.7243139	Santa Barbara County
225427	Fee-for-Service	1740296201	1740296201	1	1	WALL,MICHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3181 SW SAM JACKSON PK	RD	PORTLAND	OR	97239	3098	00	None	45.49936609	-122.6856232	Multnomah County
225444	Fee-for-Service	1003436064	1003436064	1	48	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4206 WOODRUFF AVENUE	None	LAKEWOOD	CA	90713	3143	19	06037	33.834438	-118.116514	Los Angeles County
225481	Fee-for-Service	1508363987	1508363987	1	1	WALKER, AMELIA W MD	1/28/2021	390200000X	NA	Other	026	PHYSICIANS	165304	None	None	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90809	1701	19	06037	33.808185	-118.1850575	Los Angeles County
225496	Fee-for-Service	1497724132	1497724132	1	1	WANG, RALPH C MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78496	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
225536	Fee-for-Service	1851825087	1851825087	1	1	WEN, JEFFERSON W MD	9/20/2020	207R00000X	NA	Other	026	PHYSICIANS	160266	41	Internal Medicine	0	In state provider	None	845 JACKSON ST	None	SAN FRANCISCO	CA	94133	4851	38	06075	37.79571919	-122.4089166	San Francisco County
225540	Fee-for-Service	1508992413	1508992413	1	1	WALKER, VALENTINO LCSW	11/27/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2288 FULTON ST	None	BERKELEY	CA	94704	1493	01	06001	37.8680901	-122.2660811	Alameda County
225565	Fee-for-Service	1558398628	1558398628	1	1	WILSON, STEPHEN D MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76355	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
225570	Fee-for-Service	1215361001	1215361001	1	1	WEIR, JILLIAN LCSW	6/23/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
225595	Fee-for-Service	1841283595	1841283595	1	1	WALKER, WAYNE T MD	2/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	52248	05	Anesthesiology	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3587	48	06095	38.26109552	-122.0470245	Solano County
225631	Fee-for-Service	1033167705	1033167705	1	1	WEPSIC, RICHARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	415 WEST COLUMBIA ST	None	EVANSVILLE	IN	47710	1656	00	None	37.98486618	-87.56985734	Vanderburgh County
225638	Fee-for-Service	1144235425	1144235425	1	1	WALGREEN CO	10/12/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2010 ALAMO DR	None	VACAVILLE	CA	95687	6289	48	06095	38.33537552	-121.9692825	Solano County
225688	Fee-for-Service	1780870998	1780870998	1	1	WOODWARD MACKIE, KRISTINA L	12/3/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CSW	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
225736	Fee-for-Service	1154465672	1154465672	1	1	WALLACH, JAMIE E MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	79903	40	Pediatrics	0	In state provider	None	2505 WEST HAMMER LANE	None	STOCKTON	CA	95209	2839	39	06077	38.02139448	-121.347738	San Joaquin County
225742	Fee-for-Service	1902648207	1902648207	1	1	WADE, ALEXANDRA T NP	9/4/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.28825369	-120.4963159	Merced County
225772	Fee-for-Service	1578898383	1578898383	1	1	WOOLDRIDGE, MONICA LEE NP	12/12/2012	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6120 VINELAND AVE	None	NORTH HOLLYWOOD	CA	91606	4914	19	06037	34.1819583	-118.3702737	Los Angeles County
225809	Fee-for-Service	1710073481	1710073481	1	1	WANG, SHEN YE MD	5/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	32511	13	Neurology (M.D. only)	0	In state provider	SUITE C-204	477 N EL CAMINO REAL	STE C310	ENCINITAS	CA	92024	1328	37	06073	33.05700866	-117.262449	San Diego County
225812	Fee-for-Service	1033124326	1033124326	1	1	WALGREENS CO	3/6/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18308 E COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2761	19	06037	33.9883111	-117.9052922	Los Angeles County
225825	Fee-for-Service	1861802282	1861802282	1	1	WALKER, TRAVIS C MD	3/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153475	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
225904	Fee-for-Service	1134525322	1134525322	1	1	WRIGHT, SUSAN M	12/18/2014	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	815 COURT STREET	None	JACKSON	CA	95642	2154	03	06005	38.35293152	-120.7676346	Amador County
225909	Fee-for-Service	1023187358	1023187358	1	1	WOZNIAK, CURTIS J MD	7/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129446	33	Thoracic Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
225913	Fee-for-Service	1639408362	1639408362	1	1	WALKER, CHARLIE L MD	9/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121786	25	Physical Medicine and Rehabilitation	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
225963	Fee-for-Service	1659774495	1659774495	1	1	WARREN, ADAM MD INC APC	10/1/2014	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	103633	20	Orthopedic Surgery	0	In state provider	None	20990 REDWOOD ROAD	None	CASTRO VALLEY	CA	94546	5920	01	06001	37.69338464	-122.0737355	Alameda County
225997	Fee-for-Service	1811938038	1811938038	1	1	WHITE, JEFFREY MD	12/27/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	143019	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2075 SAN JOAQUIN HILLS R	None	NEWPORT BEACH	CA	92660	6505	30	06059	33.61676129	-117.869325	Orange County
226042	Fee-for-Service	1275590549	1275590549	1	1	WARD, CHRISTOPHER DO	7/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	6878	08	Family Practice	0	In state provider	None	130 BRENTWOOD DR	None	CHESTER	CA	96020	0000	32	06063	40.30535806	-121.2340359	Plumas County
226058	Fee-for-Service	1316203235	1316203235	1	1	WONG, CAROLYN MD	11/1/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
226096	Fee-for-Service	1952396699	1952396699	1	1	WEBSTER, THOMAS H MD	1/1/1982	207P00000X	NA	Other	026	PHYSICIANS	33095	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
226098	Fee-for-Service	1710073481	1710073481	1	1	WANG, SHEN YE MD	5/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	32511	66	Emergency Medicine (Urgent Care)	0	In state provider	SUITE C-204	477 N EL CAMINO REAL	STE C310	ENCINITAS	CA	92024	1328	37	06073	33.05700866	-117.262449	San Diego County
226163	Fee-for-Service	1932304813	1932304813	1	1	WAKED, ALAIN A MD	6/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	143528	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4500 BROCKTON AVE	STE 203	RIVERSIDE	CA	92501	4006	33	06065	33.97785263	-117.3836152	Riverside County
226233	Fee-for-Service	1770686552	1770686552	1	1	WETZEL, RANDALL C MD	11/30/1996	2080P0203X	NA	Other	026	PHYSICIANS	50084	01	General Practice	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
226239	Fee-for-Service	1548659170	1548659170	1	1	WILSON, LIBBY F MD INC	5/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	18778	24	Plastic Surgery	0	In state provider	None	403 WEST ADAMS BLVD	None	LOS ANGELES	CA	90007	2664	19	06037	34.02741539	-118.2743622	Los Angeles County
226242	Fee-for-Service	1992883003	1992883003	1	1	WASIM, MARY-ANN U MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81536	41	Internal Medicine	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
226276	Fee-for-Service	1356715817	1356715817	1	1	WARNSHUIS, JENNIFER A	5/9/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
226330	Fee-for-Service	1275590549	1275590549	1	1	WARD, CHRISTOPHER DO	7/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	6878	12	Manipulative Therapy (D.O. only)	0	In state provider	None	130 BRENTWOOD DR	None	CHESTER	CA	96020	0000	32	06063	40.30535806	-121.2340359	Plumas County
226339	Fee-for-Service	1497172340	1497172340	1	1	WANG, BILLY C MD	7/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138755	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
226348	Fee-for-Service	1972690279	1972690279	1	1	WILLIAMS, SHANE K MD	11/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84725	20	Orthopedic Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
226407	Fee-for-Service	1437164779	1437164779	1	1	WALGREEN CO	9/9/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	1150 W 8TH ST	None	YUMA	AZ	85364	2863	00	None	32.713776	-114.633738	Yuma County
226412	Fee-for-Service	1235207127	1235207127	1	1	WU, PAMELA I OD INC	8/22/2008	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5414 WALNUT AVE	STE B	IRVINE	CA	92604	2522	30	06059	33.68908239	-117.7705473	Orange County
226436	Fee-for-Service	1720089337	1720089337	1	1	WAKIM, MARY E MD	4/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	68590	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
226469	Fee-for-Service	1518972801	1518972801	1	1	WALGREEN CO.	2/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12490 CENTRAL AVE	None	CHINO	CA	91710	2603	36	06071	34.026831	-117.6895075	San Bernardino County
226516	Fee-for-Service	1649263302	1649263302	1	1	WONG, ELTON Y	7/6/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	719 E 12TH ST	None	OAKLAND	CA	94606	3624	01	06001	37.79327275	-122.2528714	Alameda County
226539	Fee-for-Service	1063596039	1063596039	1	1	WARA, ANNE MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68451	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
226551	Fee-for-Service	1700950599	1700950599	1	1	WONG, KAI WAI MD	12/31/1989	207W00000X	NA	Ophthalmology	026	PHYSICIANS	64403	18	Ophthalmology	0	In state provider	None	2323 16TH ST	STE 501	BAKERSFIELD	CA	93301	3454	15	06029	35.37238027	-119.0288508	Kern County
226582	Fee-for-Service	1003102468	1003102468	1	1	WU, HUI MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126728	41	Internal Medicine	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
226583	Fee-for-Service	1477991321	1477991321	1	1	WAN, BETSY P MD	12/8/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	149867	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
226594	Fee-for-Service	1174612550	1174612550	1	1	WIRTHLIN, LAURIE S. MD	10/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6316 PRECINCT LINE RD	None	HURST	TX	76054	2766	00	None	32.863338	-97.18610249	Tarrant County
226603	Fee-for-Service	1619456928	1619456928	1	1	WHITE MEMORIAL COMMUNITY	10/3/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	1828 E CESAR E CHAVEZ AV	SUITE 4100	LOS ANGELES	CA	90033	2400	19	06037	34.05023174	-118.2154927	Los Angeles County
226647	Fee-for-Service	1578578860	1578578860	1	1	WALGREEN CO	6/15/1992	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1016 W SHAW AVE	None	FRESNO	CA	93711	3701	10	06019	36.80852466	-119.8093038	Fresno County
226648	Fee-for-Service	1912924267	1912924267	1	1	WAL-MART STORES INC	10/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM #10-2886	8500 WASHINGTON BLVD	None	PICO RIVERA	CA	90660	3788	19	06037	33.985017	-118.1050785	Los Angeles County
226677	Fee-for-Service	1013998186	1013998186	1	1	WANG, KENTEN P DO	8/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7684	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
226703	Fee-for-Service	1982643441	1982643441	1	1	WILLIAMS, GARY W MD	1/1/1982	207RR0500X	NA	Other	026	PHYSICIANS	37523	83	Rheumatology	0	In state provider	None	16870 W BERNARDO DR	None	SAN DIEGO	CA	92127	1677	37	06073	33.01956754	-117.0809122	San Diego County
226721	Fee-for-Service	1295145076	1295145076	1	1	WU, SHI-HUA MD	9/8/2017	364SP0200X	NA	Other	026	PHYSICIANS	137871	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
226724	Fee-for-Service	1609834019	1609834019	1	1	WEISS,MARK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	ONE GENESYS PARKWAY	None	GRAND BLANC	MI	48439	8065	00	None	42.89245321	-83.64137612	Genesee County
226729	Fee-for-Service	1891999363	1891999363	1	1	WU, OLSON Y MD	10/19/2010	207L00000X	NA	Other	026	PHYSICIANS	99237	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
226738	Fee-for-Service	1144235151	1144235151	1	1	WALGREENS #02623	3/21/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 3RD AVE	None	CHULA VISTA	CA	91911	3105	37	06073	32.61310923	-117.0688372	San Diego County
226742	Fee-for-Service	1215518790	1215518790	1	1	WANG, STEPHANIE F MD	7/19/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
226751	Fee-for-Service	1528166287	1528166287	1	1	WEBSTER, WILLIAM W MD	11/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87384	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
226761	Fee-for-Service	1487670220	1487670220	1	1	WILLIAMSON, ALAN E MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68558	02	General Surgery	0	In state provider	None	39300 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3203	33	06065	33.764175	-116.401977	Riverside County
226787	Fee-for-Service	1083920359	1083920359	1	1	WESTWATER, ANN N PHD	12/14/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
226868	Fee-for-Service	1366763138	1366763138	1	1	WEBER, ALEXANDER E MD	9/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144787	20	Orthopedic Surgery	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
226887	Fee-for-Service	1932872504	1932872504	1	1	WEISS, YONATAN M MD	10/5/2021	2085R0001X	NA	Other	026	PHYSICIANS	174494	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
226888	Fee-for-Service	1619456928	1619456928	1	1	WHITE MEMORIAL COMMUNITY	10/3/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	1828 E CESAR E CHAVEZ AV	SUITE 4100	LOS ANGELES	CA	90033	2400	19	06037	34.05023174	-118.2154927	Los Angeles County
226949	Fee-for-Service	1932291341	1932291341	1	1	WEINSTEIN, DAVID D MD	5/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	51984	13	Neurology (M.D. only)	0	In state provider	None	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
226965	Fee-for-Service	1659191906	1659191906	1	1	WALL, DONALD V	10/17/2024	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
226975	Fee-for-Service	1487433587	1487433587	1	1	WILLIAMS-EHRMAN, CHRISTIANNA	5/7/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	42	06083	0	0	None
226983	Fee-for-Service	1467053371	1467053371	1	1	WILSON, DAVID L NP	12/21/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
226991	Fee-for-Service	1588123368	1588123368	1	1	WILLIAMS, BROOKE T MD	2/20/2025	207L00000X	NA	Other	026	PHYSICIANS	180201	05	Anesthesiology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
227001	Fee-for-Service	1285160424	1285160424	1	1	WANG, KAI PING MD	9/11/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158049	08	Family Practice	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
227005	Fee-for-Service	1194418012	1194418012	1	2	WILCOX, MICHELLE NP	2/7/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10538 MISSION GORGE RD	100	SANTEE	CA	92071	3154	37	06073	32.8384953	-116.9677746	San Diego County
227013	Fee-for-Service	1922399021	1922399021	1	1	WONG, YUETIN T MD	7/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110707	08	Family Practice	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
227047	Fee-for-Service	1487670220	1487670220	1	1	WILLIAMSON, ALAN E MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68558	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	39300 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3203	33	06065	33.764175	-116.401977	Riverside County
227079	Fee-for-Service	1285997866	1285997866	1	1	WHITEHEAD, JESSICA L LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17777 VENTURA BLVD	STE 105	ENCINO	CA	91316	3738	19	06037	34.16286556	-118.5200521	Los Angeles County
227085	Fee-for-Service	1063881316	1063881316	1	1	WADE, SIOBAN LMFT	10/18/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
227125	Fee-for-Service	1831247774	1831247774	1	1	WHITTINGTON, JOE B MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93895	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
227128	Fee-for-Service	1922325695	1922325695	1	1	WONG, LESLIE A MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148563	02	General Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
227159	Fee-for-Service	1982489084	1982489084	1	1	WILSON, MACKENZIE J NP	1/20/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
227183	Fee-for-Service	1104037191	1104037191	1	1	WANG, JESSICA J MD	8/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104072	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MED PLAZA	# 365	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
227195	Fee-for-Service	1255504189	1255504189	1	1	WUEST, JASON CHARLES	1/23/2002	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SCOOTERVILLE	1536 S MYRTLE AVE	None	MONROVIA	CA	91016	4632	19	06037	34.134696	-118.0007835	Los Angeles County
227200	Fee-for-Service	1568693638	1568693638	1	1	WANG, MICHELLE Y MD	6/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113150	18	Ophthalmology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
227238	Fee-for-Service	1932291341	1932291341	1	1	WEINSTEIN, DAVID D MD	5/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	51984	36	Psychiatry	0	In state provider	None	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
227239	Fee-for-Service	1154703130	1154703130	1	1	WEI, YINAN MD	7/21/2023	208600000X	NA	General Surgery	026	PHYSICIANS	187616	None	None	0	In state provider	None	205 RIVER PARK CIR	None	FRESNO	CA	93720	1571	10	06019	36.85456375	-119.7863981	Fresno County
227258	Fee-for-Service	1215154018	1215154018	1	1	WAGNER, ANDREW J MD	12/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118953	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
227265	Fee-for-Service	1649315920	1649315920	1	1	WALLIS OPTICAL CO	1/1/1979	No Taxonomy Provided	NA	None	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	44407 10TH ST W	None	LANCASTER	CA	93534	3345	19	06037	34.68965953	-118.148053	Los Angeles County
227326	Fee-for-Service	1548795107	1548795107	1	1	WIELER, MATTHEW E MD	7/8/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	159633	None	None	0	In state provider	None	1201 W LA VETA AVE	FLOOR 2	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
227355	Fee-for-Service	1811074008	1811074008	1	1	WATKINS, HARLAN B JR MD	3/1/1995	207R00000X	NA	Other	026	PHYSICIANS	21261	41	Internal Medicine	0	In state provider	None	1199 BUSH ST	STE 400	SAN FRANCISCO	CA	94109	5976	38	06075	37.7891291	-122.4167087	San Francisco County
227379	Fee-for-Service	1588652143	1588652143	1	1	WITTENBERG, HEIDI G MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68207	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2100 WEBSTER ST	STE 319	SAN FRANCISCO	CA	94115	2377	38	06075	37.7904826	-122.4324477	San Francisco County
227396	Fee-for-Service	1174671077	1174671077	1	1	WARREN, JUDY A CNM	10/18/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4405 VANDEVER AVE	None	SAN DIEGO	CA	92120	3315	37	06073	32.78765609	-117.09908	San Diego County
227410	Fee-for-Service	1952429607	1952429607	1	1	WELDON, EDWARDO C CRNA	8/2/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	525 NORTH GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
227521	Fee-for-Service	1154631273	1154631273	1	1	WARDA, HUSSEIN A MD	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149838	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
227553	Fee-for-Service	1215029749	1215029749	1	1	WHITMAN, TAMMY L LMFT	3/2/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1074 EAST AVE	SUITE A-1	CHICO	CA	95926	1990	04	06007	39.76099443	-121.8353929	Butte County
227742	Fee-for-Service	1619261526	1619261526	1	1	WEAVER, CANDICE C B DO	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	11660	01	General Practice	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
227753	Fee-for-Service	1619964061	1619964061	1	1	WOOD, DOREEN DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	19829 N 27TH AVE	None	PHOENIX	AZ	85027	4001	00	None	33.665616	-112.116267	Maricopa County
227764	Fee-for-Service	1124257324	1124257324	1	1	WELLSPACE HEALTH	1/26/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY HEALTH CENTER	3415 MLK JR BLVD	None	SACRAMENTO	CA	95817	0000	34	06067	38.54376	-121.4644095	Sacramento County
227792	Fee-for-Service	1033597018	1033597018	1	1	WHITE, CRAIG A MD	7/1/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	162040	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
227809	Fee-for-Service	1245879725	1245879725	1	1	WILLIAMS, JAMIE A LCSW	5/13/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
227827	Fee-for-Service	1720367956	1720367956	1	1	WONG, ALBERT J-W PSY	2/29/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH RD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
227847	Fee-for-Service	1225562564	1225562564	1	1	WHITTIER, JOHN MD	11/21/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	172612	36	Psychiatry	0	In state provider	None	100 PINE ST	STE 1250	SAN FRANCISCO	CA	94111	5235	38	06075	37.79237874	-122.3989278	San Francisco County
227881	Fee-for-Service	1609874510	1609874510	1	2	WIRTH, STEVEN C MD	12/3/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	79607	-	NOT APPLICABLE	0	In state provider	None	1120 S DORA STREET	None	UKIAH	CA	95482	6340	23	06045	39.1362776	-123.20966	Mendocino County
227948	Fee-for-Service	1629347752	1629347752	1	1	WYCOCO, ALVIN D MD	12/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149939	41	Internal Medicine	0	In state provider	None	1415 ROSS AVENUE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
227956	Fee-for-Service	1831104124	1831104124	1	1	WALGREEN CO	8/14/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	22930 S WESTERN AVE	None	TORRANCE	CA	90501	5112	19	06037	33.81746045	-118.3087871	Los Angeles County
228036	Fee-for-Service	1619167145	1619167145	1	1	WOOLDRIDGE, THOMAS D PSYD	8/7/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2041 BANCROFT WAY	SUITE 307	BERKELEY	CA	94704	1405	01	06001	37.86751817	-122.2687345	Alameda County
228042	Fee-for-Service	1720093008	1720093008	1	1	WALGREEN CO.	3/15/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5913 CARSON ST	None	LAKEWOOD	CA	90713	3104	19	06037	33.83235946	-118.1158965	Los Angeles County
228046	Fee-for-Service	1952788184	1952788184	1	1	WU, STEPHANIE MD	5/12/2021	208M00000X	NA	Other	026	PHYSICIANS	144941	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
228052	Fee-for-Service	1124257324	1124257324	1	1	WELLSPACE HEALTH	9/2/2009	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY HEALTH CENTER	3415 MLK JR BLVD	None	SACRAMENTO	CA	95817	0000	34	06067	38.54376	-121.4644095	Sacramento County
228116	Fee-for-Service	1407253750	1407253750	1	1	WARSAME, SAINAB NP	4/16/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1751 UNIVERSITY DR	None	VISTA	CA	92083	7775	37	06073	33.17027826	-117.214478	San Diego County
228149	Fee-for-Service	1750579181	1750579181	1	1	WIJESINGHE, MANIK N MD	9/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88773	05	Anesthesiology	0	In state provider	None	20103 LAKE CHABOT ROAD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
228155	Fee-for-Service	1457747693	1457747693	1	1	WHITE, RACHEL E CO	6/9/2015	222Z00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	2575 E BIDWELL STREET	SUITE 200	FOLSOM	CA	95630	6446	34	06067	38.658888	-121.1303835	Sacramento County
228167	Fee-for-Service	1235459942	1235459942	1	1	WASINA, MARLENA F	7/30/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95865	5228	34	06067	38.56554	-121.4664615	Sacramento County
228170	Fee-for-Service	1396130571	1396130571	1	1	WANG, JASON MD	2/5/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
228189	Fee-for-Service	1992847131	1992847131	1	1	WILLIAMS, KRISTIN M MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72985	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
228190	Fee-for-Service	1518207471	1518207471	1	1	WONG, ROBERT W MD	6/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112307	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	LOS ANGELES	CA	90045	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
228216	Fee-for-Service	1114986742	1114986742	1	1	WONG, BOWEN Y MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58245	01	General Practice	0	In state provider	None	525 UNIVERSITY AVE	STE 400	PALO ALTO	CA	94301	1903	43	06085	37.44861996	-122.1589531	Santa Clara County
228262	Fee-for-Service	1003436064	1003436064	1	60	WS AUDIOLOGY (CALIFORNIA), P	2/11/2022	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 MORNING STAR	None	SONORA	CA	95370	5193	55	06109	37.98487014	-120.3706904	Tuolumne County
228327	Fee-for-Service	1932171972	1932171972	1	1	WELLBOUND OF MODESTO,LLC	7/13/2004	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1315 10TH ST	STE 100	MODESTO	CA	95354	0721	50	06099	37.64387411	-121.0043926	Stanislaus County
228357	Fee-for-Service	1831262682	1831262682	1	1	WANG, AIQUN AC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	40788 FREMONT BLVD	None	FREMONT	CA	94538	4373	01	06001	37.5349546	-121.9627551	Alameda County
228381	Fee-for-Service	1124199971	1124199971	1	1	WHITMAN,ADAM E MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71972	41	Internal Medicine	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
228401	Fee-for-Service	1912931619	1912931619	1	1	WAGNER, PHILLIP L MD	1/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29954	01	General Practice	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
228435	Fee-for-Service	1679703029	1679703029	1	1	WILLIAMS, MARISSA E LMFT	6/24/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3175 SUNSET BLVD	SUITE 107E	ROCKLIN	CA	95677	3091	31	06061	38.78584705	-121.2496644	Placer County
228445	Fee-for-Service	1336154665	1336154665	1	1	WALGREEN CO	10/18/1985	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3398 MISSION ST	None	SAN FRANCISCO	CA	94110	5009	38	06075	37.7424724	-122.4219457	San Francisco County
228457	Fee-for-Service	1750581740	1750581740	1	1	WALGREEN CO	10/9/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6199 SUNRISE BLVD	None	CITRUS HEIGHTS	CA	95610	6834	34	06067	38.67786	-121.2722235	Sacramento County
228493	Fee-for-Service	1033290390	1033290390	1	1	WALDHAUSEN, JOHN T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4500 SAND POINT WAY NE	STE 100	SEATTLE	WA	98105	3954	00	None	47.66165594	-122.2864502	King County
228505	Fee-for-Service	1053581900	1053581900	1	1	WEEKS, DAVID L MD	7/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102407	05	Anesthesiology	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93612	6800	10	06019	36.83745149	-119.6604315	Fresno County
228524	Fee-for-Service	1285155424	1285155424	1	1	WALKER, DAVID P MD	10/17/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	173054	None	None	0	In state provider	None	3000 Q STREET	4TH FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
228526	Fee-for-Service	1003436064	1003436064	1	72	WS AUDIOLOGY (CALIFORNIA), P	8/27/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	386 H ST	208	CHULA VISTA	CA	91910	7485	37	06073	32.63337265	-117.0806853	San Diego County
228529	Fee-for-Service	1174556179	1174556179	1	1	WILLIES-JACOBO, LINDIA	11/1/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	78269	40	Pediatrics	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
228551	Fee-for-Service	1003436064	1003436064	1	60	WS AUDIOLOGY (CALIFORNIA), P	7/21/2022	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	795 MORNING STAR	None	SONORA	CA	95370	5193	55	06109	37.98487014	-120.3706904	Tuolumne County
228553	Fee-for-Service	1356482962	1356482962	1	1	WILLIAMS, GENCIA M LMFT	8/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
228571	Fee-for-Service	1871520015	1871520015	1	1	WALLACE, CHRISTOPHER MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72335	41	Internal Medicine	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
228580	Fee-for-Service	1417036088	1417036088	2	1	WILLIAM DANIEL JACKSON	12/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	81 N MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1125	00	None	40.77110875	-111.840221	Salt Lake County
228592	Fee-for-Service	1841406444	1841406444	1	1	WOOD, KENNETH H	9/29/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1640 TEHAMA ST	STE B	REDDING	CA	96001	1617	45	06089	40.58456548	-122.3945917	Shasta County
228610	Fee-for-Service	1164790507	1164790507	1	1	WONG, JEFFREY E MD	10/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114599	20	Orthopedic Surgery	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
228646	Fee-for-Service	1558753699	1558753699	1	1	WILLIAMS, LAUREN A LCSW	3/8/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
228652	Fee-for-Service	1316973407	1316973407	1	1	WIESINGER, MATTHEW L MD	5/1/2000	207P00000X	NA	Other	026	PHYSICIANS	66549	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1330 NATIVIDAD RD	None	SALINAS	CA	93906	3101	27	06053	36.696996	-121.633173	Monterey County
228716	Fee-for-Service	1518257138	1518257138	1	1	WEIR, JAYSON A MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127788	None	None	0	In state provider	None	520 N PROSPECT AVE	STE 103	TORRANCE	CA	90277	3033	19	06037	33.8529819	-118.3802954	Los Angeles County
228730	Fee-for-Service	1003436064	1003436064	1	52	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3772 MISSION AVENUE	SUITE 117	OCEANSIDE	CA	92058	1453	37	06073	33.22565381	-117.3312862	San Diego County
228736	Fee-for-Service	1003436064	1003436064	1	41	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	363 LOWER SACRAMENTO ROA	SUITE B	LODI	CA	95242	3323	39	06077	38.12827053	-121.3067901	San Joaquin County
228740	Fee-for-Service	1336183730	1336183730	1	1	WINN, JAMES S DO	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	5927	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
228815	Fee-for-Service	1003436064	1003436064	1	72	WS AUDIOLOGY (CALIFORNIA), P	1/31/2025	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	386 H ST	208	CHULA VISTA	CA	91910	7485	37	06073	32.63337265	-117.0806853	San Diego County
228833	Fee-for-Service	1164623047	1164623047	1	1	WASHINGTON, TOBY MD	3/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76145	30	Radiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
228834	Fee-for-Service	1417947250	1417947250	1	1	WANG, ANDY A	4/30/1991	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	46625	30	Radiology	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
228889	Fee-for-Service	1790789592	1790789592	1	1	WHITE, HARVE J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	502 ELM ST NE	None	ALBUQUERQUE	NM	87102	2512	00	None	35.08684897	-106.6377887	Bernalillo County
228960	Fee-for-Service	1912005422	1912005422	1	1	WILSON, TIMOTHY G MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	57490	34	Urology and Urological Surgery	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
228982	Fee-for-Service	1073954442	1073954442	1	1	WU, EVA Y OD	10/7/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7330 CLAIREMONT BLVD	A102	SAN DIEGO	CA	92111	1124	37	06073	32.83271749	-117.1607916	San Diego County
228999	Fee-for-Service	1932271756	1932271756	1	1	WERES, NANCY H MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	43119	40	Pediatrics	0	In state provider	None	2450 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4356	52	06103	40.14921426	-122.2216794	Tehama County
229018	Fee-for-Service	1003436064	1003436064	1	52	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3772 MISSION AVENUE	SUITE 117	OCEANSIDE	CA	92058	1453	37	06073	33.22565381	-117.3312862	San Diego County
229086	Fee-for-Service	1538562939	1538562939	1	1	WILLIAMS, ANGELA T NP	4/9/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95000888	-	NOT APPLICABLE	0	In state provider	None	9705 S HOLMES AVE	None	LOS ANGELES	CA	90002	3031	19	06037	33.94797442	-118.2408345	Los Angeles County
229096	Fee-for-Service	1841429586	1841429586	1	1	WONG, ALBERT P MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128308	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
229112	Fee-for-Service	1659386936	1659386936	1	1	WALGREEN CO	10/1/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 W GRANGEVILLE BLVD	None	HANFORD	CA	93230	2714	16	06031	36.34269351	-119.6558325	Kings County
229132	Fee-for-Service	1215918297	1215918297	1	1	WRIGHT,DOUGLAS A DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2200 E SHOW LOW LAKE RD	None	SHOW LOW	AZ	85901	7831	00	None	34.202988	-110.0176695	Navajo County
229160	Fee-for-Service	1598980708	1598980708	1	1	WILLIAMS, SHAREE JEAN	8/3/2006	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	29221 GATEWAY DR	None	LAKE ELSINORE	CA	92530	7276	33	06065	33.69303077	-117.4137824	Riverside County
229203	Fee-for-Service	1780709931	1780709931	1	1	WU, ICHING LCSW	9/4/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8841 GARVEY AVE	None	ROSEMEAD	CA	91770	3358	19	06037	34.06276591	-118.07587	Los Angeles County
229222	Fee-for-Service	1184702946	1184702946	1	1	WERNINGHAUS, KARLA I MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68884	24	Plastic Surgery	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
229248	Fee-for-Service	1649320060	1649320060	2	1	WIGGINS HOMES LP	9/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1562 W CLARE AVENUE	None	PORTERVILLE	CA	93257	4320	54	06107	36.0636232	-119.0521357	Tulare County
229254	Fee-for-Service	1487996443	1487996443	1	1	WILLIAMS, FREDERICK LMFT	7/30/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
229257	Fee-for-Service	1275774341	1275774341	1	1	WUSTRACK, ROSANNA L MD	4/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104616	20	Orthopedic Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
229359	Fee-for-Service	1225400930	1225400930	1	1	WAGONER, SARAH K	11/10/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
229362	Fee-for-Service	1649475898	1649475898	1	1	WARREN, JANE M	2/26/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD RD	None	SANTA CLARA	CA	95051	4542	43	06085	37.33774954	-122.002065	Santa Clara County
229404	Fee-for-Service	1346626843	1346626843	1	1	WATSON, LESLIE F LCSW	5/23/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
229449	Fee-for-Service	1598980708	1598980708	1	1	WILLIAMS, SHAREE JEAN	8/3/2006	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	29221 GATEWAY DR	None	LAKE ELSINORE	CA	92530	7276	33	06065	33.69303077	-117.4137824	Riverside County
229459	Fee-for-Service	1902641459	1902641459	1	1	WINN, SHELLEY D DOULA	6/27/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
229481	Fee-for-Service	1538241237	1538241237	1	1	WATERS, ROBERT L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	14056	20	Orthopedic Surgery	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
229491	Fee-for-Service	1437119377	1437119377	1	1	W0MEN'S HEALTHCARE PHYS	8/1/1983	174400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	A MEDICAL CORP	1140 W LA VETA AVE	STE 560	ORANGE	CA	92868	4214	30	06059	33.7802984	-117.8651669	Orange County
229508	Fee-for-Service	1255326732	1255326732	2	1	WOLF, BRIAN R MD	3/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	2	Out of state provider	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
229534	Fee-for-Service	1144947680	1144947680	1	1	WANG, YUAN-CHUN	9/12/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16465 SIERRA LAKES PKWY	SUITE 275	FONTANA	CA	92336	1242	36	06071	34.13805177	-117.4457839	San Bernardino County
229650	Fee-for-Service	1750392122	1750392122	1	1	WHITE, MARY MD	10/17/2024	207R00000X	NA	Other	026	PHYSICIANS	80741	41	Internal Medicine	0	In state provider	None	2501 W BURBANK BLVD	STE 206	BURBANK	CA	91505	2347	19	06037	34.17861961	-118.3385265	Los Angeles County
229706	Fee-for-Service	1528688025	1528688025	1	1	WICO, IVY CNP	12/10/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4829 CLAIREMONT DR	None	SAN DIEGO	CA	92117	2706	37	06073	32.83175462	-117.2052088	San Diego County
229709	Fee-for-Service	1710920640	1710920640	1	1	WEE, TRACEY C PA	4/18/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	17065	-	NOT APPLICABLE	0	In state provider	None	1841 E MAIN STREET	None	BARSTOW	CA	92311	3234	36	06071	34.8901829	-116.9978731	San Bernardino County
229712	Fee-for-Service	1184778284	1184778284	1	1	WILLIAMS, STEPHEN C MD	11/22/1995	2084P0800X	NA	Psychiatry	026	PHYSICIANS	55291	36	Psychiatry	0	In state provider	None	640 N TUSTIN AVE	STE 104	SANTA ANA	CA	92705	3731	30	06059	33.75079879	-117.8341944	Orange County
229753	Fee-for-Service	1003821372	1003821372	1	1	WALGREEN CO	7/15/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4070 S EL CAMINO REAL	None	SAN MATEO	CA	94403	4537	41	06081	37.53130745	-122.2903904	San Mateo County
229756	Fee-for-Service	1538190368	1538190368	1	1	WANG, HELENA L MD	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109282	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2351 CLAY STREET	STE 501	SAN FRANCISCO	CA	94115	1931	38	06075	37.79101512	-122.4316059	San Francisco County
229763	Fee-for-Service	1982654588	1982654588	1	1	WILTON, MAAYA A MD	5/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90207	22	Pathology (M.D. only)	0	In state provider	None	3301 C ST	#103C	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
229772	Fee-for-Service	1588981807	1588981807	1	1	WARMINGTON, JANELLE J MD	9/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129997	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
229774	Fee-for-Service	1144330077	1144330077	1	1	WONG, EIRENE MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	65176	18	Ophthalmology	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
229782	Fee-for-Service	1447261334	1447261334	1	1	WOOD, BRAD W LCSW	9/14/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43646 REMBRANDT ST	None	LANCASTER	CA	93535	5745	19	06037	34.67679949	-118.1074884	Los Angeles County
229808	Fee-for-Service	1598046039	1598046039	1	1	WILLIAMS, BRIE M	11/19/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	16030 VENTURA BLVD	STE 610	ENCINO	CA	91436	4471	19	06037	34.15615339	-118.4824038	Los Angeles County
229867	Fee-for-Service	1376685230	1376685230	1	2	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	9462 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	1310	19	06037	34.242489	-118.4502025	Los Angeles County
229900	Fee-for-Service	1649289810	1649289810	1	1	WITKIN,DAVID B MD	2/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3377 RIVER BEND	None	SPRINGFIELD	OR	97477	0000	00	None	44.083053	-123.027961	Lane County
229902	Fee-for-Service	1578584017	1578584017	1	1	WARD, MICHAEL C MD INC	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	43330	05	Anesthesiology	0	In state provider	None	825 N 10TH ST	None	SANTA PAULA	CA	93060	1309	56	06111	34.36574255	-119.0654422	Ventura County
229917	Fee-for-Service	1134648132	1134648132	1	1	WU, KAREN OD	6/13/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2755 CANYON SPRINGS PKWY	None	RIVERSIDE	CA	92507	0932	33	06065	33.938604	-117.282465	Riverside County
229925	Fee-for-Service	1326234774	1326234774	1	1	WISE, LAURA J MD	6/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73054	01	General Practice	0	In state provider	None	644 SOUTHLAND MALL DRIVE	None	HAYWARD	CA	94545	2150	01	06001	37.65229537	-122.1061623	Alameda County
229985	Fee-for-Service	1104068253	1104068253	1	1	WOLINSKI, MELISSA K DO	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11552	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
229986	Fee-for-Service	1497721559	1497721559	1	1	WANG, LINAN MD	3/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	94724	None	None	0	In state provider	None	100 WEST CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
230000	Fee-for-Service	1508220658	1508220658	1	1	WIGUNA, TIFFANY MD	1/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157885	40	Pediatrics	0	In state provider	None	1716 W MEDICAL CENTER DR	None	ANAHEIM	CA	92801	1801	30	06059	33.85174853	-117.9427275	Orange County
230009	Fee-for-Service	1780756593	1780756593	1	1	WAGNER, GAIL MONA MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	37771	01	General Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
230043	Fee-for-Service	1538190368	1538190368	1	1	WANG, HELENA L MD	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109282	41	Internal Medicine	0	In state provider	None	2351 CLAY STREET	STE 501	SAN FRANCISCO	CA	94115	1931	38	06075	37.79101512	-122.4316059	San Francisco County
230076	Fee-for-Service	1386627040	1386627040	1	1	WALL, ROBERT MD	12/8/2023	207R00000X	NA	Other	026	PHYSICIANS	37606	None	None	0	In state provider	None	11525 BROOKSHIRE AVE	SUITE 202	DOWNEY	CA	90241	4983	19	06037	33.93544635	-118.1318321	Los Angeles County
230094	Fee-for-Service	1427482488	1427482488	1	1	WAL-MART STORES, INC	6/13/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14865 TELEGRAPH ROAD	None	LA MIRADA	CA	90638	1060	19	06037	33.91825479	-118.0139897	Los Angeles County
230124	Fee-for-Service	1821389339	1821389339	1	1	WILLARD, KATHRYN S	3/4/2013	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
230155	Fee-for-Service	1376685230	1376685230	1	2	WESTERN PACIFIC MED-CORP	3/1/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	9462 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	1310	19	06037	34.242489	-118.4502025	Los Angeles County
230189	Fee-for-Service	1326076746	1326076746	1	1	WANG, JEROME K MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63432	41	Internal Medicine	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
230213	Fee-for-Service	1215184288	1215184288	1	1	WEBER, PATRICIA K LCSW	1/22/2016	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	5910 CLARK RD	STE M	PARADISE	CA	95969	5705	04	06007	39.75749014	-121.6070408	Butte County
230219	Fee-for-Service	1124255757	1124255757	1	1	WALTER, THOMAS R DO	11/17/2019	207L00000X	NA	Other	026	PHYSICIANS	12633	05	Anesthesiology	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
230234	Fee-for-Service	1366004780	1366004780	1	1	WALLACE, CATHERINE L CCC-SLP	6/28/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	170 17TH ST	STE B	PACIFIC GROVE	CA	93950	7201	27	06053	36.62215796	-121.9186041	Monterey County
230262	Fee-for-Service	1548656028	1548656028	1	1	WOLFE, STEPHEN J DO	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15074	66	Emergency Medicine (Urgent Care)	0	In state provider	None	465 WEST PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
230295	Fee-for-Service	1225166283	1225166283	1	1	WHITCOMB, DEBORAH A PHD	2/8/2023	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16800 DEVONSHIRE ST	212	GRANADA HILLS	CA	91344	7403	19	06037	34.25745651	-118.4982159	Los Angeles County
230330	Fee-for-Service	1346479227	1346479227	1	1	WINEGARDEN, DEBRA L PHD	4/21/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	106 POLLASKY AVE	SUITE D	CLOVIS	CA	93612	1159	10	06019	36.828954	-119.7020255	Fresno County
230333	Fee-for-Service	1811011562	1811011562	1	1	WRIGHT, PHILLIP G MD	3/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	17389	38	Geriatrics	0	In state provider	None	2844 SUMMIT ST	STE 212	OAKLAND	CA	94609	3642	01	06001	37.81754276	-122.2646445	Alameda County
230337	Fee-for-Service	1033299912	1033299912	1	1	WOODHOUSE, DAVID M MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	47953	41	Internal Medicine	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
230347	Fee-for-Service	1558401570	1558401570	1	1	WILLETT, THERESA A MD	12/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135276	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
230364	Fee-for-Service	1316172679	1316172679	1	1	WADA, JANE MD INC	11/10/2009	207N00000X	NA	Dermatology	026	PHYSICIANS	30116	07	Dermatology	0	In state provider	None	2103 MONTROSE AVE	STE D	MONTROSE	CA	91020	1507	19	06037	34.206831	-118.224702	Los Angeles County
230366	Fee-for-Service	1801165204	1801165204	1	1	WARREN, ERIC LMFT	3/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	811 W. 7TH ST.	12TH FLOOR	LOS ANGELES	CA	90017	3403	19	06037	34.0489635	-118.2591312	Los Angeles County
230407	Fee-for-Service	1043947245	1043947245	1	2	WINGWOMEN INC	10/23/2023	374J00000X	NA	Other	107	DOULA GROUP PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	07	06013	0	0	None
230459	Fee-for-Service	1215439195	1215439195	1	1	WENDEL, TREVOR G	2/8/2023	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1775 HARRISON AVE	None	EUREKA	CA	95501	1338	12	06023	40.79191911	-124.1395817	Humboldt County
230463	Fee-for-Service	1003436064	1003436064	1	3	WS AUDIOLOGY (CALIFORNIA), P	9/11/2020	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	12791 NEWPORT AVENUE	SUITE 101	TUSTIN	CA	92780	2785	30	06059	33.75168784	-117.808677	Orange County
230479	Fee-for-Service	1326076746	1326076746	1	1	WANG, JEROME K MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63432	40	Pediatrics	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
230518	Fee-for-Service	1184169138	1184169138	1	1	WOLFF, JENNIFER D CRNA	2/13/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
230552	Fee-for-Service	1871518589	1871518589	1	1	WHITE, VERNON M MD	8/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35631	38	Geriatrics	0	In state provider	None	340 4TH AVE	STE 5A	CHULA VISTA	CA	91910	3813	37	06073	32.63831293	-117.0833536	San Diego County
230600	Fee-for-Service	1427173301	1427173301	1	1	WONG, CINDY L MD	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137340	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
230617	Fee-for-Service	1215960398	1215960398	1	1	WHITEFIELD, JULIA	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
230625	Fee-for-Service	1285989798	1285989798	1	1	WILSON, HELEN W PHD	9/27/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
230635	Fee-for-Service	1336502095	1336502095	1	1	WINKLER, GARRET A MD	6/18/2020	207P00000X	NA	Other	026	PHYSICIANS	167722	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
230637	Fee-for-Service	1972946069	1972946069	1	1	WENTLANDT, MAX W MD	8/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148857	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
230649	Fee-for-Service	1508021304	1508021304	1	1	WALGREEN CO.	10/6/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5695 ALTON PKWY	None	IRVINE	CA	92618	4059	30	06059	33.66846665	-117.786127	Orange County
230652	Fee-for-Service	1154345056	1154345056	1	1	WHITE, MELINDA M DO	1/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	8600	41	Internal Medicine	0	In state provider	None	1595 SOQUEL DR	STE 411	SANTA CRUZ	CA	95065	1724	44	06087	36.98879599	-121.9826354	Santa Cruz County
230749	Fee-for-Service	1003436064	1003436064	1	3	WS AUDIOLOGY (CALIFORNIA), P	3/29/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	12791 NEWPORT AVENUE	SUITE 101	TUSTIN	CA	92780	2785	30	06059	33.75168784	-117.808677	Orange County
230780	Fee-for-Service	1093451718	1093451718	1	1	WOOD, BLAKE CRNA	11/15/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
230801	Fee-for-Service	1003018631	1003018631	1	1	WHITTIER UNION HSD	2/9/2000	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9401 S PAINTER AVE	None	WHITTIER	CA	90605	2729	19	06037	33.953337	-118.046439	Los Angeles County
230843	Fee-for-Service	1871518589	1871518589	1	1	WHITE, VERNON M MD	8/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35631	08	Family Practice	0	In state provider	None	340 4TH AVE	STE 5A	CHULA VISTA	CA	91910	3813	37	06073	32.63831293	-117.0833536	San Diego County
230855	Fee-for-Service	1245247295	1245247295	1	1	WACHTER, DAVID A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS NORTHEAST	None	ALBUQUERQUE	NM	87106	0000	00	None	35.08771808	-106.6192188	Bernalillo County
230874	Fee-for-Service	1699794222	1699794222	1	1	WELCH, MICHAEL J MD	7/24/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	34844	40	Pediatrics	0	In state provider	None	9610 GRANITE RIDGE DR	STE B	SAN DIEGO	CA	92123	2684	37	06073	32.80529877	-117.1207841	San Diego County
230880	Fee-for-Service	1295362804	1295362804	1	1	WOLDEMARIAM, BERSABEL DO	7/27/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
230884	Fee-for-Service	1780695825	1780695825	1	1	WANG, LARRY L MD	6/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92506	22	Pathology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
230922	Fee-for-Service	1649468471	1649468471	1	1	WEBB, WENDY R NP	8/30/2024	363LN0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
230924	Fee-for-Service	1548232010	1548232010	1	1	WINSTON, MARK E OD	7/31/1990	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9153 RESEDA BLVD	None	NORTHRIDGE	CA	91324	3031	19	06037	34.236792	-118.536108	Los Angeles County
230955	Fee-for-Service	1396797817	1396797817	2	1	WYNNE, WALTER MD	10/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	43607	01	General Practice	0	In state provider	None	1133 WEST SYCAMORE ST	None	WILLOWS	CA	95988	2601	11	06021	39.5205105	-122.2082775	Glenn County
230963	Fee-for-Service	1003822677	1003822677	1	1	WALGREEN CO	5/10/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2399 S BROADWAY	None	SANTA MARIA	CA	93454	7832	42	06083	34.917165	-120.4361195	Santa Barbara County
231044	Fee-for-Service	1760914436	1760914436	1	1	WANG, ZIWEI MD	5/5/2020	207R00000X	NA	Other	026	PHYSICIANS	162653	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
231051	Fee-for-Service	1356533178	1356533178	1	1	WILGUS, MAY L MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102471	None	None	0	In state provider	None	1910 OUTLET CENTER DR	None	OXNARD	CA	93036	0677	56	06111	34.2202663	-119.1484221	Ventura County
231054	Fee-for-Service	1528271657	1528271657	1	1	WEISS, ANNA E	4/19/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
231055	Fee-for-Service	1508280827	1508280827	1	1	WUTHRICH, PATRICK M DO	9/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14609	66	Emergency Medicine (Urgent Care)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
231073	Fee-for-Service	1508542747	1508542747	1	1	WOO, WENDY MD	8/5/2024	390200000X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
231100	Fee-for-Service	1447458138	1447458138	1	1	WONG, MARILYN T MD	5/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90356	41	Internal Medicine	0	In state provider	None	2610 AUGUSTINE DR	None	SANTA CLARA	CA	95054	2900	43	06085	37.38233149	-121.9735799	Santa Clara County
231112	Fee-for-Service	1336367234	1336367234	1	1	WALTERS, JOSEPH J MD INC	2/2/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84144	08	Family Practice	0	In state provider	None	12961 VILLAGE DR	STE A	SARATOGA	CA	95070	4158	43	06085	37.28089196	-122.0049522	Santa Clara County
231123	Fee-for-Service	1003436064	1003436064	1	14	WS AUDIOLOGY (CALIFORNIA), P	6/28/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2908 WESTMINSTER	None	SEAL BEACH	CA	90740	5305	30	06059	33.7594287	-118.0804604	Orange County
231239	Fee-for-Service	1477857639	1477857639	1	1	WAL-MART STORES, INC	8/2/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	800 COMMERCE AVE	None	ATWATER	CA	95301	5217	24	06047	37.34218984	-120.6088532	Merced County
231266	Fee-for-Service	1295740561	1295740561	1	1	WALGREEN CO.	12/21/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1800 CONCORD AVE	None	CONCORD	CA	94520	2301	07	06013	37.97782892	-122.0384093	Contra Costa County
231274	Fee-for-Service	1770295685	1770295685	1	1	WIRTH, MICHAEL J MD	7/23/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
231284	Fee-for-Service	1275576225	1275576225	1	1	WEBB, HERBERT H MD	3/7/2008	207RP1001X	NA	Pulmonology	026	PHYSICIANS	23229	41	Internal Medicine	0	In state provider	None	1360 W 6TH ST	STE 325	SAN PEDRO	CA	90732	3534	19	06037	33.73886546	-118.3075065	Los Angeles County
231327	Fee-for-Service	1023114618	1023114618	1	1	WANG, GLORIA W MD	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83684	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
231354	Fee-for-Service	1295948578	1295948578	2	1	WEINMAN, JASON P MD	3/30/2017	2085P0229X	NA	Other	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
231372	Fee-for-Service	1780636092	1780636092	2	1	WONDERLY, SALLY M MD	11/25/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	52854	None	None	0	In state provider	None	625 34TH STREET	STE 100 & 200	BAKERSFIELD	CA	93301	2305	15	06029	35.39046051	-119.0092725	Kern County
231387	Fee-for-Service	1447458138	1447458138	1	1	WONG, MARILYN T MD	5/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90356	38	Geriatrics	0	In state provider	None	2610 AUGUSTINE DR	None	SANTA CLARA	CA	95054	2900	43	06085	37.38233149	-121.9735799	Santa Clara County
231403	Fee-for-Service	1326380809	1326380809	1	1	WESTERHOF, KRISTOFER R MD	9/27/2018	207LC0200X	NA	Other	026	PHYSICIANS	140554	05	Anesthesiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
231410	Fee-for-Service	1003436064	1003436064	1	14	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2908 WESTMINSTER	None	SEAL BEACH	CA	90740	5305	30	06059	33.7594287	-118.0804604	Orange County
231422	Fee-for-Service	1003436064	1003436064	1	1	WS AUDIOLOGY (CALIFORNIA), P	9/11/2020	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
231458	Fee-for-Service	1376962399	1376962399	1	1	WESTBROOK, LINDSEY M MD	5/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154391	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	RM B186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
231503	Fee-for-Service	1487795605	1487795605	1	1	WELTY, JULIE L. MD	12/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1000 STATE ST	None	MCCALL	ID	83638	3704	00	None	44.90904704	-116.1097318	Valley County
231539	Fee-for-Service	1912921727	1912921727	1	1	WILLIAMS, EVERARD H MD	9/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	16567	01	General Practice	0	In state provider	A PROFESSIONAL CORP	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
231577	Fee-for-Service	1275576225	1275576225	1	1	WEBB, HERBERT H MD	3/7/2008	207RP1001X	NA	Pulmonology	026	PHYSICIANS	23229	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1360 W 6TH ST	STE 325	SAN PEDRO	CA	90732	3534	19	06037	33.73886546	-118.3075065	Los Angeles County
231624	Fee-for-Service	1518078120	1518078120	1	1	WANG, ERIC C MD	6/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101171	30	Radiology	0	In state provider	None	450 STAYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
231656	Fee-for-Service	1376800219	1376800219	1	1	WRAY, ALISA V MD	4/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130150	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
231667	Fee-for-Service	1174878524	1174878524	1	1	WAL-MART STORES INC	2/22/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14530 NORDHOFF ST	None	PANORAMA CITY	CA	91402	1811	19	06037	34.2353795	-118.448964	Los Angeles County
231700	Fee-for-Service	1003436064	1003436064	1	74	WS AUDIOLOGY (CALIFORNIA), P	10/11/2024	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1132 SAN MARINO DRIVE	SUITE 206	SAN MARCOS	CA	92078	0000	37	06073	33.12486539	-117.2107986	San Diego County
231702	Fee-for-Service	1184821332	1184821332	1	1	WYNN, PHILLIP A MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111985	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1515 E OCEAN AVE	None	LOMPOC	CA	93436	7337	42	06083	34.63941491	-120.4393023	Santa Barbara County
231711	Fee-for-Service	1003436064	1003436064	1	1	WS AUDIOLOGY (CALIFORNIA), P	6/2/2020	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
231725	Fee-for-Service	1568873784	1568873784	1	1	WU, WEIWEI MD	8/1/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	184172	None	None	0	In state provider	None	6620 COYLE AVE	STE 212	CARMICHAEL	CA	95608	6337	34	06067	38.66751	-121.310028	Sacramento County
231754	Fee-for-Service	1356774111	1356774111	1	1	WINKELHAUS, JOHN W III	6/23/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
231759	Fee-for-Service	1952462541	1952462541	1	1	WEBMAN, ROBERT M MD INC	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	39792	41	Internal Medicine	0	In state provider	None	4305 TORRANCE BLVD	STE 406	TORRANCE	CA	90503	4497	19	06037	33.83759546	-118.359342	Los Angeles County
231789	Fee-for-Service	1043233620	1043233620	1	1	WILLIAMS, TRACI A H MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66550	40	Pediatrics	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
231797	Fee-for-Service	1326568395	1326568395	1	1	WONG, EMILY LMFT	2/10/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
231803	Fee-for-Service	1851500722	1851500722	1	1	WOODLAND RESIDENTIAL SVS	6/30/2005	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1000 4TH ST	None	WOODLAND	CA	95695	4914	57	06113	38.667717	-121.7695995	Yolo County
231824	Fee-for-Service	1912921727	1912921727	1	1	WILLIAMS, EVERARD H MD	9/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	16567	04	Otology, Laryngology, Rhinology	0	In state provider	A PROFESSIONAL CORP	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
231846	Fee-for-Service	1679293724	1679293724	1	1	WOUND DOCTORS	10/9/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	575 E HARDY ST	STE 312	INGLEWOOD	CA	90301	4050	19	06037	33.94909392	-118.3477665	Los Angeles County
231900	Fee-for-Service	1245588201	1245588201	1	1	WAL-MART STORES, INC	12/28/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1445 E FOOTHILL BLVD	None	UPLAND	CA	91786	4054	36	06071	34.10684111	-117.6294778	San Bernardino County
231955	Fee-for-Service	1033253612	1033253612	1	1	WENKER, KERILEE MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71600	66	Emergency Medicine (Urgent Care)	0	In state provider	None	52ND AND F ST	None	SACRAMENTO	CA	95819	0000	34	06067	38.570607	-121.439502	Sacramento County
231968	Fee-for-Service	1205920113	1205920113	1	1	WEIR, TAWNY M LMFT	5/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5051 CANYON CREST DR	SUITE 204	RIVERSIDE	CA	92507	0000	33	06065	33.9589602	-117.3311519	Riverside County
231988	Fee-for-Service	1003436064	1003436064	1	74	WS AUDIOLOGY (CALIFORNIA), P	10/11/2024	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1132 SAN MARINO DRIVE	SUITE 206	SAN MARCOS	CA	92078	0000	37	06073	33.12486539	-117.2107986	San Diego County
232045	Fee-for-Service	1952462541	1952462541	1	1	WEBMAN, ROBERT M MD INC	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	39792	10	Gastroenterology (M.D. only)	0	In state provider	None	4305 TORRANCE BLVD	STE 406	TORRANCE	CA	90503	4497	19	06037	33.83759546	-118.359342	Los Angeles County
232077	Fee-for-Service	1043233620	1043233620	1	1	WILLIAMS, TRACI A H MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66550	41	Internal Medicine	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
232112	Fee-for-Service	1912921727	1912921727	1	1	WILLIAMS, EVERARD H MD	9/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	16567	66	Emergency Medicine (Urgent Care)	0	In state provider	A PROFESSIONAL CORP	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
232118	Fee-for-Service	1467500322	1467500322	1	1	WIEDER, NICHOLAS A	11/30/1995	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	2230 LYNN RD	None	THOUSAND OAKS	CA	91360	1901	56	06111	34.20894685	-118.885185	Ventura County
232120	Fee-for-Service	1184804940	1184804940	1	1	WISE, LUZ M LMFT	7/11/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5857 PINE AVE	STE B #10	CHINO HILLS	CA	91709	6536	36	06071	33.9475529	-117.67656	San Bernardino County
232121	Fee-for-Service	1851033609	1851033609	1	1	WALLEN, AVA OD	11/17/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
232185	Fee-for-Service	1427444330	1427444330	1	1	WANG, VICTORIA MD	10/11/2021	208600000X	NA	General Surgery	026	PHYSICIANS	146678	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
232192	Fee-for-Service	1174977292	1174977292	1	1	WOOD, JULIE C NP	8/25/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1335 N WATERMAN AVENUE	None	SAN BERNARDINO	CA	92404	5385	36	06071	34.124274	-117.2787625	San Bernardino County
232218	Fee-for-Service	1235144569	1235144569	1	1	WALGREEN CO	3/27/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1634 E HIGHLAND AVE	None	SAN BERNARDINO	CA	92404	4616	36	06071	34.13588549	-117.2518245	San Bernardino County
232223	Fee-for-Service	1689787442	1689787442	1	1	WEINER, JERRY W MD	9/11/1985	208600000X	NA	General Surgery	026	PHYSICIANS	55996	02	General Surgery	0	In state provider	None	1206 E NORTH ST	None	MANTECA	CA	95336	4962	39	06077	37.80103862	-121.1979566	San Joaquin County
232240	Fee-for-Service	1215257464	1215257464	1	1	WE CARE MEDICAL SUPPLIES INC	12/27/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	WE CARE MEDICAL SUPPLIES	2267 W WASHINGTON BLVD	None	LOS ANGELES	CA	90018	1403	19	06037	34.03994551	-118.311102	Los Angeles County
232261	Fee-for-Service	1134709082	1134709082	1	1	WHITE, NICHOLAS MD	3/4/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	184685	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
232263	Fee-for-Service	1376857409	1376857409	1	2	WASCHE, JASON N DO	9/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	11163	-	NOT APPLICABLE	0	In state provider	None	200 7TH AVENUE	SUITE 150	SANTA CRUZ	CA	95062	4669	44	06087	36.96438797	-121.998448	Santa Cruz County
232279	Fee-for-Service	1841385135	1841385135	1	1	WUCHNER, EDWARD J MD	1/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	30331	40	Pediatrics	0	In state provider	None	16870 W BERNARDO DR	None	SAN DIEGO	CA	92127	1677	37	06073	33.01956754	-117.0809122	San Diego County
232298	Fee-for-Service	1134419427	1134419427	1	1	WILLIAMS, SHAMMAH O MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	129581	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	STE 1617	SAN BERNARDINO	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino
232309	Fee-for-Service	1346918984	1346918984	1	1	WILSON, RACHAEL A CNP	2/4/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4235 PACIFIC COAST HWY	None	TORRANCE	CA	90505	5525	19	06037	33.80817211	-118.3588219	Los Angeles County
232332	Fee-for-Service	1568227692	1568227692	1	1	WONG, KATRINA PT	3/28/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
232334	Fee-for-Service	1952462541	1952462541	1	1	WEBMAN, ROBERT M MD INC	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	39792	01	General Practice	0	In state provider	None	4305 TORRANCE BLVD	STE 406	TORRANCE	CA	90503	4497	19	06037	33.83759546	-118.359342	Los Angeles County
232340	Fee-for-Service	1689713851	1689713851	1	1	WOODS, MARK L MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	61578	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
232347	Fee-for-Service	1205902178	1205902178	1	1	WONG, WAI-LING OD	2/14/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	7TH FLOOR	SAN FRANCISCO	CA	94143	0344	38	06075	37.76344756	-122.4581992	San Francisco County
232368	Fee-for-Service	1124215710	1124215710	1	2	WHYTE, RICARDO J MD	5/16/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	95505	-	NOT APPLICABLE	0	In state provider	None	11777 SEBASTIAN WAY	STE 102	RANCHO CUCAMONGA	CA	91730	0707	36	06071	34.10414799	-117.548378	San Bernardino County
232398	Fee-for-Service	1568640217	1568640217	1	1	WHITE, MEGHAN M RN	4/15/2008	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
232443	Fee-for-Service	1629191366	1629191366	1	2	WESTERVELT, LANI G LMFT	7/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	AND FAMILY THERAPY	14090 E HWY 88	E	LOCKEFORD	CA	95237	0000	39	06077	38.16696305	-121.1448897	San Joaquin County
232452	Fee-for-Service	1518984046	1518984046	2	1	WALFORD, TANYECH P MD	12/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	75693	01	General Practice	0	In state provider	None	4121 BROCKTON AVE	104	RIVERSIDE	CA	92501	3442	33	06065	33.98089267	-117.3813658	Riverside County
232484	Fee-for-Service	1003928409	1003928409	1	1	WILLIAMS,DORIAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 STADIUM DRIVE	None	MORGANTOWN	WV	26505	0897	00	None	39.65345878	-79.95562791	Monongalia County
232488	Fee-for-Service	1518162270	1518162270	1	1	WISNER, DOROTA J MD	4/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94725	30	Radiology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
232506	Fee-for-Service	1073661948	1073661948	1	1	WATSON, STEPHEN G MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	45105	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
232517	Fee-for-Service	1336273291	1336273291	1	1	WONG, EMILY K MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	78251	13	Neurology (M.D. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
232518	Fee-for-Service	1407371115	1407371115	1	1	WEST COAST POST ACUTE PHYSIC	8/14/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	IANS, INC.	1690 BARTON RD	STE 106	REDLANDS	CA	92373	4230	36	06071	34.04836346	-117.2125293	San Bernardino County
232525	Fee-for-Service	1164926549	1164926549	1	1	WILKINS, CARISSA DO	10/21/2021	207R00000X	NA	Other	026	PHYSICIANS	18253	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
232545	Fee-for-Service	1780971465	1780971465	1	1	WANG, CHENGWEI MD	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131994	01	General Practice	0	In state provider	None	210 N GARFIELD AVE	STE 203	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
232570	Fee-for-Service	1174538466	1174538466	1	1	WALGREEN CO	11/23/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	230 N LA BREA AVE	None	INGLEWOOD	CA	90301	1215	19	06037	33.96624834	-118.3534347	Los Angeles County
232599	Fee-for-Service	1467530071	1467530071	1	1	WATSON, ELIZABETH M MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	83419	20	Orthopedic Surgery	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
232620	Fee-for-Service	1982685996	1982685996	1	2	WELLISCH, MARK MD	1/1/2016	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	800 MORADO PLACE	None	OXNARD	CA	93030	6076	56	06111	34.21171617	-119.1705695	Ventura County
232627	Fee-for-Service	1689713851	1689713851	1	1	WOODS, MARK L MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	61578	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
232634	Fee-for-Service	1790068120	1790068120	1	1	WINDERMAN, REBECCA MD	2/13/2025	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
232638	Fee-for-Service	1003436064	1003436064	1	55	WS AUDIOLOGY (CALIFORNIA), P	8/7/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	72655 HIGHWAY 111	SUITE B3	PALM DESERT	CA	92260	3307	33	06065	33.7215903	-116.3957213	Riverside County
232734	Fee-for-Service	1174017792	1174017792	1	1	WILSON, RYAN LCSW	10/10/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
232795	Fee-for-Service	1336176015	1336176015	1	1	WARREN, ROBERT S MD	7/3/1997	208600000X	NA	General Surgery	026	PHYSICIANS	64251	02	General Surgery	0	In state provider	None	533 PARNASSUS AVE	# U373	SAN FRANCISCO	CA	94143	2208	38	06075	37.76304484	-122.4592904	San Francisco County
232809	Fee-for-Service	1336273291	1336273291	1	1	WONG, EMILY K MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	78251	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
232820	Fee-for-Service	1154733053	1154733053	1	1	WANG, TZU-CHIEH MD	6/10/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	143065	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
232856	Fee-for-Service	1336574250	1336574250	1	1	WRIGHT, BROOKS E DO	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2306	00	None	36.132948	-115.136874	Clark County
232993	Fee-for-Service	1902985641	1902985641	1	1	WONG, JOE C MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70598	41	Internal Medicine	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
232995	Fee-for-Service	1740637834	1740637834	1	1	WILLIAMS SPEECH THERAPY SERV	6/15/2017	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ICES INC.	16501 VENTURA BLVD	400	ENCINO	CA	91436	2067	19	06037	34.15764432	-118.4927792	Los Angeles County
233009	Fee-for-Service	1205196441	1205196441	1	1	WONG, GENEVIEVE F MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140597	01	General Practice	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
233015	Fee-for-Service	1831370626	1831370626	1	1	WILLIAMS, VALERIE A LCSW	6/1/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2737 77TH AVENUE	None	OAKLAND	CA	94605	2815	01	06001	37.76652248	-122.1701562	Alameda County
233016	Fee-for-Service	1619280385	1619280385	1	1	WONG, KARINA PSYD	5/8/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
233019	Fee-for-Service	1750384061	1750384061	1	1	WONG, DIANNE L OD	6/30/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1033 THIRD STREET	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
233159	Fee-for-Service	1194818211	1194818211	1	1	WELLS, FAITH B MD	1/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	78473	01	General Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
233189	Fee-for-Service	1184939647	1184939647	1	1	WAGNER, JENNY F	11/17/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
233248	Fee-for-Service	1184783177	1184783177	1	1	WORKMAN, LAURA MD	8/18/2009	207SG0201X	NA	Other	026	PHYSICIANS	51809	40	Pediatrics	0	In state provider	None	5271 F STREET	BLDG C	SACRAMENTO	CA	95819	3225	34	06067	38.570598	-121.437828	Sacramento County
233249	Fee-for-Service	1760008452	1760008452	1	1	WANGANIA, GRETA CNP	4/1/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	775 E FOOTHILL BLVD	None	POMONA	CA	91767	1223	19	06037	34.1072493	-117.7374988	Los Angeles County
233307	Fee-for-Service	1649351842	1649351842	1	1	WHITLOW, KENNETH S DO	11/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	7403	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
233310	Fee-for-Service	1740634732	1740634732	1	1	WALKER, CHRISTOPHER MD INC	8/8/2016	207P00000X	NA	Other	026	PHYSICIANS	106362	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20103 LAKE CHABOT ROAD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
233337	Fee-for-Service	1205895901	1205895901	1	1	WOO, RONALD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2901 SQUALICUM PKWY	None	BELLINGHAM	WA	98225	1851	00	None	48.77211992	-122.473101	Whatcom County
233430	Fee-for-Service	1477620342	1477620342	1	1	WALLACE, WILLIAM A MD	2/28/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	79737	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
233431	Fee-for-Service	1558325092	1558325092	1	1	WHARTON, KURT R MD INC	3/22/2005	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	57090	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	970 DEWING AVE	STE 201	LAFAYETTE	CA	94549	4260	07	06013	37.89042853	-122.1235399	Contra Costa County
233446	Fee-for-Service	1255491791	1255491791	1	1	WOLFF, THOMAS W DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3175 TURNER ST	None	PLACERVILLE	CA	95667	5724	09	06017	38.72623532	-120.790035	El Dorado County
233494	Fee-for-Service	1972861052	1972861052	1	1	WOODS, SARAH R LCSW	11/21/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
233538	Fee-for-Service	1831618370	1831618370	1	1	WISNER, MADELEINE J	11/1/2017	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	4500 47TH AVE	5	SACRAMENTO	CA	95824	3847	34	06067	38.509857	-121.4532495	Sacramento County
233540	Fee-for-Service	1629009907	1629009907	1	1	WHITE, CHRISTOPHER N MD	3/31/1984	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49177	08	Family Practice	0	In state provider	None	2705 LOMA VISTA RD	None	VENTURA	CA	93003	1581	56	06111	34.27504051	-119.2600018	Ventura County
233550	Fee-for-Service	1689670986	1689670986	1	1	WELCH, JAMES H MD	2/13/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
233602	Fee-for-Service	1891213393	1891213393	1	1	WACE, TERESA LMFT	11/6/2020	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1313 LAUREL STREET	STE 224D	SAN CARLOS	CA	94070	5043	41	06081	37.49782611	-122.2507762	San Mateo County
233669	Fee-for-Service	1316914385	1316914385	1	1	WEBSTER ORTHOPAEDIC MED	1/1/1979	207XS0114X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	PROF CORP	80 GRAND AVE	STE 400	OAKLAND	CA	94612	3743	01	06001	37.81147674	-122.2656076	Alameda County
233764	Fee-for-Service	1689932089	1689932089	1	1	WANG, CHARLIE K MD	12/29/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154745	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
233792	Fee-for-Service	1437444122	1437444122	1	1	WATKINS, JESHENNA J MD	6/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145454	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
233818	Fee-for-Service	1235272196	1235272196	1	1	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	14332 VICTORY BLVD	None	VAN NUYS	CA	91401	1944	19	06037	34.18664653	-118.445544	Los Angeles County
233859	Fee-for-Service	1194056465	1194056465	1	1	WEN, SHAN MD	7/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110767	41	Internal Medicine	0	In state provider	None	450 STANYAN STREET	None	SAN FRANCISCO	CA	94117	1019	38	06075	37.7738933	-122.4544685	San Francisco County
233922	Fee-for-Service	1437221652	1437221652	1	1	WANG, YING QIU	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	970 W EL CAMINO REAL	STE 8	SUNNYVALE	CA	94087	1180	43	06085	37.37150103	-122.0473591	Santa Clara County
234032	Fee-for-Service	1003436064	1003436064	1	65	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	15100 KENSINGTON PARK	SUITE 510	TUSTIN	CA	92782	1824	30	06059	33.71435274	-117.8163174	Orange County
234095	Fee-for-Service	1134136260	1134136260	1	1	WADE ALLEMAN	8/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3269 N STOCKTON HILL RD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
234108	Fee-for-Service	1235272196	1235272196	1	1	WESTERN PACIFIC MED-CORP	7/1/1999	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	14332 VICTORY BLVD	None	VAN NUYS	CA	91401	1944	19	06037	34.18664653	-118.445544	Los Angeles County
234125	Fee-for-Service	1124112933	1124112933	1	1	WELLSPACE HEALTH	2/18/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1820 J ST	None	SACRAMENTO	CA	95811	3010	34	06067	38.57688	-121.4816625	Sacramento County
234157	Fee-for-Service	1598000507	1598000507	1	1	WATKINS-TORRY, JULIE M MD	8/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127625	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	07	06013	37.98252	-121.8030615	Contra Costa County
234201	Fee-for-Service	1467989319	1467989319	1	1	WONG-SOLOMON, BELINDA L MD	12/27/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163231	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
234231	Fee-for-Service	1174690093	1174690093	1	1	WU, HSUYUAN MD	3/20/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	55857	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
234319	Fee-for-Service	1053335802	1053335802	1	1	WRIGHT, RANDOLPH T DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1504 PARK ST	STE 39	ALAMEDA	CA	94501	2972	01	06001	37.76551283	-122.241716	Alameda County
234322	Fee-for-Service	1003436064	1003436064	1	65	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	15100 KENSINGTON PARK	SUITE 510	TUSTIN	CA	92782	1824	30	06059	33.71435274	-117.8163174	Orange County
234333	Fee-for-Service	1063942803	1063942803	1	1	WU, HOOVER MD	8/7/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
234372	Fee-for-Service	1265538912	1265538912	1	1	WU, ALLAN Y MD	2/8/2016	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	67036	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	223 W COLE BLVD	None	CALEXICO	CA	92231	9722	13	06025	32.69401949	-115.5029355	Imperial County
234373	Fee-for-Service	1245221548	1245221548	1	1	WHITE, DOUGLAS A E MD	9/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75069	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
234379	Fee-for-Service	1669413126	1669413126	1	1	WILLIS-BUCKLEY, TAMARA L	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64521	01	General Practice	0	In state provider	MD	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
234392	Fee-for-Service	1962885764	1962885764	1	1	WOLF, ALEJANDRO DO	9/9/2024	207ZP0102X	NA	Other	026	PHYSICIANS	22912	22	Pathology (M.D. only)	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
234395	Fee-for-Service	1487604286	1487604286	1	1	WINTROUB, BRUCE U MD	1/1/1994	207N00000X	NA	Dermatology	026	PHYSICIANS	47483	07	Dermatology	0	In state provider	UCSF, DEPT OF DERMATOLGY	400 PARNASSUS AVE	# 316	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
234397	Fee-for-Service	1457398281	1457398281	1	1	WIGGLESWORTH, STACEY G	8/29/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	5616	34	06067	38.571084	-121.471074	Sacramento County
234414	Fee-for-Service	1891774048	1891774048	1	1	WOOD, RACHEL DPM	12/31/1981	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	500 E CALAVERAS BLVD	STE 100	MILPITAS	CA	95035	7708	43	06085	37.43274015	-121.8967534	Santa Clara County
234435	Fee-for-Service	1245257658	1245257658	1	1	WAL-MART STORES, INC	8/13/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102557	8400 ROSEDALE HWY	None	BAKERSFIELD	CA	93312	2151	15	06029	35.386281	-119.0955735	Kern County
234457	Fee-for-Service	1144309717	1144309717	1	1	WARD, ROBERT M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
234464	Fee-for-Service	1285669861	1285669861	1	1	WU, YU-SHENG MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	40618	40	Pediatrics	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
234486	Fee-for-Service	1982093407	1982093407	1	1	WAL-MART STORES INC	8/5/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3875 RANCHO VISTA BLVD	None	PALMDALE	CA	93551	2572	19	06037	34.61334922	-118.2007639	Los Angeles County
234503	Fee-for-Service	1013316520	1013316520	1	1	WINGFIELD, CAROLYN PSYD	7/6/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
234520	Fee-for-Service	1174690093	1174690093	1	1	WU, HSUYUAN MD	3/20/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	55857	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
234535	Fee-for-Service	1376517656	1376517656	1	1	WILLIAMS, KIMBERLY D DO	10/19/2010	207R00000X	NA	Other	026	PHYSICIANS	9424	None	None	0	In state provider	None	271 TURN PIKE DR	None	FOLSOM	CA	95630	2307	34	06067	38.65509	-121.170042	Sacramento County
234615	Fee-for-Service	1225428212	1225428212	1	1	WALLACE, KATHLEEN M	7/8/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	16766 BERNARDO CENTER DR	SUITE 206	SAN DIEGO	CA	92128	2502	37	06073	33.01756519	-117.0759175	San Diego County
234635	Fee-for-Service	1457858227	1457858227	1	1	WATSON, ELIZABETH G MD	12/14/2023	207LP2900X	NA	Other	026	PHYSICIANS	187551	None	None	0	In state provider	None	18035 BROOKHURST ST	1200	FOUNTAIN VALLEY	CA	92708	6738	30	06059	33.701184	-117.9544385	Orange County
234641	Fee-for-Service	1316766397	1316766397	1	1	WEISER, LEE PSYD	12/12/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
234659	Fee-for-Service	1407923634	1407923634	1	1	WILLSON, MICHAEL S MD	7/9/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34768	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
234661	Fee-for-Service	1265427173	1265427173	1	1	WHALEN, DAVID MD	12/30/1990	207L00000X	NA	Other	026	PHYSICIANS	65365	05	Anesthesiology	0	In state provider	None	1820 TRIBUTE RD	STE J	SACRAMENTO	CA	95815	4307	34	06067	38.599578	-121.444326	Sacramento County
234669	Fee-for-Service	1669413126	1669413126	1	1	WILLIS-BUCKLEY, TAMARA L	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64521	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MD	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
234680	Fee-for-Service	1962885764	1962885764	1	1	WOLF, ALEJANDRO DO	9/9/2024	207ZP0102X	NA	Other	026	PHYSICIANS	22912	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
234683	Fee-for-Service	1730283730	1730283730	1	1	WAGNER, ROBERT E PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	125 N LINCOLN ST	STE H	DIXON	CA	95620	3260	48	06095	38.44614779	-121.8364229	Solano County
234697	Fee-for-Service	1588665392	1588665392	1	1	WU-KUO, TOBEY MD	11/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	76545	07	Dermatology	0	In state provider	None	2151 N HARBOR BLVD	None	FULLERTON	CA	92835	3820	30	06059	33.89443025	-117.9288328	Orange County
234702	Fee-for-Service	1730282286	1730282286	1	1	WALTER JAYASINGHE MD APC	12/31/1988	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LOS ANGELES MEDICAL CTR	2010 WILSHIRE BLVD	FL 2	LOS ANGELES	CA	90057	3507	19	06037	34.05748989	-118.2750432	Los Angeles County
234717	Fee-for-Service	1831779149	1831779149	1	1	WU, HARRISON DO	11/15/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21464	08	Family Practice	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
234725	Fee-for-Service	1477824720	1477824720	1	1	WHITE, COURTNEY L CRNA	7/9/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
234743	Fee-for-Service	1336352335	1336352335	1	1	WONG, EDMUND H MD	5/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	99935	None	None	0	In state provider	None	1901 OUTLET CENTER DR	SUITE 120	OXNARD	CA	93036	0664	56	06111	34.21965581	-119.1491337	Ventura County
234789	Fee-for-Service	1912170598	1912170598	1	1	WAKIM, NICOLE M MD	6/3/2008	207L00000X	NA	Other	026	PHYSICIANS	98851	05	Anesthesiology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
234795	Fee-for-Service	1598085185	1598085185	1	1	WANG, JUSTIN T MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124857	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4418	50	06099	37.66508443	-120.9962589	Stanislaus County
234799	Fee-for-Service	1922412048	1922412048	1	1	WILLIAMS, ERIK A MD	7/9/2021	207ZP0102X	NA	Other	026	PHYSICIANS	163144	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
234811	Fee-for-Service	1659802965	1659802965	1	1	WANG, MICHELLE Y MD	10/18/2021	207L00000X	NA	Other	026	PHYSICIANS	162677	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
234824	Fee-for-Service	1437360757	1437360757	1	1	WARNER, JONATHAN N MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137292	34	Urology and Urological Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
234827	Fee-for-Service	1700469764	1700469764	1	1	WARREN MURRAY, KATELYN E NP	1/30/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.28825369	-120.4963159	Merced County
234833	Fee-for-Service	1083844385	1083844385	1	1	WAL-MART STORES INC	11/10/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 105766	170 COCHRANE PLAZA	None	MORGAN HILL	CA	95037	2812	43	06085	37.15005893	-121.6543983	Santa Clara County
234848	Fee-for-Service	1528086964	1528086964	1	1	WALKER, DONNA L MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55693	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 W PUEBLO ST	RM 50	SANTA BARBARA	CA	93105	4311	42	06083	34.42946302	-119.7231388	Santa Barbara County
234854	Fee-for-Service	1073707212	1073707212	1	1	WALLINE, BENJAMIN W MD	1/11/2008	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	98343	84	Surgery-Head and Neck	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
234871	Fee-for-Service	1376815324	1376815324	1	1	WATERMULDER, SARAH E LCSW	8/6/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	123 S SAN MATEO DR	None	SAN MATEO	CA	94401	3804	41	06081	37.56576298	-122.3254099	San Mateo County
234877	Fee-for-Service	1598095481	1598095481	1	1	WALGREEN CO.	2/1/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	33060 ANTELOPE ROAD	None	MURRIETA	CA	92563	2409	33	06065	33.64097399	-117.1680516	Riverside County
234888	Fee-for-Service	1699182055	1699182055	1	1	WALTERS, MIRA LMFT	7/23/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2030 E 4TH ST	131 C	SANTA ANA	CA	92705	3937	30	06059	33.74808045	-117.8378273	Orange County
234897	Fee-for-Service	1134324791	1134324791	1	1	WILSON, MICHAEL R MD	5/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125397	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
234905	Fee-for-Service	1275623191	1275623191	1	1	WOODRUFF, NATHANIEL R MD	1/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	55840	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	280 SIERRA COLLEGE DR	SUITE 120	GRASS VALLEY	CA	95945	5763	29	06057	39.23410746	-121.0515391	Nevada County
234913	Fee-for-Service	1568429306	1568429306	1	1	WACLAWSKI, RICHARD J MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134386	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
234968	Fee-for-Service	1245335504	1245335504	1	1	WAHEED, NUZHAT F DPM	2/8/2015	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2234 S EUCLID AVE	STE E	ONTARIO	CA	91762	6501	36	06071	34.033527	-117.652059	San Bernardino County
234969	Fee-for-Service	1962885764	1962885764	1	1	WOLF, ALEJANDRO DO	9/9/2024	207ZP0102X	NA	Other	026	PHYSICIANS	22912	90	Pathology-Forensic	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
235008	Fee-for-Service	1447268966	1447268966	1	1	WENSTRUP, THOMAS R MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55290	08	Family Practice	0	In state provider	None	401 PARADISE RD	STE E	MODESTO	CA	95351	3104	50	06099	37.62692973	-121.0131742	Stanislaus County
235022	Fee-for-Service	1366760464	1366760464	1	1	WARE, PAUL F	1/4/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	89519	18	Ophthalmology	0	In state provider	None	10243 GENETIC CENTER DR	None	SAN DIEGO	CA	92121	6310	37	06073	32.90618683	-117.1814064	San Diego County
235035	Fee-for-Service	1588681803	1588681803	1	1	WAL-MART PHARMACY 102031	10/4/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	30600 DYER ST	None	UNION CITY	CA	94587	1717	01	06001	37.60494405	-122.0688532	Alameda County
235062	Fee-for-Service	1326363813	1326363813	1	1	WALHA, SUKHBIR K MD	9/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
235066	Fee-for-Service	1295357838	1295357838	1	1	WADE, RYAN M LMFT	9/20/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1000 QUAIL ST	STE 260	NEWPORT BEACH	CA	92660	2784	30	06059	33.65915099	-117.8659973	Orange County
235119	Fee-for-Service	1376729780	1376729780	1	1	WIECHMANN, WARREN F MD	4/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104250	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
235120	Fee-for-Service	1255527115	1255527115	1	1	WEIS, ADINA MD	9/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132173	30	Radiology	0	In state provider	None	39000 BOB HOPE DRIVE	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
235138	Fee-for-Service	1528086964	1528086964	1	1	WALKER, DONNA L MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55693	68	Hematology	0	In state provider	None	300 W PUEBLO ST	RM 50	SANTA BARBARA	CA	93105	4311	42	06083	34.42946302	-119.7231388	Santa Barbara County
235143	Fee-for-Service	1437736394	1437736394	1	1	WILSON, MADISON R MD	9/30/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
235172	Fee-for-Service	1386859080	1386859080	1	1	WALGREEN CO	7/20/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6570 LONE TREE WAY	None	BRENTWOOD	CA	94513	5257	07	06013	37.96174626	-121.7318398	Contra Costa County
235190	Fee-for-Service	1295197994	1295197994	1	1	WANG, KELSEY MD	2/21/2020	207L00000X	NA	Other	026	PHYSICIANS	154003	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
235212	Fee-for-Service	1467796193	1467796193	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4055 EVERGREEN VILLAGE S	None	SAN JOSE	CA	95135	1748	43	06085	37.31374428	-121.77355	Santa Clara County
235228	Fee-for-Service	1548370869	1548370869	1	2	WEST, WILLIAM B PHD	12/19/2011	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	1	Border provider	None	2617 ALMOND ST	None	KLAMATH FALLS	OR	97601	1116	00	None	42.2523938	-121.7885067	Klamath County
235259	Fee-for-Service	1548706674	1548706674	1	1	WOOD, ALANA J CCC-SLP	11/28/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	23101 LAKE CENTER DR	240	LAKE FOREST	CA	92630	2801	30	06059	33.62739598	-117.716948	Orange County
235265	Fee-for-Service	1275859324	1275859324	1	1	WARD, ASHLEY F MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98633	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
235314	Fee-for-Service	1952478190	1952478190	1	1	WHITTAKER, KENNETH M MD	5/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	36635	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
235397	Fee-for-Service	1972942522	1972942522	1	1	WHISTON-LEMM, KATHRYN NP	4/27/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	MDBZ #270	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
235404	Fee-for-Service	1528138427	1528138427	1	1	WEISS, STEPHEN D MD	6/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40701	02	General Surgery	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
235415	Fee-for-Service	1831592138	1831592138	1	1	WEBB, NATHAN S LAC	10/29/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
235422	Fee-for-Service	1407086077	1407086077	1	1	WITKOS, MACIEJ MD	12/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125812	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON STREET	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
235425	Fee-for-Service	1528086964	1528086964	1	1	WALKER, DONNA L MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55693	41	Internal Medicine	0	In state provider	None	300 W PUEBLO ST	RM 50	SANTA BARBARA	CA	93105	4311	42	06083	34.42946302	-119.7231388	Santa Barbara County
235516	Fee-for-Service	1841566403	1841566403	1	1	WANG, AO	3/1/2024	207R00000X	NA	Other	026	PHYSICIANS	154758	41	Internal Medicine	0	In state provider	None	36485 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9681	33	06065	33.591699	-117.2368285	Riverside County
235520	Fee-for-Service	1487048815	1487048815	1	1	WILSON, CASEY MD	3/17/2025	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
235531	Fee-for-Service	1801428800	1801428800	1	1	WESTHOUT MD INC	6/16/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LAZA	940 N WESTERN AVE	A	SAN PEDRO	CA	90732	2403	19	06037	33.75111361	-118.3090432	Los Angeles County
235535	Fee-for-Service	1821245580	1821245580	1	1	WRIGHT, DAHLIA LMFT	10/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1195 VALENCIA STREET	SUITE #4	SAN FRANCISCO	CA	94110	3026	38	06075	37.75384242	-122.4207982	San Francisco County
235552	Fee-for-Service	1275859324	1275859324	1	1	WARD, ASHLEY F MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98633	78	Neoplastic Diseases/Oncology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
235554	Fee-for-Service	1508944687	1508944687	1	1	WOLL, JOHN P MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	78142	20	Orthopedic Surgery	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
235626	Fee-for-Service	1912018177	1912018177	1	2	WU, CHING-FONG DO	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	6646	10	Gastroenterology (M.D. only)	0	In state provider	None	1642 S COURT ST	None	VISALIA	CA	93277	4962	54	06107	36.315774	-119.2916295	Tulare County
235652	Fee-for-Service	1437237567	1437237567	1	1	WONG, HENRY K	4/15/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	192557	07	Dermatology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
235668	Fee-for-Service	1114330370	1114330370	1	1	WIEPKING, MATTHEW D MD	8/7/2019	2086S0102X	NA	General Surgery	026	PHYSICIANS	155210	02	General Surgery	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
235694	Fee-for-Service	1952368516	1952368516	1	1	WEITZEL, JEFFREY N MD	2/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	83409	41	Internal Medicine	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
235742	Fee-for-Service	1639435357	1639435357	1	1	WHITWELL, TREVOR A MD	5/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140507	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
235793	Fee-for-Service	1396736195	1396736195	1	1	WOJDOWSKI, CHERRY P LCSW	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	4926 LA CUENTA DR	STE 200	SAN DIEGO	CA	92124	2608	37	06073	32.8205912	-117.0993934	San Diego County
235798	Fee-for-Service	1568427284	1568427284	1	1	WEATHERALL,PAUL T MD	10/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7208	00	None	32.812245	-96.841584	Dallas County
235815	Fee-for-Service	1104815380	1104815380	1	1	WIELAND, LAWRENCE J MD	3/4/1997	173000000X	NA	Other	026	PHYSICIANS	36056	01	General Practice	0	In state provider	None	2505 LUCAS ST	None	EUREKA	CA	95501	3340	12	06023	40.79130448	-124.139304	Humboldt County
235822	Fee-for-Service	1821364712	1821364712	1	1	WEEDEN, MIRIAM M LMFT	7/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	906 G ST	None	SACRAMENTO	CA	95814	1800	34	06067	38.583468	-121.49289	Sacramento County
235843	Fee-for-Service	1275859324	1275859324	1	1	WARD, ASHLEY F MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98633	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
235871	Fee-for-Service	1720145790	1720145790	1	1	WINKELMAN, DANE V MD	5/31/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	27167	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	N SHORE RD HWY 173	None	LAKE ARROWHEAD	CA	92352	0000	36	06071	34.2519607	-117.1758675	San Bernardino County
235907	Fee-for-Service	1316147515	1316147515	1	1	WINCHESTER, JOHN B MD	6/12/2020	207L00000X	NA	Other	026	PHYSICIANS	158917	05	Anesthesiology	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
235979	Fee-for-Service	1497047096	1497047096	1	1	WILLARD, SCOTT D MD	9/16/2024	2085P0229X	NA	Other	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
236006	Fee-for-Service	1699732610	1699732610	1	1	WONG, STEVEN G MD	1/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67035	41	Internal Medicine	0	In state provider	None	11600 INDIAN HILLS RD	None	MISSION HILLS	CA	91345	1225	19	06037	34.2811228	-118.4588429	Los Angeles County
236016	Fee-for-Service	1447829296	1447829296	1	1	WEST SIDE DRUG CO.	10/7/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 O ST	None	FIREBAUGH	CA	93622	2224	10	06019	36.85875277	-120.4562709	Fresno County
236185	Fee-for-Service	1891815155	1891815155	1	1	WALTERS, CAROLYN LMFT	1/28/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	43069	-	NOT APPLICABLE	0	In state provider	None	1275 B ST	None	MERCED	CA	95341	6345	24	06047	37.29119757	-120.4710848	Merced County
236192	Fee-for-Service	1811151848	1811151848	1	1	WEST, JULIE E MD	9/23/2022	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	116978	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
236224	Fee-for-Service	1093983421	1093983421	1	1	WANG, SHIH-CHIN T MD	3/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103825	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
236283	Fee-for-Service	1871795500	1871795500	2	1	WINN, JOHN N MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99180	30	Radiology	0	In state provider	None	1207 FAIRCHILD COURT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
236284	Fee-for-Service	1386167153	1386167153	1	1	WRIGHT, RACHEL M	1/5/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12 UPPER RAGSDALE	None	MONTEREY	CA	93940	5730	27	06053	36.57482436	-121.8101797	Monterey County
236307	Fee-for-Service	1265447536	1265447536	1	1	WALGREEN CO	4/2/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1333 BROADWAY	None	OAKLAND	CA	94612	1917	01	06001	37.80397489	-122.2714485	Alameda County
236319	Fee-for-Service	1679933303	1679933303	1	1	WENGER, CHRIS CCC-SLP	6/5/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1500 S HAVEN AVE	SUITE 190	ONTARIO	CA	91761	2969	36	06071	34.046307	-117.576387	San Bernardino County
236323	Fee-for-Service	1003436064	1003436064	1	42	WS AUDIOLOGY (CALIFORNIA), P	9/3/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2530 F STREET	100	BAKERSFIELD	CA	93301	3843	15	06029	35.38253482	-119.0234498	Kern County
236354	Fee-for-Service	1821177239	1821177239	1	1	WONG, TRACY OD	10/19/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9596 BASELINE ROAD	None	RANCHO CUCAMONGA	CA	91701	5034	36	06071	34.12156149	-117.5954895	San Bernardino County
236385	Fee-for-Service	1669407342	1669407342	1	1	WALL, WILLIAM W MD	7/20/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	80961	20	Orthopedic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
236400	Fee-for-Service	1861706087	1861706087	1	1	WHBC MIDWIVES INC A NURSING	8/18/2010	193200000X	NA	Other	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	CORPORATION	583 SUMMERFIELD RD	None	SANTA ROSA	CA	95405	5239	49	06097	38.45268	-122.672088	Sonoma County
236408	Fee-for-Service	1043345192	1043345192	1	1	WHITMIRE, PAULA JEAN	11/30/2004	164X00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3880 N SANTA FE AVE	None	FRESNO	CA	93704	4045	10	06019	36.78801996	-119.8095548	Fresno County
236421	Fee-for-Service	1013164847	1013164847	1	1	WASHBURN, ERIK R MD	8/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105631	05	Anesthesiology	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
236425	Fee-for-Service	1205159472	1205159472	1	1	WALGREEN CO	6/21/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3010 N DEMAREE ST	None	VISALIA	CA	93291	7147	54	06107	36.357075	-119.331513	Tulare County
236481	Fee-for-Service	1679836944	1679836944	1	1	WOLFE, KRISTEN K MD	5/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128396	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 UCLA MEDICAL PLAZA	SUITE 430	LOS ANGELES	CA	90095	0001	19	06037	34.065126	-118.446237	Los Angeles County
236489	Fee-for-Service	1598262628	1598262628	1	1	WEI, LAWRENCE C MD	7/26/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	166179	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
236567	Fee-for-Service	1821428053	1821428053	1	1	WINSHIP, BRENTON MD	8/25/2019	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	146359	25	Physical Medicine and Rehabilitation	0	In state provider	None	2080 CENTURY PARK E	STE 300	LOS ANGELES	CA	90067	2006	19	06037	34.05887194	-118.4122914	Los Angeles County
236569	Fee-for-Service	1992448401	1992448401	1	1	WONG, DARRYN DO	1/7/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21674	08	Family Practice	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
236594	Fee-for-Service	1841524352	1841524352	1	1	WOLFE, SUSANNA B	10/20/2009	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11105 KNOTT AVE	SUITE B	CYPRESS	CA	90630	5137	30	06059	33.80083909	-118.0111199	Orange County
236600	Fee-for-Service	1003436064	1003436064	1	39	WS AUDIOLOGY (CALIFORNIA), P	5/7/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5525 ETIWANDA AVENUE	309	TARZANA	CA	91356	0000	19	06037	34.17046451	-118.5308463	Los Angeles County
236610	Fee-for-Service	1003436064	1003436064	1	42	WS AUDIOLOGY (CALIFORNIA), P	4/24/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2530 F STREET	100	BAKERSFIELD	CA	93301	3843	15	06029	35.38253482	-119.0234498	Kern County
236653	Fee-for-Service	1891204251	1891204251	1	1	WU, STEFANIE NP	6/11/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
236694	Fee-for-Service	1689750325	1689750325	1	1	WAYNE, JEFFREY D MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	65909	41	Internal Medicine	0	In state provider	None	1411 SECRET RAVINE PKWY	STE 100	ROSEVILLE	CA	95661	6042	31	06061	38.76424823	-121.2440842	Placer County
236699	Fee-for-Service	1043345192	1043345192	1	1	WHITMIRE, PAULA JEAN	11/30/2004	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3880 N SANTA FE AVE	None	FRESNO	CA	93704	4045	10	06019	36.78801996	-119.8095548	Fresno County
236779	Fee-for-Service	1285297135	1285297135	1	1	WANG, VICTOR MD	8/26/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	2850 TELEGRAPH AVE	110	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
236792	Fee-for-Service	1255368593	1255368593	1	1	WASHAKIE MEDICAL CENTER	3/7/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	400 S 15TH ST	None	WORLAND	WY	82401	3531	00	None	44.0136957	-107.9484782	Washakie County
236795	Fee-for-Service	1164953618	1164953618	1	1	WONG, FRANKIE MD	9/3/2024	2086S0122X	NA	General Surgery	026	PHYSICIANS	None	24	Plastic Surgery	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
236831	Fee-for-Service	1861459570	1861459570	1	1	WILLIAM H. BICKELL, MD	1/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3401 W GORE BLVD	None	LAWTON	OK	73505	6332	00	None	34.60892764	-98.4361565	Comanche County
236889	Fee-for-Service	1003436064	1003436064	1	39	WS AUDIOLOGY (CALIFORNIA), P	5/7/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5525 ETIWANDA AVENUE	309	TARZANA	CA	91356	0000	19	06037	34.17046451	-118.5308463	Los Angeles County
236920	Fee-for-Service	1467550996	1467550996	1	1	WATSON, JENNIFER S PHD	5/5/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	21263 ERWIN ST	None	WOODLAND HILLS	CA	91367	3715	19	06037	34.18286951	-118.5949215	Los Angeles County
236930	Fee-for-Service	1356538334	1356538334	1	1	WATT, ANDREW J MD	9/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	96500	24	Plastic Surgery	0	In state provider	None	45 CASTRO STREET	STE 121	SAN FRANCISCO	CA	94114	1019	38	06075	37.76829732	-122.4357056	San Francisco County
236939	Fee-for-Service	1770525446	1770525446	1	1	WARREN, VENKAT MD	1/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	30187	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	925 E SAN ANTONIO DR	None	LONG BEACH	CA	90807	2210	19	06037	33.83838926	-118.1823231	Los Angeles County
236964	Fee-for-Service	1790987931	1790987931	1	1	WANG, CHUNSHENG MD	1/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106065	36	Psychiatry	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
236973	Fee-for-Service	1841352861	1841352861	1	1	WALGREEN CO	4/26/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	80925 US HIGHWAY 111	None	INDIO	CA	92201	6524	33	06065	33.70724154	-116.2520865	Riverside County
236979	Fee-for-Service	1184621161	1184621161	1	1	WAYNE HOSPITAL COMPANY	5/15/2013	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	835 SWEITZER ST	None	GREENVILLE	OH	45331	1007	00	None	40.08871573	-84.63514646	Darke County
237009	Fee-for-Service	1962501858	1962501858	1	1	WEISLER, SHAWNA L MD	4/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	67610	None	None	0	In state provider	None	201 S BUENA VISTA ST	STE 225	BURBANK	CA	91505	4571	19	06037	34.15978726	-118.3289164	Los Angeles County
237013	Fee-for-Service	1912440488	1912440488	1	1	WINSLOW, JANE P LMFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5601 W SLAUSON AVE	SUITE 192	CULVER CITY	CA	90230	6582	19	06037	33.98900447	-118.37979	Los Angeles County
237020	Fee-for-Service	1467696203	1467696203	1	1	WESTSIDE MEDICAL GROUP	7/21/2009	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1107 O STREET	None	FIREBAUGH	CA	93622	2224	10	06019	36.85875277	-120.4562709	Fresno County
237062	Fee-for-Service	1649260027	1649260027	1	1	WU, CHRISTINE C OD	10/12/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1377 MACARTHUR BLVD	None	SAN LEANDRO	CA	94577	3918	01	06001	37.72917298	-122.1387677	Alameda County
237083	Fee-for-Service	1255368593	1255368593	1	1	WASHAKIE MEDICAL CENTER	3/7/2009	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	400 S 15TH ST	None	WORLAND	WY	82401	3531	00	None	44.0136957	-107.9484782	Washakie County
237112	Fee-for-Service	1518294842	1518294842	1	1	WARDEN, MEREDITH M MD	4/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111216	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
237132	Fee-for-Service	1285920934	1285920934	1	1	WINKLER, KATHRIN LMFT	2/15/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	9431 ALDERBURY ST.	None	CYPRESS	CA	90630	5458	30	06059	33.82530417	-118.0507332	Orange County
237141	Fee-for-Service	1467437624	1467437624	1	1	WELLS, KENNETH DPM	1/29/2008	213EP1101X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	286 EUCLID AVE	STE 204	SAN DIEGO	CA	92114	3612	37	06073	32.70706919	-117.0850896	San Diego County
237181	Fee-for-Service	1215361126	1215361126	1	1	WAL-MART STORE INC	6/12/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	72314 HIGHWAY 111	None	PALM DESERT	CA	92260	2747	33	06065	33.7273927	-116.4018801	Riverside County
237184	Fee-for-Service	1326049115	1326049115	1	1	WRONE, ELIZABETH M MD	7/1/1998	207RN0300X	NA	Nephrology	026	PHYSICIANS	82134	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
237200	Fee-for-Service	1134204043	1134204043	1	1	WONG, SUNNY W DO	5/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	7517	08	Family Practice	0	In state provider	None	110 W EMERSON AVE	None	MONTEREY PARK	CA	91754	1718	19	06037	34.06609659	-118.1234853	Los Angeles County
237228	Fee-for-Service	1932691813	1932691813	1	1	WILLOW HOSPICE CARE, INC	11/5/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 VICTORY BLVD	STE 503A	VAN NUYS	CA	91411	4157	19	06037	34.18668846	-118.450152	Los Angeles County
237237	Fee-for-Service	1548232572	1548232572	1	1	WELLBOUND OF SAN JOSE	6/1/2003	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	1525 MERIDIAN AVENUE	SUITE 101	SAN JOSE	CA	95125	5354	43	06085	37.29736155	-121.9136189	Santa Clara County
237266	Fee-for-Service	1184621161	1184621161	1	1	WAYNE HOSPITAL COMPANY	5/15/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	835 SWEITZER ST	None	GREENVILLE	OH	45331	1007	00	None	40.08871573	-84.63514646	Darke County
237278	Fee-for-Service	1245264639	1245264639	1	1	WONGWORAWAT, AMNART A MD	2/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74440	24	Plastic Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
237342	Fee-for-Service	1790854230	1790854230	1	1	WILHITE, SCOTT C	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
237365	Fee-for-Service	1700869187	1700869187	1	1	WENSKI, MAUREEN M	7/8/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
237432	Fee-for-Service	1518498757	1518498757	2	1	WILTCHIK, ERIN D MD	6/13/2023	207RC0200X	NA	Other	026	PHYSICIANS	165071	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
237435	Fee-for-Service	1265764716	1265764716	1	1	WEST COAST SURGICAL	7/23/2010	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SPECIALISTS	39765 DATE STREET	SUITE 101	MURRIETA	CA	92653	2005	33	06065	33.54593179	-117.1538761	Riverside County
237459	Fee-for-Service	1730571134	1730571134	1	1	WILLIS, DUSTIN K	4/4/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
237463	Fee-for-Service	1770500191	1770500191	1	1	WALMART INC	10/7/1992	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4080 W SHAW AVE	None	FRESNO	CA	93722	6220	10	06019	36.810936	-119.8642545	Fresno County
237470	Fee-for-Service	1326049115	1326049115	1	1	WRONE, ELIZABETH M MD	7/1/1998	207RN0300X	NA	Nephrology	026	PHYSICIANS	82134	45	Nephrology (Renal-Kidney)	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
237487	Fee-for-Service	1740012806	1740012806	1	1	WANG, ALICE PT	9/26/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
237518	Fee-for-Service	1932691813	1932691813	1	1	WILLOW HOSPICE CARE, INC	11/5/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 VICTORY BLVD	STE 503A	VAN NUYS	CA	91411	4157	19	06037	34.18668846	-118.450152	Los Angeles County
237565	Fee-for-Service	1295308203	1295308203	1	1	WELLSTONE HEALING CENTER	4/11/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1801 BUSH ST	STE 209	SAN FRANCISCO	CA	94109	5297	38	06075	37.78777536	-122.427321	San Francisco County
237571	Fee-for-Service	1629356092	1629356092	1	1	WILSON, DANYELLE LMFT	1/9/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
237574	Fee-for-Service	1184110819	1184110819	1	1	WARREN, GISSELLE AU	8/12/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1630 E SHAW AVE	None	FRESNO	CA	93710	8105	10	06019	36.8088456	-119.7572815	Fresno County
237578	Fee-for-Service	1124215710	1124215710	1	1	WHYTE, RICARDO J MD	7/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95505	36	Psychiatry	0	In state provider	None	11374 MOUNTAIN VIEW AVE	#A	LOMA LINDA	CA	92354	3830	36	06071	34.0465275	-117.2436991	San Bernardino County
237586	Fee-for-Service	1215160932	1215160932	1	1	WILLIAMS, DAETWAN L MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115394	05	Anesthesiology	0	In state provider	None	170 ALAMDEA DE PAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48095011	-122.2532536	San Mateo County
237627	Fee-for-Service	1063590669	1063590669	1	1	WOLITZ, RICHARD A MD	2/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	44166	18	Ophthalmology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
237649	Fee-for-Service	1831274422	1831274422	1	1	WONG, TONY L MD	10/22/2016	207R00000X	NA	Other	026	PHYSICIANS	51262	41	Internal Medicine	0	In state provider	None	1800 SULLIVAN AVE	RM 304	DALY CITY	CA	94015	2223	41	06081	37.68077723	-122.4728941	San Mateo County
237693	Fee-for-Service	1508944133	1508944133	1	1	WIBBELSMAN, CHARLES J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34356	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
237709	Fee-for-Service	1003436064	1003436064	1	40	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3655 EAST FOOTHILL BLVD	None	PASADENA	CA	91107	3121	19	06037	34.15021123	-118.0751811	Los Angeles County
237713	Fee-for-Service	1063452316	1063452316	1	1	WOODCOCK, JOHN A MD	3/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6801	08	Family Practice	0	In state provider	None	2151 E PALMDALE BLVD	None	PALMDALE	CA	93550	4037	19	06037	34.58013142	-118.0898273	Los Angeles County
237799	Fee-for-Service	1700962214	1700962214	1	1	WITT, DAVID R MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54874	01	General Practice	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
237818	Fee-for-Service	1649353319	1649353319	1	1	WAGLE, RINATA K MD	2/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80742	36	Psychiatry	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
237831	Fee-for-Service	1417953274	1417953274	1	1	WANG, FELIX W MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	52507	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
237836	Fee-for-Service	1700801578	1700801578	1	2	WY, CHERRY ANN MD	11/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	70518	40	Pediatrics	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
237841	Fee-for-Service	1871100073	1871100073	1	1	WECARE HOSPICE & PALLIATIVE	9/14/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	SERVICES	405 S STATE COLLEGE BLVD	SUITE 206	BREA	CA	92821	5278	30	06059	33.91021149	-117.8888602	Orange County
237857	Fee-for-Service	1932936705	1932936705	1	1	WARFIELD, SHERYL J NP	9/25/2024	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
237874	Fee-for-Service	1861506420	1861506420	1	1	WALTON, JEFFREY WAYNE MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79380	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
237978	Fee-for-Service	1790966000	1790966000	1	1	WALKER, KIM S LCSW	3/30/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR ROAD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
237988	Fee-for-Service	1568465193	1568465193	1	1	WHITEHEAD, WILLIAM E MD	5/1/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
237989	Fee-for-Service	1306888359	1306888359	1	1	WINSTON, ROY S MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68132	05	Anesthesiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
237997	Fee-for-Service	1962569210	1962569210	1	1	WIND, REBECCA MD	2/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	43253	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1401 S GRAND AVENUE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
237999	Fee-for-Service	1003436064	1003436064	1	40	WS AUDIOLOGY (CALIFORNIA), P	7/13/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3655 EAST FOOTHILL BLVD	None	PASADENA	CA	91107	3121	19	06037	34.15021123	-118.0751811	Los Angeles County
238031	Fee-for-Service	1609812825	1609812825	1	1	WARD, JAMES E MD	11/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	123267	78	Neoplastic Diseases/Oncology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
238095	Fee-for-Service	1528075454	1528075454	1	1	WATERS, JERRY D MD	9/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	44051	05	Anesthesiology	0	In state provider	None	2721 OLIVE HWY	SUITE 9	OROVILLE	CA	95966	6115	04	06007	39.50452062	-121.5420592	Butte County
238125	Fee-for-Service	1538611348	1538611348	1	1	WADLEY, KRISTINA H	4/21/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	9441	48	06095	38.12828446	-122.24821	Solano County
238130	Fee-for-Service	1871100073	1871100073	1	1	WECARE HOSPICE & PALLIATIVE	9/14/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	SERVICES	405 S STATE COLLEGE BLVD	SUITE 206	BREA	CA	92821	5278	30	06059	33.91021149	-117.8888602	Orange County
238153	Fee-for-Service	1225315401	1225315401	1	1	WEYRENS, COLLEEN LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
238172	Fee-for-Service	1508930090	1508930090	1	1	WONG, BRADFORD C	2/1/1995	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
238221	Fee-for-Service	1386711109	1386711109	1	1	WORMLEY, SHARON E MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	55753	40	Pediatrics	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
238265	Fee-for-Service	1346350766	1346350766	1	1	WETHERHOLD, DAVID W MD	3/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	76217	01	General Practice	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
238269	Fee-for-Service	1316003163	1316003163	1	1	WACHTEL, RENEE C MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	85795	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
238288	Fee-for-Service	1003436064	1003436064	1	27	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 SAN PABLO	None	PINOLE	CA	94564	2081	07	06013	38.00427797	-122.2971175	Contra Costa County
238316	Fee-for-Service	1609812825	1609812825	1	1	WARD, JAMES E MD	11/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	123267	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
238317	Fee-for-Service	1710419049	1710419049	1	1	WALKER, DON	8/26/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
238329	Fee-for-Service	1275243339	1275243339	1	1	WONG, MURRAY T MD	12/1/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	185911	None	None	0	In state provider	None	100 MED PLAZA	100, 755	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
238346	Fee-for-Service	1437343894	1437343894	1	1	WONG, WESLEY W LMFT	5/2/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1007 E COOLEY DR	STE 111	COLTON	CA	92324	3901	36	06071	34.05461152	-117.310599	San Bernardino County
238366	Fee-for-Service	1528490794	1528490794	1	1	WAL-MART STORES, INC	9/23/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1425 N HACIENDA BLVD	None	LA PUENTE	CA	91744	1133	19	06037	34.04639379	-117.9485428	Los Angeles County
238386	Fee-for-Service	1528075454	1528075454	1	1	WATERS, JERRY D MD	9/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	44051	08	Family Practice	0	In state provider	None	2721 OLIVE HWY	SUITE 9	OROVILLE	CA	95966	6115	04	06007	39.50452062	-121.5420592	Butte County
238403	Fee-for-Service	1851465686	1851465686	1	1	WONG, MATTHEW L	2/14/2011	2084P0800X	NA	Psychiatry	026	PHYSICIANS	84553	None	None	0	In state provider	None	23700 CAMINO DEL SOL	None	TORRANCE	CA	90505	5017	19	06037	33.8102385	-118.3441185	Los Angeles County
238408	Fee-for-Service	1073073540	1073073540	1	1	WEINTRAUB, SARA E	7/5/2023	207L00000X	NA	Other	026	PHYSICIANS	186343	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
238433	Fee-for-Service	1497172613	1497172613	1	1	WON, LUCY Y DO	10/1/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	15920	None	None	0	In state provider	None	1101 BRYAN AVE	STE E	TUSTIN	CA	92780	4401	30	06059	33.74272355	-117.8149529	Orange County
238550	Fee-for-Service	1265700694	1265700694	1	1	WANG, ANN NP	5/7/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
238575	Fee-for-Service	1003436064	1003436064	1	27	WS AUDIOLOGY (CALIFORNIA), P	5/21/2021	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1700 SAN PABLO	None	PINOLE	CA	94564	2081	07	06013	38.00427797	-122.2971175	Contra Costa County
238576	Fee-for-Service	1992725071	1992725071	1	1	WATSON, ANDREW D MD	8/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79605	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
238589	Fee-for-Service	1861482853	1861482853	1	1	WANG, WEI MD	5/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95030	41	Internal Medicine	0	In state provider	None	2100 WEBSTER ST	STE 326	SAN FRANCISCO	CA	94115	2378	38	06075	37.7904826	-122.4324477	San Francisco County
238607	Fee-for-Service	1609812825	1609812825	1	1	WARD, JAMES E MD	11/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	123267	68	Hematology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
238658	Fee-for-Service	1760409015	1760409015	1	1	WAL-MART STORES, INC	2/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-2950	37140 47TH ST E	None	PALMDALE	CA	93552	4450	19	06037	34.556751	-118.04229	Los Angeles County
238673	Fee-for-Service	1528075454	1528075454	1	1	WATERS, JERRY D MD	9/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	44051	01	General Practice	0	In state provider	None	2721 OLIVE HWY	SUITE 9	OROVILLE	CA	95966	6115	04	06007	39.50452062	-121.5420592	Butte County
238677	Fee-for-Service	1841774080	1841774080	1	1	WEST COVINA ADULT DAY	9/25/2020	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1501 W CAMERON AVE	STE 100	WEST COVINA	CA	91790	2724	19	06037	34.06831975	-117.9417887	Los Angeles County
238687	Fee-for-Service	1427008135	1427008135	1	1	WALL MEDICAL GROUP, THE	12/1/1984	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	2001 UNION ST	STE 300	SAN FRANCISCO	CA	94123	4108	38	06075	37.7974427	-122.432532	San Francisco County
238694	Fee-for-Service	1831874791	1831874791	1	1	WOODLEY, CHINELLE LCSW	3/15/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9324 W STOCKTON BLVD	None	ELK GROVE	CA	95758	8012	34	06067	38.418309	-121.3939665	Sacramento County
238725	Fee-for-Service	1285779389	1285779389	1	1	WITTELES, RONALD M MD	4/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76510	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
238752	Fee-for-Service	1154409886	1154409886	1	1	WAKAMIYA, RICHARD T MD	2/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45301	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
238865	Fee-for-Service	1992725071	1992725071	1	1	WATSON, ANDREW D MD	8/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79605	41	Internal Medicine	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
238875	Fee-for-Service	1861482853	1861482853	1	1	WANG, WEI MD	5/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95030	78	Neoplastic Diseases/Oncology	0	In state provider	None	2100 WEBSTER ST	STE 326	SAN FRANCISCO	CA	94115	2378	38	06075	37.7904826	-122.4324477	San Francisco County
238879	Fee-for-Service	1770544900	1770544900	1	1	WAKELING, DAVIS DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	19300 SW 65TH AVE	None	TUALATIN	OR	97062	7706	00	None	45.378774	-122.740551	Clackamas County
238912	Fee-for-Service	1831123272	1831123272	1	1	WANG, MICHELLE P MD	7/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	90523	68	Hematology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
238926	Fee-for-Service	1578847034	1578847034	1	1	WHITE, ALICIA L CNP	8/2/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2826 HARRIS ST	None	EUREKA	CA	95503	4809	12	06023	40.78047614	-124.1355056	Humboldt County
238929	Fee-for-Service	1215508601	1215508601	1	1	WINSON, PAUL I CRNA	3/6/2024	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
238935	Fee-for-Service	1639110257	1639110257	2	1	WARD, MARK A MD	1/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83686	08	Family Practice	0	In state provider	None	1405 TERESA DR	None	MORRO BAY	CA	93442	2458	40	06079	35.36492306	-120.8250111	San Luis Obispo County
238949	Fee-for-Service	1114992971	1114992971	1	1	WEIDERMAN, WILLIAM C MD	8/1/1987	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	43902	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2607 HARRIS ST	STE E	EUREKA	CA	95503	4876	12	06023	40.78053517	-124.1380509	Humboldt County
238955	Fee-for-Service	1821283946	1821283946	1	1	WINN, AYISHA L LCSW	3/2/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
238979	Fee-for-Service	1427008135	1427008135	1	1	WALL MEDICAL GROUP, THE	12/1/1984	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2001 UNION ST	STE 300	SAN FRANCISCO	CA	94123	4108	38	06075	37.7974427	-122.432532	San Francisco County
239013	Fee-for-Service	1245722883	1245722883	1	1	WOMENS HEALTH CENTER LLC	9/20/2019	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2435 MARSHALL RD	None	IMPERIAL	CA	92251	9599	13	06025	32.83046425	-115.5688567	Imperial County
239014	Fee-for-Service	1285779389	1285779389	1	1	WITTELES, RONALD M MD	4/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76510	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
239027	Fee-for-Service	1992090278	1992090278	1	1	WASKO-JONES, JALECIA	4/8/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
239055	Fee-for-Service	1184653875	1184653875	1	1	WAGAR, ELIZABETH A MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	48534	22	Pathology (M.D. only)	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
239103	Fee-for-Service	1164834339	1164834339	1	1	WIN, LEE Y MD	8/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144405	41	Internal Medicine	0	In state provider	None	1680 EAST 120TH STREET	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
239224	Fee-for-Service	1639110257	1639110257	2	1	WARD, MARK A MD	1/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83686	02	General Surgery	0	In state provider	None	1405 TERESA DR	None	MORRO BAY	CA	93442	2458	40	06079	35.36492306	-120.8250111	San Luis Obispo County
239285	Fee-for-Service	1215126859	1215126859	1	1	WANG, YANFENG MD	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106058	25	Physical Medicine and Rehabilitation	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
239305	Fee-for-Service	1699188904	1699188904	1	1	WONG, ANDREA D OD	8/21/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8250 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
239370	Fee-for-Service	1528221249	1528221249	2	1	WELLBOUND OF MENLO PARK LLC	9/1/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1166 POST STREET	STE 201	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
239372	Fee-for-Service	1013555291	1013555291	1	1	WALKER, ELEASHA LMFT	3/26/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
239383	Fee-for-Service	1730104472	1730104472	1	1	WARNELL, RONALD L MD	3/1/1999	2084P0800X	NA	Psychiatry	026	PHYSICIANS	24960	36	Psychiatry	0	In state provider	None	11374 MOUNTAIN VIEW AVE	None	LOMA LINDA	CA	92354	3830	36	06071	34.0465275	-117.2436991	San Bernardino County
239403	Fee-for-Service	1992732333	1992732333	1	1	WESTERN PHYSICAL THERAPY	3/1/2006	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	116 S LASSEN ST	None	WILLOWS	CA	95988	3009	11	06021	39.52027795	-122.1995617	Glenn County
239525	Fee-for-Service	1861837650	1861837650	1	1	WANG, ALEXANDER MD	8/16/2023	207P00000X	NA	Other	026	PHYSICIANS	147897	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1301 N ROSE DR	None	PLACENTIA	CA	92870	3802	30	06059	33.8868003	-117.8420447	Orange County
239551	Fee-for-Service	1801967625	1801967625	1	1	WHEELCHAIRS OF SAN MATEO	8/2/2001	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ANTONIO GUTIERREZ	808 BURLWAY RD	STE 7	BURLINGAME	CA	94010	1710	41	06081	37.59594247	-122.3658683	San Mateo County
239645	Fee-for-Service	1760440531	1760440531	1	1	WONG, KIN S DO	5/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	8177	41	Internal Medicine	0	In state provider	None	115 WEST E STREET	None	TEHACHAPI	CA	93561	1607	15	06029	35.13009994	-118.4488237	Kern County
239684	Fee-for-Service	1902039308	1902039308	1	1	WHEELER, NAXYELI S LMFT	11/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29970 TECHNOLOGY DR	STE 117B	MURRIETA	CA	92563	2647	33	06065	33.5604702	-117.1370275	Riverside County
239709	Fee-for-Service	1104137769	1104137769	1	1	WAXER, NATHAN J DO	1/26/2016	207L00000X	NA	Other	026	PHYSICIANS	12107	05	Anesthesiology	0	In state provider	None	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
239715	Fee-for-Service	1972939155	1972939155	1	1	WILLIAMS, DONALD M LCSW	3/2/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
239718	Fee-for-Service	1073645677	1073645677	1	1	WARREN, ROSALYN S LCSW	5/1/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	44444 20TH ST W	None	LANCASTER	CA	93534	2714	19	06037	34.69063406	-118.1656452	Los Angeles County
239744	Fee-for-Service	1841336252	1841336252	1	1	WU, I-HUI MD	11/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143847	18	Ophthalmology	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
239778	Fee-for-Service	1174615215	1174615215	1	1	WANG, KIM L MD	3/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96087	22	Pathology (M.D. only)	0	In state provider	None	3301 C ST	STE 200E	SACRAMENTO	CA	95816	3363	34	06067	38.579877	-121.456143	Sacramento County
239859	Fee-for-Service	1740490341	1740490341	1	1	WAL-MART STORE, INC	10/26/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-3652	755 RIVERPOINT CT	None	WEST SACRAMENTO	CA	95605	1654	57	06113	38.58898952	-121.5502188	Yolo County
239886	Fee-for-Service	1487978235	1487978235	1	1	WANG, FREDERICK MD	10/1/2021	208200000X	NA	General Surgery	026	PHYSICIANS	119258	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
239930	Fee-for-Service	1578503041	1578503041	1	1	WARD, HERMAN V MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2735 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	7924	00	None	35.110926	-114.5552445	Mohave County
239950	Fee-for-Service	1366604209	1366604209	1	1	WILLIAMS, DEIDRE E MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106036	36	Psychiatry	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
239974	Fee-for-Service	1043654551	1043654551	1	1	WONG, SUSAN Y MD	8/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135614	40	Pediatrics	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
240043	Fee-for-Service	1518211887	1518211887	1	2	WHEEL N RIDE TRANSPORT, INC.	6/19/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1057 MACARTHUR BLVD	210	SAN LEANDRO	CA	94577	3000	01	06001	37.73198607	-122.1396953	Alameda County
240069	Fee-for-Service	1104998863	1104998863	1	1	WILL, TERRY D MD	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53412	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
240076	Fee-for-Service	1619995057	1619995057	1	1	WOLIVER, THOMAS B MD	4/30/1991	207RH0003X	NA	Oncology	026	PHYSICIANS	39797	None	None	0	In state provider	None	300 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4311	42	06083	34.42946302	-119.7231388	Santa Barbara County
240113	Fee-for-Service	1093240178	1093240178	1	1	WEBSTER, JOHN R DO	4/1/2019	207R00000X	NA	Other	026	PHYSICIANS	17018	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
240290	Fee-for-Service	1225458433	1225458433	1	1	WILLIAMS, SAMANTHA A MD	2/23/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	155294	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
240306	Fee-for-Service	1982704920	1982704920	1	1	WEINREB, RACHEL MD	3/16/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40913	40	Pediatrics	0	In state provider	None	77 CADILLAC DR	None	SACRAMENTO	CA	95825	5453	34	06067	38.572551	-121.4181585	Sacramento County
240336	Fee-for-Service	1932170727	1932170727	1	1	WANG, YU R MD	6/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89283	41	Internal Medicine	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
240375	Fee-for-Service	1558331819	1558331819	1	1	WEINSTEIN, AMY S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9205 SW BARNES RD	None	PORTLAND	OR	97225	6603	00	None	45.51093	-122.771907	Washington County
240389	Fee-for-Service	1730946773	1730946773	1	1	WATERFORD UNIFIED SCHOOL DIS	3/13/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	219 NORTH REINWAY AVENUE	None	WATERFORD	CA	95386	0000	50	06099	37.64005583	-120.7739166	Stanislaus County
240461	Fee-for-Service	1427442441	1427442441	1	1	WHITLOCK, ARIEL LMFT	4/17/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
240515	Fee-for-Service	1154646271	1154646271	1	1	WALTER BROWN	6/28/2019	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	L CORPORATION	5800 HANNUM AVE	105	CULVER CITY	CA	90230	6553	19	06037	33.98724995	-118.3858338	Los Angeles County
240530	Fee-for-Service	1710336698	1710336698	1	1	WELLS, LYNNEL LMFT	4/26/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	433 CALLAN AVE	309	SAN LEANDRO	CA	94577	4641	01	06001	37.72706807	-122.1519034	Alameda County
240539	Fee-for-Service	1699064857	1699064857	1	1	WELKER, KATHERINE L MD	10/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142680	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
240631	Fee-for-Service	1144625823	1144625823	1	1	WON, LUKE DPM	10/1/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1101 BRYAN AVE	STE E	TUSTIN	CA	92780	4401	30	06059	33.74272355	-117.8149529	Orange County
240632	Fee-for-Service	1417339607	1417339607	1	1	WONG, ELLEN C MD	7/3/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	146928	13	Neurology (M.D. only)	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
240639	Fee-for-Service	1538770193	1538770193	1	1	WATKINS, DARREN L RCP	6/30/2021	2279P1006X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
240646	Fee-for-Service	1144782319	1144782319	1	1	WONG, MICHELLE N DO	6/30/2022	207P00000X	NA	Other	026	PHYSICIANS	19458	None	None	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
240658	Fee-for-Service	1003436064	1003436064	1	63	WS AUDIOLOGY (CALIFORNIA), P	7/19/2022	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5800 SANTA ROSA	SUITE 123	CAMARILLO	CA	93012	7056	56	06111	34.226169	-118.9882109	Ventura County
240694	Fee-for-Service	1730162421	1730162421	1	1	WATKINS, ZENJA J MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60596	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	455 WALNUT ST	None	STOCKTON	CA	95204	0000	39	06077	37.96825648	-121.3016719	San Joaquin County
240698	Fee-for-Service	1144837386	1144837386	1	1	WELBY WAY HOME LLC	1/20/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	21550 OXNARD ST	SUITE 57	WOODLAND HILLS	CA	91367	7100	19	06037	34.17915348	-118.59984	Los Angeles County
240702	Fee-for-Service	1922181866	1922181866	1	1	WATSON, TIMOTHY D MD	7/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96181	30	Radiology	0	In state provider	None	880 OAK PARK BLVD	STE 201	ARROYO GRANDE	CA	93420	1821	40	06079	35.13368306	-120.6053585	San Luis Obispo County
240741	Fee-for-Service	1457300493	1457300493	1	1	WHITTIER RADIOLOGICAL	4/15/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	ASSOCIATES INC	9080 COLIMA RD	None	WHITTIER	CA	90605	1600	19	06037	33.95062799	-118.0051627	Los Angeles County
240802	Fee-for-Service	1154646271	1154646271	1	1	WALTER BROWN	1/22/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	L CORPORATION	5800 HANNUM AVE	105	CULVER CITY	CA	90230	6553	19	06037	33.98724995	-118.3858338	Los Angeles County
240830	Fee-for-Service	1821207804	1821207804	1	1	WONG, SEONG YEON P MD	1/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112159	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	5207	37	06073	32.79293009	-117.0952438	San Diego County
240855	Fee-for-Service	1891745501	1891745501	1	1	WONG, LAWRENCE B MD	7/31/1989	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	55812	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	596 CARROLL ST	None	SUNNYVALE	CA	94086	6207	43	06085	37.36853041	-122.0305901	Santa Clara County
240901	Fee-for-Service	1821331893	1821331893	1	1	WILSON, CHRISTIAN MD	11/18/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
240902	Fee-for-Service	1982847752	1982847752	1	1	WUERSTLE, MELANIE C MD	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103579	14	Neurological Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
240919	Fee-for-Service	1427716612	1427716612	1	1	WOO-SAM, LYNETTE CNP	11/27/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16955 VANOWEN	None	VAN NUYS	CA	91406	4542	19	06037	34.19389751	-118.503342	Los Angeles County
240948	Fee-for-Service	1497799522	1497799522	1	1	WALKER, MATTHEW W MD	9/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52781	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
240950	Fee-for-Service	1003436064	1003436064	1	63	WS AUDIOLOGY (CALIFORNIA), P	7/19/2022	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5800 SANTA ROSA	SUITE 123	CAMARILLO	CA	93012	7056	56	06111	34.226169	-118.9882109	Ventura County
240960	Fee-for-Service	1760963532	1760963532	1	1	WOERTLER, ANNA CNM	12/12/2018	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
240963	Fee-for-Service	1801829775	1801829775	1	1	WATERS, MICHAEL P MD	10/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90012	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
240983	Fee-for-Service	1346544848	1346544848	1	1	WISTERIA HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4195 VIKING WAY	SUITE 140	LONG BEACH	CA	90808	1466	19	06037	33.83357279	-118.1256257	Los Angeles County
240986	Fee-for-Service	1144837386	1144837386	1	1	WELBY WAY HOME LLC	1/20/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	21550 OXNARD ST	SUITE 57	WOODLAND HILLS	CA	91367	7100	19	06037	34.17915348	-118.59984	Los Angeles County
241023	Fee-for-Service	1679005813	1679005813	1	1	WITONSKY, JONATHAN I MD	6/8/2022	2080P0201X	NA	Neurology	026	PHYSICIANS	160639	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
241026	Fee-for-Service	1538582465	1538582465	1	1	WONG, JONATHAN S	8/5/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
241082	Fee-for-Service	1396890380	1396890380	1	1	WALCOTT, DAMON M MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	60800	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
241097	Fee-for-Service	1629124623	1629124623	1	1	WEBER, NATHAN R MD	5/1/2013	207L00000X	NA	Other	026	PHYSICIANS	91196	05	Anesthesiology	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
241102	Fee-for-Service	1083632962	1083632962	1	1	WINCHELL, JOSEPH W DO	12/10/2019	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
241119	Fee-for-Service	1801282074	1801282074	1	1	WADE, ANDREA M NP	10/4/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1406 BAILEY AVE	STE D	NEEDLES	CA	92363	3115	36	06071	34.83259864	-114.6183514	San Bernardino County
241154	Fee-for-Service	1528003092	1528003092	1	1	WENDECKER, ANN T DO	4/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13501	30	Radiology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
241159	Fee-for-Service	1265490965	1265490965	1	1	WOOLLEY-LEVINE, SUSAN C PHD	5/28/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2324 SACRAMENTO ST	#111	SAN FRANCISCO	CA	94115	1931	38	06075	37.79020149	-122.4313011	San Francisco County
241198	Fee-for-Service	1205841533	1205841533	1	1	WALGREEN CO.	11/12/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2799 S WHITE RD	None	SAN JOSE	CA	95148	2093	43	06085	37.32572871	-121.7973412	Santa Clara County
241206	Fee-for-Service	1013029065	1013029065	1	1	WONG, JENNIFER L MD	5/11/2010	207R00000X	NA	Other	026	PHYSICIANS	87388	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
241270	Fee-for-Service	1346544848	1346544848	1	1	WISTERIA HOSPICE INC	8/13/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4195 VIKING WAY	SUITE 140	LONG BEACH	CA	90808	1466	19	06037	33.83357279	-118.1256257	Los Angeles County
241283	Fee-for-Service	1679734966	1679734966	1	1	WILSON, MELISSA S	8/1/2011	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1234 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3911	38	06075	37.781144	-122.4390035	San Francisco County
241296	Fee-for-Service	1659448850	1659448850	1	1	WONG, DAVID E MD	10/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87029	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
241306	Fee-for-Service	1437440609	1437440609	1	1	WRIGHT BECKER, CAROL L MD	6/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	214 E 23RD STREET	None	CHEYENNE	WY	82001	3748	00	None	41.1402124	-104.8159812	Laramie County
241316	Fee-for-Service	1538704457	1538704457	1	1	WEST, ADAM PSYD	4/5/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	15235 BURBANK BLVD	STE A2	SHERMAN OAKS	CA	91411	3555	19	06037	34.17211848	-118.465128	Los Angeles County
241364	Fee-for-Service	1659782605	1659782605	1	1	WANG, HENRY MEDICAL INC	6/23/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	72545	78	Neoplastic Diseases/Oncology	0	In state provider	None	289 WEST HUNTINGTON DR	SUITE 301	ARCADIA	CA	91007	3439	19	06037	34.13549119	-118.0419175	Los Angeles County
241379	Fee-for-Service	1144277492	1144277492	1	1	WEISSMAN, MARK A DPM	2/8/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
241498	Fee-for-Service	1013029065	1013029065	1	1	WONG, JENNIFER L MD	5/11/2010	207R00000X	NA	Other	026	PHYSICIANS	87388	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
241505	Fee-for-Service	1487186961	1487186961	1	1	WROBLEWSKI, KEVIN	7/12/2021	390200000X	NA	Other	026	PHYSICIANS	160680	None	None	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
241525	Fee-for-Service	1003475427	1003475427	1	1	WELLBEING RX, INC.	9/17/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1415 W ROSAMOND BLVD	22	ROSAMOND	CA	93560	7429	15	06029	34.86452101	-118.156126	Kern County
241542	Fee-for-Service	1730643636	1730643636	1	1	WAHBA, ELIZABETH LMFT	8/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
241552	Fee-for-Service	1952721367	1952721367	1	1	WIGHT, ANGELA B MD	7/25/2018	390200000X	NA	Other	026	PHYSICIANS	139966	05	Anesthesiology	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
241599	Fee-for-Service	1972131944	1972131944	1	1	WIESHOFER, ERICH L MD	1/13/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181504	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
241605	Fee-for-Service	1720594468	1720594468	1	1	WALL, KELLI O LMFT	12/12/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	829 JEFFERSON STREET	STE 3	NAPA	CA	94559	2210	28	06055	38.29622996	-122.2936116	Napa County
241649	Fee-for-Service	1235627340	1235627340	1	1	WILKINS Y MARTINEZ, ERIKA-LI	8/31/2021	390200000X	NA	Other	026	PHYSICIANS	174736	None	None	0	In state provider	ZETT T MD	1680 E 120 ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
241652	Fee-for-Service	1659782605	1659782605	1	1	WANG, HENRY MEDICAL INC	6/23/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	72545	68	Hematology	0	In state provider	None	289 WEST HUNTINGTON DR	SUITE 301	ARCADIA	CA	91007	3439	19	06037	34.13549119	-118.0419175	Los Angeles County
241653	Fee-for-Service	1891836490	1891836490	1	1	WHEELCARE EXPRESS INC	11/28/1990	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	BUNEK HIRANPRADIST	2999 DUTTON AVE	STE C	SANTA ROSA	CA	95407	5711	49	06097	38.40408	-122.723946	Sonoma County
241686	Fee-for-Service	1003436064	1003436064	1	66	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2360 S AZUSA AVE	A3	WEST COVINA	CA	91792	1539	19	06037	34.03422947	-117.9131031	Los Angeles County
241692	Fee-for-Service	1043675747	1043675747	1	1	WREN, JYESHA I CNM	7/21/2017	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
241716	Fee-for-Service	1932536992	1932536992	1	1	WINSLOW, ANGELA J	2/10/2014	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 THE CITY DRIVE SOUTH	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
241774	Fee-for-Service	1639605884	1639605884	1	1	WU, TERESA Q MD	9/22/2022	2084E0001X	NA	Neurology	026	PHYSICIANS	157936	None	None	0	In state provider	None	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	38	06075	37.78594176	-122.421322	San Francisco County
241779	Fee-for-Service	1962787036	1962787036	1	1	WALKER, TIFFANY A	7/2/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2138 MARGUERITE ST	None	DOS PALOS	CA	93620	2351	24	06047	36.986775	-120.6301889	Merced County
241806	Fee-for-Service	1114940855	1114940855	1	1	WONG, VICTOR MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	46578	05	Anesthesiology	0	In state provider	None	23560 CRENSHAW BLVD	STE 104	TORRANCE	CA	90505	5233	19	06037	33.811677	-118.328042	Los Angeles County
241810	Fee-for-Service	1487304911	1487304911	1	1	WU, PEISHAN OD	4/30/2025	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	STE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
241840	Fee-for-Service	1497043749	1497043749	1	1	WALGREEN CO.	9/28/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8030 IMPERIAL HWY	None	DOWNEY	CA	90242	3714	19	06037	33.92334172	-118.1509525	Los Angeles County
241941	Fee-for-Service	1558423954	1558423954	1	1	WILLIAM CHIANG	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
241956	Fee-for-Service	1710939681	1710939681	1	1	WEINERT, CARL R MD	10/22/1997	174400000X	NA	Other	026	PHYSICIANS	39051	20	Orthopedic Surgery	0	In state provider	None	1310 W STEWART DR	STE 508	ORANGE	CA	92868	3856	30	06059	33.78236048	-117.8664975	Orange County
241962	Fee-for-Service	1649419086	1649419086	1	1	WAGNER, RONALD W CRNA	10/21/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
241964	Fee-for-Service	1760852966	1760852966	1	1	WIN FAMILY MEDICINE INC	6/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132423	01	General Practice	0	In state provider	None	811 E 11TH ST	STE 205	UPLAND	CA	91786	4872	36	06071	34.1034335	-117.6398415	San Bernardino County
242024	Fee-for-Service	1982828166	1982828166	1	1	WESTCARE CALIFORNIA, INC	8/18/2016	261QR0405X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2772 SOUTH MARTIN LUTHER	KING BOULEVARD	FRESNO	CA	93606	5345	10	06019	36.70032437	-119.7998745	Fresno County
242029	Fee-for-Service	1457500944	1457500944	1	1	WARD, CRYSTAL K LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
242042	Fee-for-Service	1750006946	1750006946	1	2	WILD PAW LLC	11/3/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	25201 AVENUE TIBBITTS	SUITE 103	VALENCIA	CA	91355	3433	19	06037	34.42872823	-118.5738422	Los Angeles County
242050	Fee-for-Service	1548555014	1548555014	1	1	WANG, CHRISTINA MD	1/21/2025	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
242080	Fee-for-Service	1013103324	1013103324	1	1	WEINTRAUB, JENNIFER L MD	9/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	84000	24	Plastic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
242085	Fee-for-Service	1881774743	1881774743	1	1	WILLETT, GREGORY MD INC	9/13/1977	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22826	26	Psychiatry (child)	0	In state provider	None	4477 W 118TH ST	STE 400	HAWTHORNE	CA	90250	2259	19	06037	33.92734752	-118.354221	Los Angeles County
242111	Fee-for-Service	1659329993	1659329993	1	1	WU, WENDONG MD	6/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	74074	41	Internal Medicine	0	In state provider	None	7880 WREN AVE	STE D143	GILROY	CA	95020	7802	43	06085	37.00983795	-121.5870382	Santa Clara County
242113	Fee-for-Service	1629271879	1629271879	1	1	WOO, WESLEY S MD	8/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88816	38	Geriatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
242201	Fee-for-Service	1033117494	1033117494	1	1	WANG, YONKER Y MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83559	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
242203	Fee-for-Service	1114313012	1114313012	1	1	WELFORD, ELLIOTT M MD	6/28/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	162023	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
242205	Fee-for-Service	1619921947	1619921947	1	1	WEIRTON, MEDICAL CENTER	6/6/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	601 COLLIERS WAY	None	WEIRTON	WV	26062	0000	00	None	40.39387022	-80.52955048	Brooke County
242211	Fee-for-Service	1700543196	1700543196	1	1	WONG, MELISSA S OD	1/31/2025	152WV0400X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 S ATLANTIC BLVD	STE A	MONTEREY PARK	CA	91754	3872	19	06037	34.05627946	-118.1347926	Los Angeles County
242237	Fee-for-Service	1316074487	1316074487	1	1	WILSON-MCGEE, SHANTEL J	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	101395	-	NOT APPLICABLE	0	In state provider	None	100 EAST WARDLOW RD	None	LONG BEACH	CA	90503	1727	19	06037	33.8188341	-118.1923297	Los Angeles County
242245	Fee-for-Service	1972112340	1972112340	1	1	WEBB, ALEXANDRA E AU	9/2/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
242326	Fee-for-Service	1003436064	1003436064	1	20	WS AUDIOLOGY (CALIFORNIA), P	7/2/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2941 COCHRAN	SUITE 2A3	SIMI VALLEY	CA	93065	2789	56	06111	34.27903952	-118.739646	Ventura County
242334	Fee-for-Service	1689748451	1689748451	1	1	WILLIAMS, MARTHA F	1/9/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	81 CERNON STREET	None	VACAVILLE	CA	95688	2803	48	06095	38.36102104	-121.9906107	Solano County
242375	Fee-for-Service	1881774743	1881774743	1	1	WILLETT, GREGORY MD INC	9/13/1977	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22826	36	Psychiatry	0	In state provider	None	4477 W 118TH ST	STE 400	HAWTHORNE	CA	90250	2259	19	06037	33.92734752	-118.354221	Los Angeles County
242384	Fee-for-Service	1225126956	1225126956	1	1	WEAVER, SEYMOUR M III MD	12/5/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	38690	01	General Practice	0	In state provider	None	4579 DON RICARDO DR	None	LOS ANGELES	CA	90008	2811	19	06037	34.01142582	-118.353193	Los Angeles County
242422	Fee-for-Service	1104312180	1104312180	1	1	WARDINGER, JAIMIE E MD	9/12/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
242476	Fee-for-Service	1689105587	1689105587	1	1	WANG, LIBING MD	8/10/2021	207L00000X	NA	Other	026	PHYSICIANS	159634	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
242478	Fee-for-Service	1477732238	1477732238	1	1	WATTERS, EDWARD J	1/24/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
242558	Fee-for-Service	1568735496	1568735496	1	1	WATSON, NYREE LMFT	1/13/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14751 SEVENTH ST	#D	VICTORVILLE	CA	92395	4022	36	06071	34.51916209	-117.3101115	San Bernardino County
242560	Fee-for-Service	1780994558	1780994558	1	1	WESTPHAL, WENDY PT	12/1/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5255 EL CAMINO REAL	SUITE C	ATASCADERO	CA	93422	3351	40	06079	35.49280107	-120.6762923	San Luis Obispo County
242611	Fee-for-Service	1003436064	1003436064	1	20	WS AUDIOLOGY (CALIFORNIA), P	7/2/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2941 COCHRAN	SUITE 2A3	SIMI VALLEY	CA	93065	2789	56	06111	34.27903952	-118.739646	Ventura County
242630	Fee-for-Service	1063434348	1063434348	1	1	WEITZMAN, JEFFREY D MD	2/28/1991	207P00000X	NA	Other	026	PHYSICIANS	50122	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
242651	Fee-for-Service	1316585300	1316585300	1	1	WILKS, ARIEL OT	3/23/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4000 CIVIC CENTER DRIVE	STE 100	SAN RAFAEL	CA	94903	4173	21	06041	38.0041783	-122.538861	Marin County
242694	Fee-for-Service	1538275862	1538275862	1	1	WHITLOCK, JAMES R DC	1/24/2004	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	WHITLOCK CHIROPRACTIC IN	55887 YUCCA TRAIL	None	YUCCA VALLEY	CA	92284	2546	36	06071	34.12065895	-116.4449644	San Bernardino County
242703	Fee-for-Service	1861796989	1861796989	1	1	WHEELER, JEDEDIAH L DO	9/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11998	40	Pediatrics	0	In state provider	None	1820 41ST AVENUE	SUITE D	SANTA CRUZ	CA	95010	2516	44	06087	36.975573	-121.964832	Santa Cruz
242706	Fee-for-Service	1932348158	1932348158	1	1	WALGREEN CO	7/16/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12120 NEW AIRPORT RD	None	AUBURN	CA	95603	9592	31	06061	38.93274836	-121.0900902	Placer County
242744	Fee-for-Service	1386647469	1386647469	1	1	WATSON, BRANDON J MD	1/31/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7124	00	None	32.683167	-114.633459	Yuma County
242749	Fee-for-Service	1922441211	1922441211	1	1	WUSIRIKA, LAVANYA MD	4/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136831	26	Psychiatry (child)	0	In state provider	None	1120 W LA VETA AVE	STE 470	ORANGE	CA	92868	4231	30	06059	33.78029455	-117.864369	Orange County
242793	Fee-for-Service	1073288221	1073288221	1	1	WILLIAMS, TERESA Y CCC-SLP	11/2/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8265 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	7671	36	06071	34.10330723	-117.5642502	San Bernardino County
242810	Fee-for-Service	1053648626	1053648626	1	1	WILSON, DEISHA L M DO	10/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	11676	01	General Practice	0	In state provider	None	145 THUNDER DR	None	VISTA	CA	92083	6010	37	06073	33.18535652	-117.288201	San Diego County
242848	Fee-for-Service	1942403860	1942403860	1	1	WONG, ANDREW TY DO	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	9437	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
242986	Fee-for-Service	1730228768	1730228768	1	1	WIEMANN, JOHN M IV MD	3/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140151	40	Pediatrics	0	In state provider	None	729 N MEDICAL CTR DR W	SUITE 111	CLOVIS	CA	93611	6880	10	06019	36.84152435	-119.6624818	Fresno County
243014	Fee-for-Service	1740810613	1740810613	1	1	WON, JENIFFER NP	4/17/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7677 CENTER AVE	STE 214	HUNTINGTON BEACH	CA	92647	9102	30	06059	33.736257	-117.995535	Orange County
243048	Fee-for-Service	1780627414	1780627414	1	1	WISE, DAVID S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2455 NE LOOP 410	STE 235	SAN ANTONIO	TX	78217	5650	00	None	29.51639559	-98.41706947	Bexar County
243051	Fee-for-Service	1225289788	1225289788	1	1	WILLIAMS, RICHARD B PHD MD	12/15/2011	207R00000X	NA	Other	026	PHYSICIANS	58242	41	Internal Medicine	0	In state provider	INC	630 MISSION ST	None	SOUTH PASADENA	CA	91030	3038	19	06037	34.11573853	-118.1624085	Los Angeles County
243071	Fee-for-Service	1497172712	1497172712	1	1	WITMER, NATHANIEL D DPM	2/5/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	02	General Surgery	0	In state provider	None	23803 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39750589	-118.552072	Los Angeles County
243089	Fee-for-Service	1912953217	1912953217	2	1	WOODBURN, KEVIN D OD	4/25/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 SIERRA COLLEGE DR	STE A	GRASS VALLEY	CA	95945	5093	29	06057	39.23646768	-121.0569129	Nevada County
243143	Fee-for-Service	1508943358	1508943358	1	1	WENDLAND, BARBARA S CNP	3/20/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
243214	Fee-for-Service	1902991961	1902991961	1	1	WANG, SHIRONG S MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54082	22	Pathology (M.D. only)	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
243256	Fee-for-Service	1013060631	1013060631	1	1	WOODS, JACQUELINE A PSYD	12/28/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	4633	07	06013	38.00771973	-122.1331484	Contra Costa County
243280	Fee-for-Service	1649469701	1649469701	1	1	WALKER, CHRISTOPHER A MD	12/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106362	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
243283	Fee-for-Service	1013208735	1013208735	1	1	WARREN, JASON L CO	6/10/2011	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	1236 N EL DORADO ST	#3	STOCKTON	CA	95202	1324	39	06077	37.96528882	-121.293196	San Joaquin County
243348	Fee-for-Service	1588999494	1588999494	1	1	WHITE, KRISTIE L MD	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110420	68	Hematology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
243373	Fee-for-Service	1790036291	1790036291	1	1	WOODWARD, JENNIFER A LMFT	7/24/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	114372	-	NOT APPLICABLE	0	In state provider	None	2180 JOHNSON AVE	1ST FLOOR	SAN LUIS OBISPO	CA	93401	4513	40	06079	35.27488974	-120.6468257	San Luis Obispo County
243379	Fee-for-Service	1225063555	1225063555	1	1	WELCH, MARK A DO	7/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	8950	36	Psychiatry	0	In state provider	None	11374 MOUNTAIN VIEW AVE	STE A	LOMA LINDA	CA	92354	3830	36	06071	34.0465275	-117.2436991	San Bernardino County
243387	Fee-for-Service	1023193117	1023193117	1	1	WU, PETER EN-YUAN MD	12/30/1990	174400000X	NA	Other	026	PHYSICIANS	72358	None	None	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
243459	Fee-for-Service	1548216724	1548216724	1	1	WEINER,ROBIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SANFORD CLINIC DERMATO-	LOGY	1310 W 22ND ST	SIOUX FALLS	SD	57105	0000	00	None	0	0	None
243486	Fee-for-Service	1265525612	1265525612	1	1	WILSON, PAMELA E MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	25	Physical Medicine and Rehabilitation	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
243502	Fee-for-Service	1902991961	1902991961	1	1	WANG, SHIRONG S MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54082	01	General Practice	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
243510	Fee-for-Service	1588695340	1588695340	1	1	WUDRICK, ROBERT B MD	4/29/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49426	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
243511	Fee-for-Service	1114931151	1114931151	1	1	WONG, CURTIS S F MD	9/10/1993	208200000X	NA	General Surgery	026	PHYSICIANS	74386	24	Plastic Surgery	0	In state provider	None	2510 AIRPARK DR	STE 104	REDDING	CA	96001	2461	45	06089	40.57119566	-122.4016582	Shasta County
243563	Fee-for-Service	1609809847	1609809847	1	1	WEST, MICHAEL A MD	5/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88483	02	General Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A37	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
243567	Fee-for-Service	1508945643	1508945643	1	1	WEIL, JOSHUA B MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61092	66	Emergency Medicine (Urgent Care)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
243599	Fee-for-Service	1407240096	1407240096	1	1	WUNG, WILLIAM MD	3/29/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	145714	41	Internal Medicine	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
243624	Fee-for-Service	1346254257	1346254257	1	1	WALGREEN CO	10/12/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #09486	18296 COLLIER AVE	None	LAKE ELSINORE	CA	92530	2754	33	06065	33.69042777	-117.3403538	Riverside County
243637	Fee-for-Service	1588999494	1588999494	1	1	WHITE, KRISTIE L MD	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110420	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
243653	Fee-for-Service	1093139131	1093139131	1	1	WAGNER, HILARY CRNA	5/2/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
243672	Fee-for-Service	1801931431	1801931431	1	1	WEST VALLEY HEARING CENTER I	2/6/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	21731 VENTURA BLVD	#165	WOODLAND HILLS	CA	91364	5110	19	06037	34.16839279	-118.6016172	Los Angeles County
243677	Fee-for-Service	1144488974	1144488974	1	1	WONG, JENISE C MD	5/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108771	01	General Practice	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
243702	Fee-for-Service	1669117966	1669117966	1	1	WILLIAM KURBAN MD INC	8/29/2022	207RE0101X	NA	Endocrinology	026	PHYSICIANS	None	None	None	0	In state provider	None	210 S GRAND AVE	224	GLENDORA	CA	91741	4273	19	06037	34.133859	-117.872523	Los Angeles County
243728	Fee-for-Service	1518744184	1518744184	1	1	WHITE MOUNTAIN FIRE PROTECTI	3/1/2024	341600000X	NA	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ON DISTRICT	25470 HIGHWAY 6	None	BENTON	CA	93512	7407	26	06051	37.81574498	-118.4760372	Mono County
243734	Fee-for-Service	1417478835	1417478835	1	1	WOMACK, MASON R OD	6/5/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	817 COURT ST	STE 10	JACKSON	CA	95642	2156	03	06005	38.35288237	-120.7662416	Amador County
243737	Fee-for-Service	1316799109	1316799109	1	1	WELLCOME PHARMACY, INC.	12/19/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1440 EL PASEO DE SARATOG	None	SAN JOSE	CA	95130	1633	43	06085	37.2901612	-121.9932186	Santa Clara County
243741	Fee-for-Service	1336113737	1336113737	1	1	WHITAKER, SUSAN E	2/27/2011	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2208 PARK MARINA DR	None	REDDING	CA	96001	2111	45	06089	40.58138366	-122.3714737	Shasta County
243749	Fee-for-Service	1376602086	1376602086	1	1	WILSON, GARY S CRNA	4/5/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
243774	Fee-for-Service	1265525612	1265525612	1	1	WILSON, PAMELA E MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
243775	Fee-for-Service	1750813432	1750813432	1	1	WADOOD, ZARA MD	9/28/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	189810	None	None	0	In state provider	None	74785 US HIGHWAY 111	STE 101	INDIAN WELLS	CA	92210	7129	33	06065	33.72131925	-116.360116	Riverside County
243850	Fee-for-Service	1366691099	1366691099	1	1	WONG, VINCENT MD	7/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119991	None	None	0	In state provider	None	300 HOSPITAL DRIVE	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
243860	Fee-for-Service	1548551682	1548551682	1	1	WANG, XIAOBO MD	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117005	41	Internal Medicine	0	In state provider	None	3000 LAS POSITAS	None	LIVERMORE	CA	94551	9627	01	06001	37.69960369	-121.7628917	Alameda County
244014	Fee-for-Service	1558464065	1558464065	1	1	WEST COAST PULMONARY	8/6/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1910 OUTLET CENTER DR	None	OXNARD	CA	93036	0677	56	06111	34.2202663	-119.1484221	Ventura County
244086	Fee-for-Service	1497768329	1497768329	1	1	WANG, JENNIFER L MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95818	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
244136	Fee-for-Service	1184634586	1184634586	1	1	WISE, DENISE K MD	6/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	74394	None	None	0	In state provider	None	2581 SAMARITAN DR	STE 100 & 206	SAN JOSE	CA	95124	4112	43	06085	37.25305684	-121.9507351	Santa Clara County
244158	Fee-for-Service	1780663450	1780663450	1	1	WEINMANN,ROBERT HENRY	7/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	250 THOMPSON ST	None	ST PAUL	MN	55102	2370	00	None	44.94428014	-93.10733608	Ramsey County
244176	Fee-for-Service	1649613761	1649613761	1	1	WAY, JENNIFER S MD	4/8/2022	207RE0101X	NA	Endocrinology	026	PHYSICIANS	133595	None	None	0	In state provider	None	1250 LA VENTA DRIVE	100, 101A, 105, 207, 211	WESTLAKE VILLAGE	CA	91361	3774	19	06037	34.14827603	-118.8227637	Ventura County
244234	Fee-for-Service	1851341176	1851341176	1	1	WINE, RODGER S MD	1/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71194	05	Anesthesiology	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
244258	Fee-for-Service	1124257324	1124257324	1	4	WELLSPACE HEALTH	4/15/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	6060 WATT AVENUE	None	NORTH HIGHLANDS	CA	95660	4212	34	06067	38.676105	-121.3811235	Sacramento County
244340	Fee-for-Service	1821003104	1821003104	1	1	WALGREEN CO	1/5/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2900 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2302	34	06067	38.547882	-121.454955	Sacramento County
244366	Fee-for-Service	1831106061	1831106061	1	1	WHITLOCK, DAVID E MD	2/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37805	66	Emergency Medicine (Urgent Care)	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
244372	Fee-for-Service	1265829345	1265829345	1	1	WU, CHRIS MD	7/15/2019	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	161633	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
244393	Fee-for-Service	1922092469	1922092469	1	1	WOODWARD, EDWARD B MD	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65740	02	General Surgery	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
244525	Fee-for-Service	1336115401	1336115401	1	1	WYNNE, JULIE LAMAR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL	None	TUCSON	AZ	85724	0000	00	None	32.240493	-110.9460825	Pima County
244546	Fee-for-Service	1124257324	1124257324	1	9	WELLSPACE HEALTH	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8231 E STOCKTON BLVD	SUITE C	SACRAMENTO	CA	95828	8200	34	06067	38.459727	-121.410315	Sacramento County
244593	Fee-for-Service	1124443098	1124443098	1	1	WIN, JASMINE MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141094	41	Internal Medicine	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
244677	Fee-for-Service	1881655017	1881655017	1	1	WU, RICHARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
244697	Fee-for-Service	1538328588	1538328588	1	1	WEBBER, ALLISON B MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109068	45	Nephrology (Renal-Kidney)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
244706	Fee-for-Service	1023161734	1023161734	1	1	WELLBOUND OF SAN JOSE	7/12/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	2000 S EL CAMINO REAL	FL 2	SAN MATEO	CA	94403	1805	41	06081	37.54812128	-122.3096746	San Mateo County
244716	Fee-for-Service	1275511644	1275511644	1	1	WIEBE & CARDAN MDS	1/1/1987	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	1700 N ROSE AVE	STE 430	OXNARD	CA	93030	7657	56	06111	34.21746	-119.155545	Ventura County
244774	Fee-for-Service	1104999739	1104999739	1	1	WATKINS, HUBERT C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	8729	07	Dermatology	0	In state provider	None	6926 BROCKTON AVE	STE 10	RIVERSIDE	CA	92506	3880	33	06065	33.947919	-117.3967225	Riverside County
244819	Fee-for-Service	1124257324	1124257324	1	11	WELLSPACE HEALTH	3/11/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6015 WATT AVE	STE 2&3	NORTH HIGHLANDS	CA	95660	4294	34	06067	38.676627	-121.3842375	Sacramento County
244825	Fee-for-Service	1801257043	1801257043	1	1	WINDHAM, ALIA M LAC	10/5/2016	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9333 GENESEE AVE	STE 200	SAN DIEGO	CA	92121	2113	37	06073	32.875668	-117.2139225	San Diego County
244828	Fee-for-Service	1265660112	1265660112	1	1	WOO, ELLEN PHD	7/14/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
244835	Fee-for-Service	1124257324	1124257324	1	9	WELLSPACE HEALTH	11/25/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8231 E STOCKTON BLVD	SUITE C	SACRAMENTO	CA	95828	8200	34	06067	38.459727	-121.410315	Sacramento County
244858	Fee-for-Service	1174753784	1174753784	1	1	WONGSAROJ, PATARAPHA MD	11/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119992	45	Nephrology (Renal-Kidney)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	7804	19	06037	34.07671715	-118.3799413	Los Angeles County
244920	Fee-for-Service	1538153127	1538153127	1	1	WILLIS, JAMES A MD	9/30/1991	207L00000X	NA	Other	026	PHYSICIANS	37443	05	Anesthesiology	0	In state provider	None	1900 POINT WEST WAY	STE 222	SACRAMENTO	CA	95815	4704	34	06067	38.599677	-121.431447	Sacramento County
244956	Fee-for-Service	1932373693	1932373693	1	1	WARNER, FRANCENE A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	AZ REGIONAL MED CTR	515 N. MESA DR	None	MESA	AZ	85201	5914	00	None	33.424767	-111.8219445	Maricopa County
244988	Fee-for-Service	1538328588	1538328588	1	1	WEBBER, ALLISON B MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109068	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
245062	Fee-for-Service	1659661072	1659661072	1	1	WOOD, BREANNA C	2/26/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
245073	Fee-for-Service	1982120127	1982120127	1	1	WALKER, MATTHEW D PT	4/27/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1229 COMMERCE AVE	None	ATWATER	CA	95301	5224	24	06047	37.34298769	-120.6128556	Merced County
245077	Fee-for-Service	1427087790	1427087790	1	1	WALSH, EMILY R Z NP	10/19/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
245090	Fee-for-Service	1982877312	1982877312	1	1	WHITE MEMORIAL OTOLARYNGOLOG	6/29/2009	251V00000X	NA	Other	026	PHYSICIANS	29478	04	Otology, Laryngology, Rhinology	0	In state provider	Y FOUNDATION INC	1700 CESAR E CHAVEZ AVE	2300	LOS ANGELES	CA	90033	2410	19	06037	34.05101259	-118.217259	Los Angeles County
245094	Fee-for-Service	1730240912	1730240912	1	1	WONG, BRYAN C MD	4/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89028	08	Family Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
245099	Fee-for-Service	1215218896	1215218896	1	1	WESTERN PALLIATIVE CARE INC	5/5/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	21860 BURBANK BLVD	STE 180 B	WOODLAND HILLS	CA	91367	6477	19	06037	34.17221715	-118.6035697	Los Angeles County
245114	Fee-for-Service	1124257324	1124257324	1	11	WELLSPACE HEALTH	3/11/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6015 WATT AVE	STE 2&3	NORTH HIGHLANDS	CA	95660	4294	34	06067	38.676627	-121.3842375	Sacramento County
245123	Fee-for-Service	1124257324	1124257324	1	4	WELLSPACE HEALTH	4/15/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	6060 WATT AVENUE	None	NORTH HIGHLANDS	CA	95660	4212	34	06067	38.676105	-121.3811235	Sacramento County
245144	Fee-for-Service	1174753784	1174753784	1	1	WONGSAROJ, PATARAPHA MD	11/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119992	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	7804	19	06037	34.07671715	-118.3799413	Los Angeles County
245187	Fee-for-Service	1568539468	1568539468	1	1	WINNICK, ANDREA C MD	9/30/1984	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	54135	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
245196	Fee-for-Service	1346245883	1346245883	1	1	WILLIAM GUTHEIM MD	3/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3355 RIVERBEND DR	STE 200	SPRINGFIELD	OR	97477	8800	00	None	44.08239413	-123.0281717	Lane County
245212	Fee-for-Service	1356802375	1356802375	1	1	WALIANY, SARAH MD	6/8/2022	207R00000X	NA	Other	026	PHYSICIANS	176869	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
245230	Fee-for-Service	1093911299	1093911299	1	1	WU, JING-FUN MD	4/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102025	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
245238	Fee-for-Service	1295408862	1295408862	1	1	WISE CHOICE HOME HEALTH CARE	5/10/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	7017 VAN NUYS BLVD	STE 3	VAN NUYS	CA	91405	3095	19	06037	34.19799657	-118.4487934	Los Angeles County
245275	Fee-for-Service	1154680650	1154680650	1	1	WONG, VANESSA L MD	10/18/2022	2080P0203X	NA	Other	026	PHYSICIANS	130899	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
245299	Fee-for-Service	1619283025	1619283025	1	1	WALGREEN CO	12/20/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #10764	2376 E COLORADO BLVD	None	PASADENA	CA	91107	4249	19	06037	34.1460495	-118.1013165	Los Angeles County
245348	Fee-for-Service	1568816163	1568816163	1	1	WONG, SHUNDE T MD	5/28/2020	207R00000X	NA	Other	026	PHYSICIANS	151943	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
245357	Fee-for-Service	1851929566	1851929566	1	1	WELKER, OLIVIA M MD	1/21/2025	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
245378	Fee-for-Service	1982877312	1982877312	1	1	WHITE MEMORIAL OTOLARYNGOLOG	6/29/2009	251V00000X	NA	Other	026	PHYSICIANS	29478	01	General Practice	0	In state provider	Y FOUNDATION INC	1700 CESAR E CHAVEZ AVE	2300	LOS ANGELES	CA	90033	2410	19	06037	34.05101259	-118.217259	Los Angeles County
245380	Fee-for-Service	1306101746	1306101746	1	1	WONG, MATTHEW H OD	1/23/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
245388	Fee-for-Service	1215218896	1215218896	1	1	WESTERN PALLIATIVE CARE INC	5/5/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	21860 BURBANK BLVD	STE 180 B	WOODLAND HILLS	CA	91367	6477	19	06037	34.17221715	-118.6035697	Los Angeles County
245392	Fee-for-Service	1548919442	1548919442	1	1	WALKER, KEVIN MD	8/25/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	189338	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
245411	Fee-for-Service	1770361552	1770361552	1	1	WHALEN, NESHOMA E	10/8/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
245433	Fee-for-Service	1215103072	1215103072	1	1	WU, SHIRLEY MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109833	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
245473	Fee-for-Service	1275535627	1275535627	1	1	WILEY, MYLEA N MD	8/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88917	41	Internal Medicine	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
245475	Fee-for-Service	1568539468	1568539468	1	1	WINNICK, ANDREA C MD	9/30/1984	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	54135	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
245508	Fee-for-Service	1578528170	1578528170	1	1	WACHTER, ROBERT M MD	10/31/1986	207R00000X	NA	Other	026	PHYSICIANS	53933	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	# 1E	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
245523	Fee-for-Service	1659665461	1659665461	1	1	WALTERS, DANIEL C MD	7/16/2019	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	129565	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
245589	Fee-for-Service	1275895294	1275895294	1	1	WILLIAMS, LA SHAWNA C MD	10/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135677	25	Physical Medicine and Rehabilitation	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
245657	Fee-for-Service	1053404608	1053404608	1	1	WONG, DAVID H MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	47951	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
245700	Fee-for-Service	1487817268	1487817268	1	1	WEAVER, COLLEEN A NP	4/22/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
245721	Fee-for-Service	1215103072	1215103072	1	1	WU, SHIRLEY MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109833	01	General Practice	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
245726	Fee-for-Service	1356475347	1356475347	1	1	WEBB-KUMMER, GRETCHEN G	6/6/2016	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	94868	01	General Practice	0	In state provider	MD	1425 W H ST	STE 200	OAKDALE	CA	95361	3590	50	06099	37.75771796	-120.8627767	Stanislaus County
245764	Fee-for-Service	1508337510	1508337510	1	1	WISE CARE PHARMACY INC	1/11/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8980 KNOTT AVE	None	BUENA PARK	CA	90620	4137	30	06059	33.83248287	-118.0108412	Orange County
245791	Fee-for-Service	1124112578	1124112578	1	1	WOTHERSPOON, ANN M DPM	8/8/1988	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1792 ROSSWOOD DR	None	SAN JOSE	CA	95124	5223	43	06085	37.24907485	-121.9151708	Santa Clara County
245796	Fee-for-Service	1881619146	1881619146	1	1	WILLIAMS, EARL F LCSW	6/13/1999	101YM0800X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	10101 SLATER AVE	STE 220	FOUNTAIN VALLEY	CA	92708	4741	30	06059	33.70909852	-117.9525465	Orange County
245804	Fee-for-Service	1073831145	1073831145	1	1	WALGREEN CO	8/30/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2810 S TRACY BLVD	None	TRACY	CA	95377	8127	39	06077	37.707805	-121.4344886	San Joaquin County
245805	Fee-for-Service	1619982626	1619982626	1	1	WALGREEN CO	12/1/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	885 EUCLID AVE	None	NATIONAL CITY	CA	91950	3862	37	06073	32.68129235	-117.0810306	San Diego County
245860	Fee-for-Service	1043225329	1043225329	1	1	WALGREEN CO.	9/5/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3093 MARLOW RD	None	SANTA ROSA	CA	95403	2426	49	06097	38.466126	-122.751954	Sonoma County
245862	Fee-for-Service	1376106369	1376106369	1	1	WE DO CARE HOSPICE	3/10/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14349 VICTORY BLVD	STE 102	VAN NUYS	CA	91401	6516	19	06037	34.18669646	-118.4460435	Los Angeles County
245868	Fee-for-Service	1487634861	1487634861	1	1	WEE, TIEN AHN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 DIVISION ST	None	OREGON CITY	OR	97045	1527	00	None	45.35630784	-122.5883649	Clackamas County
246027	Fee-for-Service	1568857753	1568857753	1	1	WETZEL, ALLAN B	5/23/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
246063	Fee-for-Service	1265539514	1265539514	1	1	WONG, JOHN P MD	5/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66312	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
246076	Fee-for-Service	1588205140	1588205140	1	1	WANG, BILLY OD	12/15/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
246149	Fee-for-Service	1376106369	1376106369	1	1	WE DO CARE HOSPICE	3/10/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14349 VICTORY BLVD	STE 102	VAN NUYS	CA	91401	6516	19	06037	34.18669646	-118.4460435	Los Angeles County
246168	Fee-for-Service	1295777100	1295777100	1	1	WIDNELL, KATHERINE L MD	7/31/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	141716	None	None	0	In state provider	None	2625 W ALAMEDA AVE	300, 322	BURBANK	CA	91505	4819	19	06037	34.1577056	-118.329779	Los Angeles County
246189	Fee-for-Service	1831251966	1831251966	1	1	WALSH, NANCY LMFT	8/6/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1190 MARSH ST	STE C	SAN LUIS OBISPO	CA	93401	3332	40	06079	35.28206085	-120.6574329	San Luis Obispo County
246231	Fee-for-Service	1487920724	1487920724	1	1	WIGBY, KRISTEN M MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136240	40	Pediatrics	0	In state provider	None	7920 FROST ST	STE 200	SAN DIEGO	CA	92123	4289	37	06073	32.80027449	-117.153846	San Diego County
246241	Fee-for-Service	1396224671	1396224671	1	1	WILLIAMS, ALYCIA R LCSW	11/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
246257	Fee-for-Service	1487842035	1487842035	1	1	WILSHIRE ONCOLOGY MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	GRP INC	210 S GRAND AVE	STE 402	GLENDORA	CA	91741	4291	19	06037	34.133859	-117.872523	Los Angeles County
246301	Fee-for-Service	1629731187	1629731187	1	1	WASON, SONALI PSYD	5/8/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
246363	Fee-for-Service	1669812913	1669812913	1	1	WERTZ, ROBERT M MD	1/9/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182591	None	None	0	In state provider	None	1380 LEAD HILL RD	SUITE 100	ROSEVILLE	CA	95661	2997	31	06061	38.74953449	-121.2601832	Placer County
246376	Fee-for-Service	1114984457	1114984457	1	1	WINTERS, JAN S LMFT	11/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	255 TERRACINA BLVD	SUITE 204	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
246389	Fee-for-Service	1124384425	1124384425	1	1	WANG, RICHARD J MD	6/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137315	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANICSCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco
246406	Fee-for-Service	1285760611	1285760611	1	1	WATTS, MELANIE R MD	5/28/2010	207P00000X	NA	Other	026	PHYSICIANS	105102	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
246447	Fee-for-Service	1144737073	1144737073	1	1	WANG, ABIGAIL Y	10/21/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
246490	Fee-for-Service	1851708168	1851708168	1	1	WILLIAMS, MARCUS L MD	6/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130108	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39400 PASEO PADRE PRKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
246521	Fee-for-Service	1487920724	1487920724	1	1	WIGBY, KRISTEN M MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136240	01	General Practice	0	In state provider	None	7920 FROST ST	STE 200	SAN DIEGO	CA	92123	4289	37	06073	32.80027449	-117.153846	San Diego County
246543	Fee-for-Service	1487842035	1487842035	1	1	WILSHIRE ONCOLOGY MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GRP INC	210 S GRAND AVE	STE 402	GLENDORA	CA	91741	4291	19	06037	34.133859	-117.872523	Los Angeles County
246590	Fee-for-Service	1902284912	1902284912	1	1	WHITAKER, CHANDRA PT	1/17/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
246592	Fee-for-Service	1033529235	1033529235	1	1	WILLIAMS, KIRVIA J DO	9/1/2020	2084V0102X	NA	Neurology	026	PHYSICIANS	14936	None	None	0	In state provider	None	58457 29 PALMS HIGHWAY	STE 200	YUCCA VALLEY	CA	92284	5879	36	06071	34.13247642	-116.3885551	San Bernardino County
246615	Fee-for-Service	1144704495	1144704495	1	1	WALKER, ERIC P LMFT	1/6/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	130352	-	NOT APPLICABLE	0	In state provider	None	10221 S. COMPTON AVE,	SUITE 105 & 103	LOS ANGELES	CA	90002	2802	19	06037	33.943518	-118.246236	Los Angeles County
246619	Fee-for-Service	1760496764	1760496764	1	1	WHITLEY, THERESA B MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	65738	41	Internal Medicine	0	In state provider	None	500 1ST AVE	None	PORTOLA	CA	96122	9406	32	06063	39.80595392	-120.4626723	Plumas County
246629	Fee-for-Service	1790903656	1790903656	1	1	WOLCOTT, KEVIN R	5/11/2009	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	101 S 1ST ST	STE 1800	BURBANK	CA	91502	1938	19	06037	34.17942444	-118.3096895	Los Angeles County
246633	Fee-for-Service	1366524605	1366524605	1	1	WIGHT, NANCY E MD	6/21/2000	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	38723	40	Pediatrics	0	In state provider	None	3666 KEARNY VILLA RD	None	SAN DIEGO	CA	92123	1949	37	06073	32.80970214	-117.1513084	San Diego County
246643	Fee-for-Service	1033736939	1033736939	1	1	WALTERS, TRISHA PT	1/22/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1914 TICE VALLEY BLVD	None	WALNUT CREEK	CA	94595	2203	07	06013	37.87851556	-122.0745896	Contra Costa County
246668	Fee-for-Service	1881354306	1881354306	1	1	WARD, KRISTINA M AU	1/12/2022	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
246738	Fee-for-Service	1679589071	1679589071	1	1	WALGREEN CO	11/15/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1311 E FLORIDA AVE	None	HEMET	CA	92544	8606	33	06065	33.74752354	-116.9580825	Riverside County
246771	Fee-for-Service	1306610936	1306610936	1	1	WADE, SARAH J NP	1/8/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
246810	Fee-for-Service	1417229022	1417229022	1	1	WELLBOUND OF MENLO PARK LLC	6/12/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2001 JUNIPERO SERRA BLVD	SUITE 535	DALY CITY	CA	94014	3889	41	06081	37.70124814	-122.4706974	San Mateo County
246834	Fee-for-Service	1487842035	1487842035	1	1	WILSHIRE ONCOLOGY MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GRP INC	210 S GRAND AVE	STE 402	GLENDORA	CA	91741	4291	19	06037	34.133859	-117.872523	Los Angeles County
246869	Fee-for-Service	1215446109	1215446109	1	2	WELLBE HOME INC	3/4/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	12950 HAYNES ST	None	NORTH HOLLYWOOD	CA	91606	1105	19	06037	34.18956234	-118.4156029	Los Angeles County
246877	Fee-for-Service	1346234671	1346234671	1	1	WILLIAMS, TRACI R PT	5/7/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	440 E. HUNTINGTON DR	SUITE 104	ARCADIA	CA	91006	3709	19	06037	34.14014147	-118.0220265	Los Angeles County
246895	Fee-for-Service	1053733584	1053733584	1	1	WONG, SARA DO	8/18/2020	207R00000X	NA	Other	026	PHYSICIANS	13130	41	Internal Medicine	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
246933	Fee-for-Service	1184736548	1184736548	1	1	WEISENBERGER, JOHN E MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	25851	08	Family Practice	0	In state provider	None	912 N DOUTY ST	STE D	HANFORD	CA	93230	3918	16	06031	36.334656	-119.6460775	Kings County
246944	Fee-for-Service	1750609285	1750609285	1	1	WALGAMA, EVAN S MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136819	None	None	0	In state provider	None	8635 W 3RD ST	STE 1190W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
246979	Fee-for-Service	1306153424	1306153424	1	1	WASFI, SAMEH LMFT	1/30/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	96157	-	NOT APPLICABLE	0	In state provider	None	4000 BIRCH ST	SUITE 112A	NEWPORT BEACH	CA	92660	2211	30	06059	33.66463772	-117.8698289	Orange County
247004	Fee-for-Service	1184011710	1184011710	1	1	WAHBE, DINA S NP	7/10/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
247070	Fee-for-Service	1003846189	1003846189	1	1	WATCHI, RALPH MD APC	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	48327	40	Pediatrics	0	In state provider	None	1300 N VERMONT AVE	# 901	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
247082	Fee-for-Service	1871850933	1871850933	1	1	WAL-MART STORES, INC	8/8/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3300 BROADWAY STREET	BAYSHORE MALL	EUREKA	CA	95501	3809	12	06023	40.7788121	-124.188062	Humboldt County
247087	Fee-for-Service	1588632137	1588632137	1	1	WATT, TIMOTHY S MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67400	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
247233	Fee-for-Service	1689746885	1689746885	1	1	WU, RONALD S MD APC	10/15/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	16648	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1505 WILSON TERRACE	STE 220	GLENDALE	CA	91206	4071	19	06037	34.14960934	-118.2313491	Los Angeles County
247263	Fee-for-Service	1700850104	1700850104	1	1	WU, MICHAEL C MD	12/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53050	78	Neoplastic Diseases/Oncology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
247264	Fee-for-Service	1598983181	1598983181	1	1	WANG, ALICE W MD	6/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106683	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
247276	Fee-for-Service	1629104807	1629104807	1	1	WEILL, DAVID MD	12/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	52127	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
247302	Fee-for-Service	1457333247	1457333247	1	1	WILSON, CLAIRE M MD	7/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	45530	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
247365	Fee-for-Service	1629426077	1629426077	1	1	WEI, MARGARET MD	5/23/2019	207R00000X	NA	Other	026	PHYSICIANS	154742	41	Internal Medicine	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
247382	Fee-for-Service	1417247537	1417247537	1	1	WILDENAUER, ALEXIS R DO	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13902	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
247498	Fee-for-Service	1215078886	1215078886	1	1	WU, HUI-SUN NP	9/22/2008	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6120 VINELAND AVENUE	None	NORTH HOLLYWOOD	CA	91606	4914	19	06037	34.1819583	-118.3702737	Los Angeles County
247507	Fee-for-Service	1922612118	1922612118	1	1	WELL CARE HOSPICE INC	10/4/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1543 E PALMDALE BLVD	STE J	PALMDALE	CA	93550	4881	19	06037	34.57966352	-118.101582	Los Angeles County
247552	Fee-for-Service	1700850104	1700850104	1	1	WU, MICHAEL C MD	12/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53050	68	Hematology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
247553	Fee-for-Service	1598983181	1598983181	1	1	WANG, ALICE W MD	6/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106683	31	Roentgenology, Radiology (M.D. only)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
247619	Fee-for-Service	1952476350	1952476350	1	1	WAYMAN, DANIEL M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	04	Otology, Laryngology, Rhinology	1	Border provider	None	555 BLACK OAK DR	STE 210	MEDFORD	OR	97504	8491	00	None	42.318873	-122.835653	Jackson County
247661	Fee-for-Service	1891114617	1891114617	1	1	WOOLEN, SEAN A MD	5/15/2019	390200000X	NA	Other	026	PHYSICIANS	160099	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
247674	Fee-for-Service	1801872619	1801872619	1	1	WANG, DALE S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
247692	Fee-for-Service	1760825517	1760825517	1	1	WEI, ALAN C Y MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135747	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
247709	Fee-for-Service	1396750675	1396750675	1	1	WALGREEN CO	1/2/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#7577	1695 N SUNRISE WAY	None	PALM SPRINGS	CA	92262	3701	33	06065	33.844239	-116.5282075	Riverside County
247733	Fee-for-Service	1386650950	1386650950	1	1	WALGREEN CO.	1/9/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	342 W CALAVERAS BLVD	None	MILPITAS	CA	95035	5242	43	06085	37.426839	-121.9117873	Santa Clara County
247764	Fee-for-Service	1659743433	1659743433	1	1	WESTCOAST WELLNESS &	7/29/2016	207R00000X	NA	Other	026	PHYSICIANS	42932	41	Internal Medicine	0	In state provider	PREVENTIVE CARE INC	7895 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	7847	30	06059	33.75930046	-117.991053	Orange County
247786	Fee-for-Service	1922612118	1922612118	1	1	WELL CARE HOSPICE INC	10/4/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1543 E PALMDALE BLVD	STE J	PALMDALE	CA	93550	4881	19	06037	34.57966352	-118.101582	Los Angeles County
247800	Fee-for-Service	1083615082	1083615082	1	1	WINSTON, LORI D MD	10/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54788	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	54	06107	36.327888	-119.294919	Tulare County
247848	Fee-for-Service	1669425765	1669425765	1	1	WARE, PAUL F MD	6/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73645	25	Physical Medicine and Rehabilitation	0	In state provider	None	2250 HAYES ST	None	SAN FRANCISCO	CA	94117	1078	38	06075	37.77302042	-122.45342	San Francisco County
247861	Fee-for-Service	1225044498	1225044498	1	1	WATTS, WILLIAMS J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1135 116TH AVE NE	STE 600	BELLEVUE	WA	98004	4623	00	None	47.62130171	-122.1857045	King County
247916	Fee-for-Service	1851385579	1851385579	1	1	WEINER, RICHARD A	10/31/1991	207L00000X	NA	Other	026	PHYSICIANS	59209	None	None	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
247928	Fee-for-Service	1790064228	1790064228	1	1	WALSH-ROSENN, CHELSEA M LMFT	1/5/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	959 COLORADO BLVD.	220	PASADENA	CA	91106	5900	19	06037	34.14594353	-118.1306205	Los Angeles County
247936	Fee-for-Service	1124226121	1124226121	1	1	WALGREEN CO.	12/18/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2331 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	6805	19	06037	34.03684323	-118.147526	Los Angeles County
247946	Fee-for-Service	1609819622	1609819622	1	1	WACK, JON P MD	10/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23313	30	Radiology	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
247963	Fee-for-Service	1861615783	1861615783	1	1	WHEELER, CHERI D PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	39675 CEDAR BLVD	STE 240A	NEWARK	CA	94560	8540	01	06001	37.52050519	-121.9962032	Alameda County
248018	Fee-for-Service	1609084763	1609084763	1	1	WHIDBY, WAMAITHA LCSW	10/9/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2222 E ORANGEBURG AVE	None	MODESTO	CA	95355	3399	50	06099	37.66353653	-120.9564675	Stanislaus County
248054	Fee-for-Service	1992870364	1992870364	1	1	WONG, JENNY W	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
248074	Fee-for-Service	1578798914	1578798914	1	1	WAGNER, JEFFREY M	1/1/2019	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1430 ESPLANADE	STE 8	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
248119	Fee-for-Service	1649534603	1649534603	1	1	WYMAN, VALERIE A NP	11/7/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
248175	Fee-for-Service	1700272176	1700272176	1	1	WRIGHT, MICHAEL D MD	4/7/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	145117	30	Radiology	0	In state provider	None	10101 RIVERSIDE DR	None	TOLUCA LAKE	CA	91602	2517	19	06037	34.15223753	-118.3508865	Los Angeles County
248177	Fee-for-Service	1194150953	1194150953	1	1	WONG, CHRISTINA OD	7/3/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
248197	Fee-for-Service	1255536306	1255536306	1	1	WEISS, ELLA A LMFT	8/29/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
248295	Fee-for-Service	1306821228	1306821228	1	1	WOLF, DAVID L MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63319	05	Anesthesiology	0	In state provider	None	6409 LINCOLN AVE	None	CARMICHAEL	CA	95608	2487	34	06067	38.640879	-121.3158825	Sacramento County
248330	Fee-for-Service	1952343907	1952343907	1	1	WILLIAM BURT MD	5/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3215 N NORTHHILLS BLVD	None	FAYETTEVILLE	AR	72703	4424	00	None	36.109287	-94.160007	Washington County
248355	Fee-for-Service	1730430588	1730430588	1	1	WEAVER, RONALD SEYMOUR MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	30118	None	None	0	In state provider	INC	11860 WILSHIRE BLVD	STE 100	LOS ANGELES	CA	90025	6613	19	06037	34.04705881	-118.4637989	Los Angeles County
248361	Fee-for-Service	1396399101	1396399101	1	1	WESTCARE CALIFORNIA, INC.	10/5/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	208 23RD ST	None	RICHMOND	CA	94804	1830	07	06013	37.93445293	-122.347539	Contra Costa County
248368	Fee-for-Service	1437561537	1437561537	1	1	WALKER, LAURA DPM	10/10/2019	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	201 N COLLEGE DRIVE	SUITE 100	SANTA MARIA	CA	93454	4614	42	06083	34.954461	-120.424836	Santa Barbara County
248383	Fee-for-Service	1922755974	1922755974	1	1	WILLIAMS, TRACI H LPCC	2/25/2025	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
248399	Fee-for-Service	1013332915	1013332915	1	1	WILSON, BRYAN J MD	10/18/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
248400	Fee-for-Service	1326112053	1326112053	1	1	WELLS, JOSEPH S DPM	4/15/2020	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	24640 JEFFERSON AVE	STE 109	MURRIETA	CA	92562	9027	33	06065	33.56027016	-117.2095112	Riverside County
248408	Fee-for-Service	1124344767	1124344767	1	1	WANG, GEORGE C MD	2/24/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	121613	None	None	0	In state provider	None	3747 WORSHAM AVENUE	#100	LONG BEACH	CA	90808	1774	19	06037	33.82647568	-118.1462742	Los Angeles County
248423	Fee-for-Service	1538101506	1538101506	1	1	WONG, JON MD INC	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	23011	36	Psychiatry	0	In state provider	None	8306 WILSHIRE BLVD	STE 501	BEVERLY HILLS	CA	90211	2304	19	06037	34.06425377	-118.3724288	Los Angeles County
248430	Fee-for-Service	1205841392	1205841392	1	1	WALGREEN CO	4/22/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	205 SHAW AVE	None	CLOVIS	CA	93612	3602	10	06019	36.80862386	-119.7060389	Fresno County
248463	Fee-for-Service	1578820080	1578820080	1	1	WENBERG, ALICIA S MD	9/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120526	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
248498	Fee-for-Service	1205288818	1205288818	1	1	WELDE SEMAT, MAHALET Z MD	4/26/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	151612	08	Family Practice	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
248510	Fee-for-Service	1316381973	1316381973	1	1	WASHINGTON, ELEBY R MD	7/15/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	155473	30	Radiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
248584	Fee-for-Service	1306821228	1306821228	1	1	WOLF, DAVID L MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63319	02	General Surgery	0	In state provider	None	6409 LINCOLN AVE	None	CARMICHAEL	CA	95608	2487	34	06067	38.640879	-121.3158825	Sacramento County
248692	Fee-for-Service	1891127072	1891127072	1	1	WILLIAMS, KRISTI L	7/30/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
248719	Fee-for-Service	1578764593	1578764593	1	1	WANG, JIMMY C MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110883	30	Radiology	0	In state provider	None	200 W ARBOR DRIVE	#100	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
248721	Fee-for-Service	1689826042	1689826042	1	1	WALGREENS CO.	12/8/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#13435	555 S SUNRISE WAY	STE 112-113	PALM SPRINGS	CA	92264	7869	33	06065	33.814971	-116.528247	Riverside County
248753	Fee-for-Service	1093728859	1093728859	1	1	WILMANNS, AVERY M K MD	1/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	55453	41	Internal Medicine	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
248777	Fee-for-Service	1417337809	1417337809	1	1	WRIGHT, DENISHA D LCSW	2/19/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1545 ST MARKS PLAZA	STE 5	STOCKTON	CA	95207	6411	39	06077	37.98892524	-121.3254177	San Joaquin County
248784	Fee-for-Service	1831358134	1831358134	1	1	WANG, DANNY C MD	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134591	30	Radiology	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
248785	Fee-for-Service	1215201983	1215201983	1	1	WALAVALKAR, VIGHNESH M MD	6/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118337	22	Pathology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
248870	Fee-for-Service	1306821228	1306821228	1	1	WOLF, DAVID L MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63319	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6409 LINCOLN AVE	None	CARMICHAEL	CA	95608	2487	34	06067	38.640879	-121.3158825	Sacramento County
248897	Fee-for-Service	1467439836	1467439836	1	1	WANG, CAROLYN C OD	9/1/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	855 W FOOTHILL BLVD	None	MONROVIA	CA	91016	1938	19	06037	34.1511692	-118.0177106	Los Angeles County
248952	Fee-for-Service	1104998053	1104998053	1	1	WILLIS, MARY JANE MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75301	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
248979	Fee-for-Service	1982848594	1982848594	1	1	WEAVER, JHOSMARA A LCSW	4/12/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
249033	Fee-for-Service	1528282233	1528282233	1	1	WANG, YI-PING MD	3/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	79532	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
249038	Fee-for-Service	1619360203	1619360203	1	1	WOODS, KATIE M NP	5/16/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
249042	Fee-for-Service	1528360229	1528360229	1	1	WONG, RONALD N MD INC	5/25/2017	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	34227	84	Surgery-Head and Neck	0	In state provider	None	355 CAMPUS DR	SUITE B	HANFORD	CA	93230	4310	16	06031	36.3271295	-119.6633596	Kings County
249051	Fee-for-Service	1427435700	1427435700	1	1	WU, GRACE T MD	2/17/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	177633	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
249102	Fee-for-Service	1114190972	1114190972	1	1	WHITLATCH, NICOLE L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108945	78	Neoplastic Diseases/Oncology	0	In state provider	None	265 COHASSET RD	STE 170	CHICO	CA	95926	2273	04	06007	39.75090044	-121.8522609	Butte County
249103	Fee-for-Service	1336776806	1336776806	1	1	WAALEN, ANDERS	8/21/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	184854	36	Psychiatry	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
249114	Fee-for-Service	1619063336	1619063336	1	1	WALDROP, WILLIAM B MD	7/1/2021	207LC0200X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
249319	Fee-for-Service	1528282233	1528282233	1	1	WANG, YI-PING MD	3/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	79532	68	Hematology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
249321	Fee-for-Service	1821006982	1821006982	1	1	WALKER, DAVID P MD	8/10/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	38498	84	Surgery-Head and Neck	0	In state provider	None	800 3RD ST	None	MARYSVILLE	CA	95901	5831	58	06115	39.13757487	-121.5949642	Yuba County
249336	Fee-for-Service	1053653709	1053653709	1	1	WANG, SHYH-JEUN MD	9/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
249342	Fee-for-Service	1770961757	1770961757	1	1	WILLIS, STEVEN DO MD	8/21/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
249346	Fee-for-Service	1417078387	1417078387	1	1	WU, DIANNE E MD SC APC	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	79383	24	Plastic Surgery	0	In state provider	None	1048 S GARFIELD AVE	STE 300	ALHAMBRA	CA	91801	4768	19	06037	34.083009	-118.123041	Los Angeles County
249380	Fee-for-Service	1740452721	1740452721	1	1	WARD, DAVID C MD	8/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109397	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 204B	LOMA LINDA	CA	92354	3130	36	06071	34.04805253	-117.249534	San Bernardino County
249390	Fee-for-Service	1114190972	1114190972	1	1	WHITLATCH, NICOLE L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108945	68	Hematology	0	In state provider	None	265 COHASSET RD	STE 170	CHICO	CA	95926	2273	04	06007	39.75090044	-121.8522609	Butte County
249407	Fee-for-Service	1922494020	1922494020	1	1	WU, DEREK B MD	10/1/2021	207Y00000X	NA	ENT/Otolaryngology	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
249419	Fee-for-Service	1700073343	1700073343	1	1	WINTON SCHOOL DISTRICT	6/16/1999	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	7000 N CENTER ST	None	WINTON	CA	95388	0008	24	06047	37.38946693	-120.6147177	Merced County
249438	Fee-for-Service	1871335075	1871335075	1	1	WATTERS, OPREA BIRTH DOULA	6/27/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	38	06075	0	0	None
249502	Fee-for-Service	1851346548	1851346548	1	1	WHANG, S JOHN MD	4/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92903	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
249506	Fee-for-Service	1740634567	1740634567	1	1	WALLSH, JOSH O MD	5/11/2023	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	184249	None	None	0	In state provider	None	4201 TORRANCE BLVD	STE 220	TORRANCE	CA	90503	4537	19	06037	33.8375955	-118.358748	Los Angeles County
249511	Fee-for-Service	1508925827	1508925827	1	1	WOOLRIDGE, DALE P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 E AJO WAY	SOUTH CAMPUS	TUCSON	AZ	85713	6204	00	None	32.175801	-110.9306925	Pima County
249521	Fee-for-Service	1447397708	1447397708	1	1	WIDDEL, LARS MD	6/17/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	171096	None	None	0	In state provider	None	2624 EDITH	None	REDDING	CA	96001	3043	45	06089	40.57136027	-122.397513	Shasta County
249528	Fee-for-Service	1902956865	1902956865	1	1	WU, SHANNON M	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
249573	Fee-for-Service	1083781280	1083781280	1	1	WONG, ERIC M MD	2/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81103	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
249599	Fee-for-Service	1689435299	1689435299	1	1	WORDSMYWAY SPEECH & LANGUAGE	10/8/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	THERAPY INC.	9565 WAPLES STREET	SUITE 100	SAN DIEGO	CA	92121	2973	37	06073	32.90339001	-117.1821141	San Diego County
249608	Fee-for-Service	1336201615	1336201615	1	1	WONG, KEITH Y	8/31/1992	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
249612	Fee-for-Service	1821006982	1821006982	1	1	WALKER, DAVID P MD	8/10/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	38498	04	Otology, Laryngology, Rhinology	0	In state provider	None	800 3RD ST	None	MARYSVILLE	CA	95901	5831	58	06115	39.13757487	-121.5949642	Yuba County
249618	Fee-for-Service	1578578811	1578578811	1	1	WALGREEN CO	12/1/1989	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	602 10TH ST	None	MARYSVILLE	CA	95901	5104	58	06115	39.14550676	-121.5932806	Yuba County
249716	Fee-for-Service	1811037344	1811037344	1	1	WALI, ABDUL W MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	52901	41	Internal Medicine	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
249730	Fee-for-Service	1326343302	1326343302	1	1	WATERS, NICOLE M LMFT	8/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	65 MAIN ST	None	QUINCY	CA	95971	9494	32	06063	39.93769446	-120.9389523	Plumas County
249734	Fee-for-Service	1346716941	1346716941	1	1	WOODS, SARAH NP	2/3/2025	2080P0205X	NA	Endocrinology	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
249750	Fee-for-Service	1700452299	1700452299	1	1	WHITAKER, LILY NP	7/9/2024	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
249757	Fee-for-Service	1013965748	1013965748	1	1	WOELKERS, DOUGLAS A MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	77134	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
249793	Fee-for-Service	1083713655	1083713655	1	1	WANG, VINCENT J MD	4/1/1999	2080P0204X	NA	Other	026	PHYSICIANS	80706	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
249805	Fee-for-Service	1659560654	1659560654	1	1	WOMEN 2 WOMEN MEDICAL CENTER	12/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77891	14	Neurological Surgery	0	In state provider	INC	33 CREEK RD	STE 270	IRVINE	CA	92604	7707	30	06059	33.67506955	-117.796973	Orange County
249847	Fee-for-Service	1417974825	1417974825	1	1	WAL-MART PHCY 10-1587	10/1/1990	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2225 PLAZA PKWY	None	MODESTO	CA	95350	6215	50	06099	37.67177347	-121.0351635	Stanislaus County
249856	Fee-for-Service	1720432420	1720432420	1	1	WANG, LAN MD	1/27/2023	207RH0003X	NA	Oncology	026	PHYSICIANS	150793	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
249886	Fee-for-Service	1700934395	1700934395	1	1	WILLIAM S HART UHSD	10/23/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	19	06037	34.41078438	-118.510775	Los Angeles County
249892	Fee-for-Service	1073530200	1073530200	1	1	WAL-MART STORES INC	10/6/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 103524	605 FLETCHER PKWY	None	EL CAJON	CA	92020	2522	37	06073	32.8075167	-116.9697503	San Diego County
249903	Fee-for-Service	1174953814	1174953814	1	1	WARD, TRACY A NP	5/17/2017	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
249964	Fee-for-Service	1417296211	1417296211	1	1	WILSON, ANDRINEE A PHD	1/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	800 SERENO DRIVE	None	VALLEJO	CA	94589	2411	48	06095	38.12792924	-122.2506587	Solano County
250030	Fee-for-Service	1104238112	1104238112	1	1	WARD, KATHRYN J PHD	10/5/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
250052	Fee-for-Service	1447667118	1447667118	1	1	WALGREEN CO	11/3/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2050 GLENOAKS BLVD	None	SAN FERNANDO	CA	91340	1625	19	06037	34.29901991	-118.4387726	Los Angeles County
250085	Fee-for-Service	1659561652	1659561652	1	1	WILLIAMS, HEATHER A PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
250125	Fee-for-Service	1942336342	1942336342	1	1	WONG, COLLEEN T LMFT	2/15/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	720 ALHAMBRA BLVD	None	SACRAMENTO	CA	95816	3825	34	06067	38.57532638	-121.4641964	Sacramento County
250145	Fee-for-Service	1487134342	1487134342	1	1	WONG, JONATHAN R PT	12/29/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
250149	Fee-for-Service	1891178273	1891178273	1	1	WAVE IMAGING LLC	12/8/2015	261QR0200X	NA	Mammography/MRI Provider	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	675 CAMINO DE LOS MARES	SUITE 101	SAN CLEMENTE	CA	92673	2838	30	06059	33.45710369	-117.6474248	Orange County
250159	Fee-for-Service	1548422744	1548422744	1	1	WU, ALISON R	6/18/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	159353	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
250195	Fee-for-Service	1255927661	1255927661	1	1	WECARE FOR ABETTERU MEDICAL	10/24/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SUPPLY	1190 BURNETT AVE	SUITE A	CONCORD	CA	94520	5640	07	06013	37.97820603	-122.0557192	Contra Costa County
250247	Fee-for-Service	1497203566	1497203566	1	2	WONDERLAB	4/4/2024	261QP2000X	NA	Physical Therapist	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	10431 COMMERCE ST	STE A	REDLANDS	CA	92374	0110	36	06071	34.06427678	-117.2416506	San Bernardino County
250255	Fee-for-Service	1841241841	1841241841	1	1	WESLEY HEALTH SYSTEM LLC	2/15/2018	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5001 HARDY STREET	None	HATTIESBURG	MS	39402	1308	00	None	31.327236	-89.367345	Lamar County
250270	Fee-for-Service	1407039480	1407039480	1	1	WILTZ, LINDA K	12/27/2007	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1911 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5605	19	06037	34.03097999	-118.4838241	Los Angeles County
250306	Fee-for-Service	1962902593	1962902593	1	1	WILBURN, ASHA K LPCC	10/20/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
250335	Fee-for-Service	1124033220	1124033220	1	1	WALGREEN CO	3/14/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5260 DIAMOND HEIGHTS BLV	None	SAN FRANCISCO	CA	94131	2118	38	06075	37.7440015	-122.4385518	San Francisco County
250345	Fee-for-Service	1457588691	1457588691	1	1	WOLLAM, KATHLEEN R	2/8/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 EAST WASHINGTON BLVD	STE 200	CRESCENT CITY	CA	95531	8160	08	06015	41.77274546	-124.19892	Del Norte County
250447	Fee-for-Service	1346255619	1346255619	1	1	WALGREEN CO	9/22/1975	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1334 SARATOGA AVE	None	SAN JOSE	CA	95129	4336	43	06085	37.30015404	-121.982283	Santa Clara County
250454	Fee-for-Service	1750957692	1750957692	1	1	WILLIAMS, TATYANA I NP	2/2/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	37	06073	32.99706	-117.05544	San Diego County
250455	Fee-for-Service	1679742308	1679742308	1	1	WALGREEN CO.	9/5/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	250 FLORIN RD.	None	SACRAMENTO	CA	95831	1405	34	06067	38.509461	-121.543011	Sacramento County
250512	Fee-for-Service	1538486675	1538486675	1	1	WARRIER, NIKHIL P MD	8/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133900	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	18111 BROOKHURST ST	STE 5100	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
250544	Fee-for-Service	1841241841	1841241841	1	1	WESLEY HEALTH SYSTEM LLC	2/15/2018	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5001 HARDY STREET	None	HATTIESBURG	MS	39402	1308	00	None	31.327236	-89.367345	Lamar County
250584	Fee-for-Service	1568548642	1568548642	1	1	WOLFE, THOMAS J MD	4/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109946	13	Neurology (M.D. only)	0	In state provider	None	400 NORTH PEPPER AVE	MOD 3	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
250615	Fee-for-Service	1376076471	1376076471	1	1	WU, WEI DER MD	5/17/2022	207L00000X	NA	Other	026	PHYSICIANS	159631	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
250635	Fee-for-Service	1578900999	1578900999	1	1	WADIA, SUBEER K MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139639	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
250656	Fee-for-Service	1295718864	1295718864	1	1	WOOLF,KAREN E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
250670	Fee-for-Service	1730120106	1730120106	1	1	WASSERMAN, MARDY I	12/13/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	959 E WALNUT ST	SUITE 212	PASADENA	CA	91106	1451	19	06037	34.14962102	-118.1305187	Los Angeles County
250705	Fee-for-Service	1417336306	1417336306	1	1	WANG, JASMINE MD	6/20/2019	207P00000X	NA	Other	026	PHYSICIANS	147519	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
250789	Fee-for-Service	1730204884	1730204884	1	1	WINSTON, STEPHEN C PHD	8/7/1996	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	STEPHEN WINSTON CONSULT	22910 PORTAGE CIRCLE DR	None	TOPANGA	CA	90290	4029	19	06037	34.11729835	-118.6259231	Los Angeles County
250790	Fee-for-Service	1912998311	1912998311	1	1	WILLEY, STEPHEN M	1/16/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
250828	Fee-for-Service	1952310450	1952310450	1	1	WEYAND, CORNELIA M MD	8/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54171	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
250902	Fee-for-Service	1326737545	1326737545	1	1	WILEY, AMBER	5/3/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	43	06085	0	0	None
251075	Fee-for-Service	1487686903	1487686903	1	1	WARING, RANDALL W MD	7/1/1998	207L00000X	NA	Other	026	PHYSICIANS	46772	05	Anesthesiology	0	In state provider	None	400 E MAIN ST	# 200	STOCKTON	CA	95202	3000	39	06077	37.95344497	-121.2852303	San Joaquin County
251084	Fee-for-Service	1538200274	1538200274	1	1	WILMETH JO B MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	21115	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	223 E THOUSAND OAKS BLVD	STE 407	THOUSAND OAKS	CA	91360	8244	56	06111	34.17924113	-118.8725574	Ventura County
251117	Fee-for-Service	1952310450	1952310450	1	1	WEYAND, CORNELIA M MD	8/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54171	83	Rheumatology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
251127	Fee-for-Service	1447773353	1447773353	1	1	WASHINGTON, VICTOR MSW LCSW	12/26/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
251154	Fee-for-Service	1053085076	1053085076	1	1	WACKERMAN, JESSIE NP	3/3/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
251180	Fee-for-Service	1225013790	1225013790	1	1	WONG, GRANGER B MD INC	8/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	54333	24	Plastic Surgery	0	In state provider	None	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
251212	Fee-for-Service	1366499709	1366499709	1	1	WILLIAMS, LOUIS J DC	8/29/2019	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	29645 RANCHO CALIFORNIA	218	TEMECULA	CA	92591	6200	33	06065	33.50627123	-117.1431728	Riverside County
251300	Fee-for-Service	1861991564	1861991564	1	1	WILSON, CHRISTINA A CNP	9/20/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
251316	Fee-for-Service	1538170808	1538170808	1	1	WOO, DENNIS B MD	1/1/1982	207R00000X	NA	Other	026	PHYSICIANS	32682	40	Pediatrics	0	In state provider	None	2122 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5787	19	06037	34.03261067	-118.4816424	Los Angeles County
251368	Fee-for-Service	1134134414	1134134414	1	1	WALGREEN CO	8/21/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5005 BALL RD	None	CYPRESS	CA	90630	3643	30	06059	33.81701014	-118.0450115	Orange County
251372	Fee-for-Service	1538200274	1538200274	1	1	WILMETH JO B MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	21115	41	Internal Medicine	0	In state provider	None	223 E THOUSAND OAKS BLVD	STE 407	THOUSAND OAKS	CA	91360	8244	56	06111	34.17924113	-118.8725574	Ventura County
251409	Fee-for-Service	1689613358	1689613358	2	1	WONG, JOHN C MD	4/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75042	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
251421	Fee-for-Service	1750898078	1750898078	1	1	WITTEN, ELIZABETH A CNM	6/22/2018	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
251477	Fee-for-Service	1902069289	1902069289	1	1	WAZIRI, FARADEBAH LCSW	7/8/2022	171M00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
251479	Fee-for-Service	1700832375	1700832375	1	1	WOLF, EUGENE M MD INC	1/1/1979	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	33945	20	Orthopedic Surgery	0	In state provider	None	3000 CALIFORNIA ST	FL 3	SAN FRANCISCO	CA	94115	2411	38	06075	37.78762785	-122.443976	San Francisco County
251486	Fee-for-Service	1194796144	1194796144	1	1	WEISSMAN, ADAM MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74030	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
251501	Fee-for-Service	1982122560	1982122560	1	1	WHITEHEAD, THOMAS L CNP	6/21/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
251513	Fee-for-Service	1730183344	1730183344	1	1	WILSON, KEITH MD	6/30/1984	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	49347	01	General Practice	0	In state provider	None	2220 CLARK AVE	None	LONG BEACH	CA	90815	2521	19	06037	33.79772674	-118.1338339	Los Angeles County
251559	Fee-for-Service	1679549026	1679549026	1	1	WEGLOWSKI, JENNIFER MD	8/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52811	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
251607	Fee-for-Service	1437390697	1437390697	1	1	WILSON, SARAH F LMFT	10/25/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1331 DOWNER ST.	None	OROVILLE	CA	95965	4945	04	06007	39.51423256	-121.5543314	Butte County
251668	Fee-for-Service	1174619811	1174619811	1	1	WONG, BEN S MD	12/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73295	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
251684	Fee-for-Service	1558438762	1558438762	1	1	WANG, CHAIN-CHI MD	10/31/1987	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	45191	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
251690	Fee-for-Service	1831117308	1831117308	1	1	WAL-MART STORES, INC	12/7/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15950 DAM ROAD EXT	None	CLEARLAKE	CA	95422	9399	17	06033	38.93110106	-122.6176781	Lake County
251696	Fee-for-Service	1760479745	1760479745	1	1	W L BROWN MEDICAL CORP	9/5/1987	193400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6225 N FRESNO ST	SUITE 104	FRESNO	CA	93710	5268	10	06019	36.82701573	-119.781425	Fresno County
251717	Fee-for-Service	1982161584	1982161584	1	1	WALAND, SONALI NP	1/14/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
251721	Fee-for-Service	1932300456	1932300456	1	1	WENG, ERIC L MD	6/11/2008	207ZP0102X	NA	Other	026	PHYSICIANS	99932	22	Pathology (M.D. only)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
251775	Fee-for-Service	1104096551	1104096551	1	1	WATT, CLIFTON C MD	11/24/2009	207R00000X	NA	Other	026	PHYSICIANS	101950	41	Internal Medicine	0	In state provider	None	222 W 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
251799	Fee-for-Service	1336146869	1336146869	1	1	WILLIAM BARSON	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PEDIATRIC ACADEMIC ASSOC	555 S 18TH STREET	None	COLUMBUS	OH	43205	0000	00	None	39.95323846	-82.9765048	Franklin County
251804	Fee-for-Service	1730183344	1730183344	1	1	WILSON, KEITH MD	6/30/1984	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	49347	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2220 CLARK AVE	None	LONG BEACH	CA	90815	2521	19	06037	33.79772674	-118.1338339	Los Angeles County
251820	Fee-for-Service	1528841160	1528841160	1	1	WOMACK, TYLER A PHD	9/18/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
251931	Fee-for-Service	1881695567	1881695567	1	1	WHELAN, VERONICA MD	4/30/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	48409	08	Family Practice	0	In state provider	None	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
251952	Fee-for-Service	1063814903	1063814903	1	1	WILLIS, ANN E	10/27/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
251973	Fee-for-Service	1578551362	1578551362	1	1	WEYDERT, JAMIE A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
251982	Fee-for-Service	1760479745	1760479745	1	1	W L BROWN MEDICAL CORP	11/24/2004	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	6225 N FRESNO ST	SUITE 104	FRESNO	CA	93710	5268	10	06019	36.82701573	-119.781425	Fresno County
252021	Fee-for-Service	1184065856	1184065856	1	1	WORNER, GIULIA C NP	1/22/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
252042	Fee-for-Service	1336167956	1336167956	1	1	WU, ALLAN D MD	9/1/2000	2084N0400X	NA	Neurology	026	PHYSICIANS	72935	13	Neurology (M.D. only)	0	In state provider	None	1510 SAN PABLO ST	STE 268	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
252064	Fee-for-Service	1285696203	1285696203	1	1	WALLERSTEIN, ROBERT J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88350	38	Geriatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
252072	Fee-for-Service	1174799464	1174799464	1	1	WOODS, DEBORAH A NP	10/24/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
252144	Fee-for-Service	1447309422	1447309422	1	1	WHITMORE, GERALD P PHD	6/30/2020	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
252166	Fee-for-Service	1366635484	1366635484	1	1	WOLOWODIUK, OLEH J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47818	66	Emergency Medicine (Urgent Care)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
252175	Fee-for-Service	1679523906	1679523906	1	1	WANG, TEI-CHEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30323	08	Family Practice	0	In state provider	None	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
252185	Fee-for-Service	1891713004	1891713004	1	1	WANG, LAWRENCE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	62881	25	Physical Medicine and Rehabilitation	0	In state provider	None	18377 BEACH BLVD	STE 326	HUNTINGTON BEACH	CA	92648	1350	30	06059	33.69580652	-117.9895815	Orange County
252213	Fee-for-Service	1467615070	1467615070	1	1	WAHL, CARTER E MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85194	22	Pathology (M.D. only)	0	In state provider	None	1207 FAIRCHILD COURT	None	WOODLAND	CA	95684	4321	57	06113	38.6657551	-121.7922645	Yolo County
252278	Fee-for-Service	1215904198	1215904198	1	1	WONG, GODFREY E MD	1/3/2011	207L00000X	NA	Other	026	PHYSICIANS	102650	05	Anesthesiology	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
252353	Fee-for-Service	1285696203	1285696203	1	1	WALLERSTEIN, ROBERT J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88350	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
252400	Fee-for-Service	1003848193	1003848193	1	1	WESTERN PULMONARY ASSOC	2/22/1985	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	MEDICAL GROUP	8631 W 3RD ST	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
252416	Fee-for-Service	1881772473	1881772473	1	1	WOOD, JOHN A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	17687	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
252458	Fee-for-Service	1770994436	1770994436	1	1	WOOD, DAVID B MD	9/19/2019	207P00000X	NA	Other	026	PHYSICIANS	160486	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
252462	Fee-for-Service	1679523906	1679523906	1	1	WANG, TEI-CHEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30323	01	General Practice	0	In state provider	None	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
252581	Fee-for-Service	1578619417	1578619417	1	1	WILLIAMSON, RICKEY PHD	2/17/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8939 S SEPULVEDA BLVD	SUITE #200	LOS ANGELES	CA	90045	3631	19	06037	33.95485856	-118.3962461	Los Angeles County
252654	Fee-for-Service	1548217045	1548217045	1	1	WALGREEN CO	12/20/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	670 N LAKE AVE	None	PASADENA	CA	91101	1220	19	06037	34.15746153	-118.1324264	Los Angeles County
252712	Fee-for-Service	1285714386	1285714386	1	1	WALKER, JOHN A MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	64249	41	Internal Medicine	0	In state provider	None	820 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64721651	-120.9829551	Stanislaus County
252731	Fee-for-Service	1710104591	1710104591	1	1	WHITE, MICHAEL D	4/15/2011	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
252761	Fee-for-Service	1043397029	1043397029	1	1	WOODGLEN RECOVERY	9/18/2017	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	JUNCTION INC	751 W ORANGETHORPE AVE	None	FULLERTON	CA	92832	2016	30	06059	33.85956584	-117.9391123	Orange County
252802	Fee-for-Service	1831245026	1831245026	1	1	WEEDEN, SARAH E LCSW	2/15/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
252888	Fee-for-Service	1922396076	1922396076	1	1	WOO, STEPHANIE L OD	1/6/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	110 N SPRING STREET	None	BLYTHE	CA	92225	1633	33	06065	33.61069481	-114.5981348	Riverside County
252931	Fee-for-Service	1033401039	1033401039	1	1	WEST, CRES-ANNE U NP	5/11/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
252934	Fee-for-Service	1548288459	1548288459	1	1	WAUBANT, EMMANUELLE MD	10/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85429	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
252950	Fee-for-Service	1952765919	1952765919	1	1	WONG, VINCENT W DO	10/30/2018	208M00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
252966	Fee-for-Service	1366081986	1366081986	1	1	WILSON, JENNIFER	1/16/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	317 S CARRILLO RD	None	OJAI	CA	93023	3604	56	06111	34.43910034	-119.2643768	Ventura County
252974	Fee-for-Service	1013065077	1013065077	1	1	WESTRA, TODD A MD	7/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	64220	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
253036	Fee-for-Service	1457617482	1457617482	1	1	WEISIGER, KAITLIN E MD	4/24/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	155482	30	Radiology	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
253037	Fee-for-Service	1861506495	1861506495	1	1	WAN, LORI J MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62185	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
253051	Fee-for-Service	1295171387	1295171387	1	1	WARSHAUER, JEREMY T MD	10/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140579	41	Internal Medicine	0	In state provider	None	375 LAGUNA HONDA BLVD	RM B200	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
253068	Fee-for-Service	1841288644	1841288644	1	1	WINDOM AREA HOSPITAL	9/28/2017	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2150 HOSPITAL DR	None	WINDOM	MN	56101	1287	00	None	43.87837285	-95.11212234	Cottonwood County
253155	Fee-for-Service	1154469328	1154469328	1	1	WILLIAM DITTRICH MD	1/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
253202	Fee-for-Service	1578522751	1578522751	1	1	WATSON, BILL P MD	10/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77488	20	Orthopedic Surgery	0	In state provider	None	1600 ESPLANADE	STE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
253218	Fee-for-Service	1871553347	1871553347	1	1	WOMAN TO WOMAN OB & GYN	3/31/1986	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	249 E HIGHLAND AVE	None	SAN BERNARDINO	CA	92404	3700	36	06071	34.13591253	-117.280809	San Bernardino County
253248	Fee-for-Service	1689695967	1689695967	1	1	WILLIAMSON, STEVEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 10TH AVE N	None	BILLINGS	MT	59101	0703	00	None	45.789696	-108.5132835	Yellowstone County
253260	Fee-for-Service	1821561861	1821561861	1	1	WALGREEN CO	2/3/2020	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#21193	1757 W SAN CARLOS ST	None	SAN JOSE	CA	95128	5222	43	06085	37.32350418	-121.9244334	Santa Clara County
253274	Fee-for-Service	1639234602	1639234602	1	1	WAL-MART STORES INC	2/9/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHMCY 10-3712	7010 AUBURN BLVD	None	CITRUS HEIGHTS	CA	95621	4342	34	06067	38.689965	-121.2951285	Sacramento County
253281	Fee-for-Service	1538301981	1538301981	1	1	WILKES BARRE BEHAVIORAL	9/30/2013	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL COMPANY LLC	562 WYOMING AVE	None	KINGSTON	PA	18704	3721	00	None	41.26943744	-75.88890356	Luzerne County
253341	Fee-for-Service	1801800933	1801800933	2	1	WYNNE, LESLIE B III MD	3/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	46663	05	Anesthesiology	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91110	3010	19	06037	34.141905	-118.1323975	Los Angeles County
253356	Fee-for-Service	1841288644	1841288644	1	1	WINDOM AREA HOSPITAL	9/28/2017	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2150 HOSPITAL DR	None	WINDOM	MN	56101	1287	00	None	43.87837285	-95.11212234	Cottonwood County
253469	Fee-for-Service	1952701856	1952701856	1	1	WISE-PETRENKO, JENNIFER LMF	2/21/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	T	11512 B AVE	None	AUBURN	CA	95603	2605	31	06061	38.93969517	-121.1046397	Placer County
253490	Fee-for-Service	1336103076	1336103076	1	1	WELLS, LAWRENCE E MD	10/30/1990	207P00000X	NA	Other	026	PHYSICIANS	49234	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
253517	Fee-for-Service	1043650088	1043650088	1	1	WU, MICHELLE L MD	2/17/2023	2084P0804X	NA	Psychiatry	026	PHYSICIANS	125139	None	None	0	In state provider	None	8001 FROST STREET	None	SAN DIEGO	CA	92123	2746	37	06073	32.802147	-117.151371	San Diego County
253538	Fee-for-Service	1073017208	1073017208	1	1	WAI, KAREN M MD	6/3/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	176636	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
253553	Fee-for-Service	1255661468	1255661468	1	1	WILLYERD, FREDERICK A MD	8/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS ROAD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
253566	Fee-for-Service	1538301981	1538301981	1	1	WILKES BARRE BEHAVIORAL	9/30/2013	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL COMPANY LLC	562 WYOMING AVE	None	KINGSTON	PA	18704	3721	00	None	41.26943744	-75.88890356	Luzerne County
253630	Fee-for-Service	1427402122	1427402122	1	1	WANG, ROBERT Z MD	4/27/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158931	08	Family Practice	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
253635	Fee-for-Service	1629450770	1629450770	1	1	WATKINS, CHRISTINA M LCSW	8/7/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
253647	Fee-for-Service	1427370733	1427370733	1	1	WILLE, MAYA E MD	10/18/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	124078	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
253742	Fee-for-Service	1861570681	1861570681	1	1	WYMAN, PAUL MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63416	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
253747	Fee-for-Service	1720405707	1720405707	1	1	WILLIAMS, SHILANA LMFT	7/19/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
253846	Fee-for-Service	1386848422	1386848422	1	1	WALKER, NANCY C LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
253850	Fee-for-Service	1285799668	1285799668	1	1	WENG, EDWARD E MD	1/6/2018	208600000X	NA	General Surgery	026	PHYSICIANS	43087	02	General Surgery	0	In state provider	None	2800 L STREET	SUITE 200	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
253858	Fee-for-Service	1275573727	1275573727	1	1	WOOD, LORNA P MD	9/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73802	05	Anesthesiology	0	In state provider	None	9080 COLIMA RD	None	WHITTIER	CA	90605	1600	19	06037	33.95062799	-118.0051627	Los Angeles County
253879	Fee-for-Service	1558384602	1558384602	1	1	WRIGHT, GAIL A LCSW	10/9/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
253929	Fee-for-Service	1942321138	1942321138	1	2	WILKES, CRAIG A DPM	10/28/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	6000 FAIRWAY DR	#18	ROCKLIN	CA	95677	4246	31	06061	38.79220243	-121.2621624	Placer County
253991	Fee-for-Service	1962900852	1962900852	1	1	WHOLESOME ELDERLY CARE HOMES	10/4/2018	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5205 ARGO WAY	None	SACRAMENTO	CA	95820	5737	34	06067	38.527695	-121.4334675	Sacramento County
254002	Fee-for-Service	1699810689	1699810689	2	1	WARNER, GREGORY C MD	7/26/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	55305	41	Internal Medicine	0	In state provider	None	202 WEST WILLOW AVE	None	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
254011	Fee-for-Service	1851307508	1851307508	1	1	WALGREEN CO	8/14/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1916 WEBSTER ST	None	ALAMEDA	CA	94501	2140	01	06001	37.77899648	-122.2765416	Alameda County
254015	Fee-for-Service	1093893729	1093893729	1	1	WEBER, JOEL B MD	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70903	05	Anesthesiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
254019	Fee-for-Service	1487683603	1487683603	1	1	WITZTUM, KATHRYN F MD	3/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	31766	30	Radiology	0	In state provider	None	2110 PROFESSIONAL DR	STE 100	ROSEVILLE	CA	95661	3752	31	06061	38.74234873	-121.2521259	Placer County
254066	Fee-for-Service	1760547533	1760547533	1	1	WINTERS, ROBERT A MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	45910	77	Infectious Disease	0	In state provider	None	2001 SANTA MONICA BLVD	STE 665W	SANTA MONICA	CA	90404	2118	19	06037	34.02891163	-118.4797466	Los Angeles County
254077	Fee-for-Service	1659463305	1659463305	1	1	WILD, MARTA E MD	3/23/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	176524	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
254080	Fee-for-Service	1316075997	1316075997	1	1	WICK, ELIZABETH C MD	10/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	76824	02	General Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
254109	Fee-for-Service	1932760535	1932760535	1	1	WALGREEN CO	10/7/2020	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#21231	1487 E CHEVY CHASE	None	GLENDALE	CA	91206	4008	19	06037	34.15195587	-118.2327541	Los Angeles County
254110	Fee-for-Service	1821012063	1821012063	1	1	WIESNER, CHRISTOPHER T	4/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88882	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15615 POMERADO RD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
254115	Fee-for-Service	1912990698	1912990698	1	1	WILLIAM GOLDBERG	4/19/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 1ST AVE	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
254148	Fee-for-Service	1821054552	1821054552	1	1	WONG, RITCHIE MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34923	08	Family Practice	0	In state provider	None	3650 MISSION AVE	# 1	CARMICHAEL	CA	95608	2933	34	06067	38.631726	-121.3549155	Sacramento County
254157	Fee-for-Service	1255383683	1255383683	1	1	WONG, ROBIN L MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31241	08	Family Practice	0	In state provider	None	2003 N CALIFORNIA ST	None	STOCKTON	CA	95204	6006	39	06077	37.97231426	-121.2898134	San Joaquin County
254202	Fee-for-Service	1992228779	1992228779	1	1	WARREN G ANSALDO OD, APC	10/31/2019	152WC0802X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7038 KATELLA AVE	None	STANTON	CA	90680	2805	30	06059	33.8027637	-118.0101193	Orange County
254204	Fee-for-Service	1396786547	1396786547	1	1	WIRTH, ROBERT L MD	3/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	55313	30	Radiology	0	In state provider	None	700 RIVER DR	None	FORT BRAGG	CA	95437	5403	23	06045	39.43163763	-123.8007631	Mendocino County
254251	Fee-for-Service	1346558921	1346558921	1	1	WALGREEN CO	5/26/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	50-040 HARRISON ST	None	COACHELLA	CA	92236	1474	33	06065	33.71023983	-116.1827622	Riverside County
254283	Fee-for-Service	1699865741	1699865741	1	3	WONG, KELLY K MD	1/14/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	65226	40	Pediatrics	0	In state provider	None	595 BUCKINGHAM WAY	STE 314	SAN FRANCISCO	CA	94132	1911	38	06075	37.73012679	-122.4767395	San Francisco County
254290	Fee-for-Service	1699810689	1699810689	2	1	WARNER, GREGORY C MD	7/26/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	55305	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	202 WEST WILLOW AVE	None	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
254301	Fee-for-Service	1174616684	1174616684	1	1	WU, MIN-SHUNG, MD	8/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	51671	None	None	0	In state provider	None	510 W OAK AVE	None	VISALIA	CA	93291	6039	54	06107	36.332118	-119.297178	Tulare County
254335	Fee-for-Service	1326572116	1326572116	1	1	WALHEIM, CHRISTOPHER MD	10/20/2020	208M00000X	NA	Other	026	PHYSICIANS	169711	None	None	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
254355	Fee-for-Service	1427197235	1427197235	1	1	WELDON, NATHAN R MD	10/26/2010	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	95657	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
254360	Fee-for-Service	1598028367	1598028367	1	1	WATTERSON, CHRISTOPHER T MD	9/28/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	130898	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
254399	Fee-for-Service	1821157389	1821157389	1	1	WAHL-ANDERSON, BETHANY	1/13/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8001 VENTURA CANYON AVE	None	PANORAMA CITY	CA	91402	6312	19	06037	34.21619623	-118.4287605	Los Angeles County
254431	Fee-for-Service	1093068454	1093068454	1	1	WOLLANK, JASCHA A MD	8/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123703	41	Internal Medicine	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
254485	Fee-for-Service	1649474909	1649474909	1	1	WILLNER, ALAN G PHD	11/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	110 N LA BREA AVE	None	INGLEWOOD	CA	90301	1708	19	06037	33.96345848	-118.3533454	Los Angeles County
254494	Fee-for-Service	1700940590	1700940590	1	1	WALTERS, PATRICIA L DPM	3/25/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	18366 CLARK ST	106	TARZANA	CA	91356	3502	19	06037	34.16975482	-118.5331876	Los Angeles County
254521	Fee-for-Service	1780620088	1780620088	1	1	WING, VIVIAN W MD	2/28/1985	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	44367	30	Radiology	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
254534	Fee-for-Service	1326309436	1326309436	1	1	WASIO, LINA N MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131511	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
254567	Fee-for-Service	1306044615	1306044615	1	1	WOLFE, MARTHA L LMFT	6/12/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3911 HARRISON STREET	None	OAKLAND	CA	94611	4536	01	06001	37.82172633	-122.2501907	Alameda County
254603	Fee-for-Service	1033136353	1033136353	1	1	WAL-MART PHARMACY 10-200	8/10/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5125 E KINGS CANYON RD	None	FRESNO	CA	93727	3937	10	06019	36.738243	-119.7216945	Fresno County
254653	Fee-for-Service	1487686473	1487686473	1	1	WONG, CLYDE Y MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	53166	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1524 W LACEY BLVD	None	HANFORD	CA	93230	5965	16	06031	36.32816338	-119.6690189	Kings County
254687	Fee-for-Service	1124487525	1124487525	1	1	WATERS, JENNIFER J	8/30/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
254783	Fee-for-Service	1790728749	1790728749	1	1	WONG, TAN L MD	5/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50496	41	Internal Medicine	0	In state provider	None	2100 FOOTHILL BLVD	SUITE A	LA VERNE	CA	91750	2905	19	06037	34.11308422	-117.764666	Los Angeles County
254798	Fee-for-Service	1255523312	1255523312	1	1	WEINTRAUB, BERNARD S MD	11/27/2007	207RP1001X	NA	Pulmonology	026	PHYSICIANS	36942	None	None	0	In state provider	None	2001 SANTA MONICA BLVD	STE 660W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
254823	Fee-for-Service	1790817682	1790817682	1	1	WILLIAMS, JESSICA I LMFT	9/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
254861	Fee-for-Service	1255402608	1255402608	1	1	WEINSTEIN, JOHN R MD	7/1/1998	2084P0800X	NA	Psychiatry	026	PHYSICIANS	64936	36	Psychiatry	0	In state provider	None	12373 LEWIS ST	STE 103	GARDEN GROVE	CA	92840	4676	30	06059	33.78307435	-117.8981519	Orange County
254879	Fee-for-Service	1780625012	1780625012	1	1	WONG, SHEILA X.MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	570 W BROWN RD	None	MESA	AZ	85201	3227	00	None	33.434577	-111.8444355	Maricopa County
254883	Fee-for-Service	1184267254	1184267254	1	1	WEBER, JUSTINE L PSYD	6/15/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2075 SAN JOAQUIN HILLS R	None	NEWPORT BEACH	CA	92660	6505	30	06059	33.61676129	-117.869325	Orange County
254884	Fee-for-Service	1609835412	1609835412	1	1	WU, TANZHEN J MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	81203	None	None	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
254911	Fee-for-Service	1346638707	1346638707	1	1	WILD, BRENT A	3/9/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3191 MISSION INN AVE	SUITE B	RIVERSIDE	CA	92507	4188	33	06065	33.98015514	-117.3677324	Riverside County
254920	Fee-for-Service	1174606511	1174606511	1	2	WESTERN PATHOLOGY	10/1/2001	193400000X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	ASSOCIATES, INC	1025 S ANAHEIM BLVD	None	ANAHEIM	CA	92805	5806	30	06059	33.81994338	-117.9087416	Orange County
254938	Fee-for-Service	1952317455	1952317455	1	1	WILLEY, ANDREA MD	9/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	75733	07	Dermatology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
254942	Fee-for-Service	1487686473	1487686473	1	1	WONG, CLYDE Y MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	53166	08	Family Practice	0	In state provider	None	1524 W LACEY BLVD	None	HANFORD	CA	93230	5965	16	06031	36.32816338	-119.6690189	Kings County
254996	Fee-for-Service	1023035367	1023035367	1	1	WAL-MART PHARMACY	7/6/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	10-2082	12701 TOWNE CENTER DR	None	CERRITOS	CA	90703	8545	19	06037	33.872445	-118.061748	Los Angeles County
255119	Fee-for-Service	1265458293	1265458293	1	1	WARNER, MICHAEL A MD	10/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	52765	18	Ophthalmology	0	In state provider	None	855 W FOOTHILL BLVD	None	MONROVIA	CA	91016	1938	19	06037	34.1511692	-118.0177106	Los Angeles County
255149	Fee-for-Service	1851616775	1851616775	1	1	WAN, XIAO H DO	8/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11881	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
255183	Fee-for-Service	1831338060	1831338060	1	1	WATSON, ERIC DO INC A	10/10/2014	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	10400	25	Physical Medicine and Rehabilitation	0	In state provider	PROFESSIONAL CORPORATION	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
255196	Fee-for-Service	1942453295	1942453295	1	1	WILKOWSKI, KATHRIN S MD	11/21/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157632	08	Family Practice	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
255245	Fee-for-Service	1053408708	1053408708	1	1	WOICZIK R MARCELLA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 MARIO CAPECCHI DR	STE 4550	SALT LAKE CITY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
255277	Fee-for-Service	1811491327	1811491327	1	1	WATSON, TAMEKA T MD	5/7/2020	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	165674	40	Pediatrics	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
255283	Fee-for-Service	1346268067	1346268067	1	1	WASSERMAN, RONALD B MD	8/27/1997	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	58454	41	Internal Medicine	0	In state provider	None	365 LENNON LANE	STE 200	WALNUT CREEK	CA	94598	5912	07	06013	37.92784983	-122.0301444	Contra Costa County
255292	Fee-for-Service	1801030911	1801030911	1	1	WHEELER, MELISSA A MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103117	05	Anesthesiology	0	In state provider	None	2420 CAMINO RAMON	None	SAN RAMON	CA	94583	4319	07	06013	37.77229042	-121.9634581	Contra Costa County
255316	Fee-for-Service	1659301216	1659301216	1	1	WHITE, NEIL W MD	5/31/1987	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54732	07	Dermatology	0	In state provider	None	770 WELCH RD	STE 100	PALO ALTO	CA	94304	1505	43	06085	37.43748087	-122.1759625	Santa Clara County
255420	Fee-for-Service	1992540827	1992540827	1	1	WAMBUI WARUINGI MD INC	7/22/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	45	06089	40.57278686	-122.3958519	Shasta County
255459	Fee-for-Service	1588679856	1588679856	1	1	WALGREEN CO	10/1/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11565 SAN PABLO AVE	None	EL CERRITO	CA	94530	1951	07	06013	37.92491582	-122.3182936	Contra Costa County
255462	Fee-for-Service	1669549549	1669549549	1	1	WONG, DAVID MD	1/31/1993	207R00000X	NA	Other	026	PHYSICIANS	71971	41	Internal Medicine	0	In state provider	None	2301 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1735	19	06037	34.17252521	-118.3332018	Los Angeles County
255560	Fee-for-Service	1790903722	1790903722	1	1	WELLERSDICK, JANET E B LMFT	8/26/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	921 WESTERN DR	None	SANTA CRUZ	CA	95060	3036	44	06087	36.97396371	-122.0584411	Santa Cruz County
255570	Fee-for-Service	1346268067	1346268067	1	1	WASSERMAN, RONALD B MD	8/27/1997	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	58454	77	Infectious Disease	0	In state provider	None	365 LENNON LANE	STE 200	WALNUT CREEK	CA	94598	5912	07	06013	37.92784983	-122.0301444	Contra Costa County
255575	Fee-for-Service	1932775319	1932775319	1	1	WIRTZ, CHRISTIAN	11/22/2023	261QU0200X	NA	Other	026	PHYSICIANS	191822	None	None	0	In state provider	None	2545 W HAMMER LN	None	STOCKTON	CA	95209	2839	39	06077	38.0214303	-121.3461515	San Joaquin County
255634	Fee-for-Service	1124259361	1124259361	1	1	WEISER, PINKY S OD	8/1/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
255653	Fee-for-Service	1396198982	1396198982	1	1	WELLSPACE HEALTH	9/20/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2425 ALHAMBRA BLVD	None	SACRAMENTO	CA	95817	1109	34	06067	38.55627	-121.471875	Sacramento County
255668	Fee-for-Service	1205004108	1205004108	1	1	WILLIAMS, TAUJAI N MD	1/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	107900	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
255754	Fee-for-Service	1063613578	1063613578	1	1	WIN, SANDAR MD	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100405	08	Family Practice	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
255759	Fee-for-Service	1831325943	1831325943	1	1	WALGREEN CO	8/19/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	770 1ST ST	None	GILROY	CA	95020	7804	43	06085	37.01344257	-121.5843817	Santa Clara County
255769	Fee-for-Service	1225021017	1225021017	1	1	WONG, ALEXANDER K	5/31/1994	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	288 N LA CADENA DR	None	COLTON	CA	92324	2926	36	06071	34.0677475	-117.3241087	San Bernardino County
255771	Fee-for-Service	1811776560	1811776560	1	1	WILLIAM F RESH MD, SKIN & SK	1/17/2024	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	15725 POMERADO RD	102	POWAY	CA	92064	2057	37	06073	33.00037882	-117.0580735	San Diego County
255790	Fee-for-Service	1750347860	1750347860	1	1	WHITE, TERRY MD	2/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	78356	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94118	4242	01	06001	37.79926205	-122.2314248	Alameda County
255828	Fee-for-Service	1932303146	1932303146	1	1	WANG, YANG MD	5/6/2010	207P00000X	NA	Other	026	PHYSICIANS	110282	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
255859	Fee-for-Service	1619715711	1619715711	1	1	WHOLISTIC HEALING LICENSED C	9/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LINICAL SOCIAL WORKER	337 N VINEYARD AVE	400	ONTARIO	CA	91764	4436	36	06071	34.066728	-117.611622	San Bernardino County
255860	Fee-for-Service	1821353731	1821353731	1	1	WARD, ASHLEY G LCSW	11/5/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 S E STREET	None	SANTA ROSA	CA	95404	5132	49	06097	38.435895	-122.706396	Sonoma County
255941	Fee-for-Service	1396198982	1396198982	1	1	WELLSPACE HEALTH	9/20/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2425 ALHAMBRA BLVD	None	SACRAMENTO	CA	95817	1109	34	06067	38.55627	-121.471875	Sacramento County
255966	Fee-for-Service	1295850048	1295850048	1	1	WAYS, SUSAN PHD MD INC	6/23/2010	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W COOLIDGE AVE	None	MODESTO	CA	95250	4447	50	06099	37.66550267	-120.9951522	Stanislaus County
255991	Fee-for-Service	1629087002	1629087002	1	1	WARD, MARIANN M NP	6/19/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
256019	Fee-for-Service	1831532118	1831532118	1	1	WILLIAMS, JAY T MD	9/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2865 DAGGETT AVENUE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
256040	Fee-for-Service	1376589333	1376589333	1	1	WILBUR, BRIAN R MD	3/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83861	66	Emergency Medicine (Urgent Care)	0	In state provider	EMERGENCY DEPT	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
256060	Fee-for-Service	1497160576	1497160576	1	1	WEST, NATHANIEL H MD	2/15/2022	207P00000X	NA	Other	026	PHYSICIANS	169302	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
256104	Fee-for-Service	1194841429	1194841429	1	1	WESSON, INC.	11/11/2020	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1079 EUCALYPTUS	STE B	MANTECA	CA	95337	4317	39	06077	37.80126585	-121.2326114	San Joaquin County
256140	Fee-for-Service	1972630267	1972630267	1	1	WILLIAMS, T CRAIG	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	32747	29	Pulmonary Diseases (M.D. only)	0	In state provider	A PROFESSIONAL CORP	13855 E 14TH ST	None	SAN LEANDRO	CA	94578	2611	01	06001	37.712385	-122.143428	Alameda County
256203	Fee-for-Service	1265486427	1265486427	1	4	WEST VALLEY RADIOLOGY MEDICA	2/27/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	L GROUP, INC.	215 JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
256217	Fee-for-Service	1508871518	1508871518	1	1	WALGREEN CO	9/19/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13655 BEAR VALLEY RD	None	VICTORVILLE	CA	92392	8518	36	06071	34.47037254	-117.3649815	San Bernardino County
256229	Fee-for-Service	1396198982	1396198982	1	1	WELLSPACE HEALTH	3/21/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	2425 ALHAMBRA BLVD	None	SACRAMENTO	CA	95817	1109	34	06067	38.55627	-121.471875	Sacramento County
256241	Fee-for-Service	1124403860	1124403860	1	1	WILLIAMSON, DANIELLE M MD	6/3/2022	207L00000X	NA	Other	026	PHYSICIANS	163177	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
256372	Fee-for-Service	1518045202	1518045202	1	1	WESTLAKE, ROBYN E MD	11/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84724	41	Internal Medicine	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
256400	Fee-for-Service	1760661060	1760661060	1	1	WONG, NANCY P OD	10/15/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	611 BROADWAY	None	SAN FRANCISCO	CA	94133	4405	38	06075	37.79779175	-122.4073064	San Francisco County
256401	Fee-for-Service	1336212810	1336212810	1	1	WEN-HUI, ANGELA TAI MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	250 THOMPSON ST	None	SAINT PAUL	MN	55102	2370	00	None	44.94428014	-93.10733608	Ramsey County
256408	Fee-for-Service	1396750683	1396750683	1	1	WALGREEN CO	8/25/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1055 FREMONT BLVD	None	SEASIDE	CA	93955	5712	27	06053	36.59960815	-121.8503464	Monterey County
256412	Fee-for-Service	1396835054	1396835054	1	1	WENNOGLE, CHARLES F MD	7/15/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	159518	None	None	0	In state provider	None	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
256448	Fee-for-Service	1194873075	1194873075	1	1	WEST, STEPHEN SEVILLE MD	12/3/1995	2086S0105X	NA	General Surgery	026	PHYSICIANS	78623	None	None	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
256459	Fee-for-Service	1093764359	1093764359	1	1	WISHINGRAD, MARC MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69602	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 SANTA MONICA BLVD	#360W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
256493	Fee-for-Service	1265486427	1265486427	1	4	WEST VALLEY RADIOLOGY MEDICA	2/27/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	L GROUP, INC.	215 JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
256511	Fee-for-Service	1255764775	1255764775	1	1	WAL-MART STORES INC	3/14/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2204 TAPO ST	None	SIMI VALLEY	CA	93063	3022	56	06111	34.27572114	-118.7089232	Ventura County
256535	Fee-for-Service	1033125786	1033125786	1	1	WALGREEN CO.	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1524 POLK ST	None	SAN FRANCISCO	CA	94109	3607	38	06075	37.79099372	-122.4207382	San Francisco County
256577	Fee-for-Service	1902160799	1902160799	1	1	WALKER STREET IMAGING CARE	6/20/2016	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	INC	10601 WALKER STREET	SUITE 150	CYPRESS	CA	90630	4733	30	06059	33.809724	-118.036976	Orange County
256686	Fee-for-Service	1467467746	1467467746	1	1	WALGREEN CO.	1/19/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	621 I ST	None	CHULA VISTA	CA	91910	5110	37	06073	32.62736031	-117.0886342	San Diego County
256689	Fee-for-Service	1437590312	1437590312	1	1	WONGPRASERT, HANSA MD	2/1/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	141533	None	None	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.28825369	-120.4963159	Merced County
256703	Fee-for-Service	1184644262	1184644262	1	2	WARD, KATHERINE T MD	10/16/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	75695	-	NOT APPLICABLE	0	In state provider	None	1000 W CARSON ST	PCDC MODULE B & C	TORRANCE	CA	90502	2004	19	06037	33.83155851	-118.2920625	Los Angeles County
256731	Fee-for-Service	1285661983	1285661983	1	1	WAGNER,ROBERT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1690 E LAYTON	STE B	FREELAND	WA	98249	0000	00	None	48.01136878	-122.5238519	Island County
256746	Fee-for-Service	1093764359	1093764359	1	1	WISHINGRAD, MARC MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69602	01	General Practice	0	In state provider	None	2001 SANTA MONICA BLVD	#360W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
256757	Fee-for-Service	1346324068	1346324068	1	1	WEST, HOWARD L MD	3/19/2019	207RX0202X	NA	Oncology	026	PHYSICIANS	55294	41	Internal Medicine	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
256806	Fee-for-Service	1790987501	1790987501	1	1	WONG, ESTHER W MD	10/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111982	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
256808	Fee-for-Service	1265485478	1265485478	1	1	WENDELL WALTER HOFFMAN MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1305 W 18TH ST	None	SIOUX FALLS	SD	57105	0401	00	None	43.535484	-96.7428585	Minnehaha County
256876	Fee-for-Service	1659028538	1659028538	1	1	WINOGRAD, SARA PSYD	12/18/2023	390200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
256878	Fee-for-Service	1255358479	1255358479	1	1	WALMART INC.	2/22/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	2840 HWAY 95	500	BULLHEAD CITY	AZ	86442	7792	00	None	35.082423	-114.595128	Mohave County
256930	Fee-for-Service	1144258963	1144258963	1	1	WITKIN, JOSEPH MD	8/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	32398	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
256974	Fee-for-Service	1902819782	1902819782	1	2	WILSON, MARK D MD	3/2/2018	207RE0101X	NA	Endocrinology	026	PHYSICIANS	76968	41	Internal Medicine	0	In state provider	None	320 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4311	42	06083	34.42954414	-119.7230551	Santa Barbara County
256975	Fee-for-Service	1326011941	1326011941	1	1	WANG, CHIHYING J MD	1/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88944	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
256981	Fee-for-Service	1629120431	1629120431	1	1	WISE, DAVID M MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	35170	01	General Practice	0	In state provider	None	20 GLEN DR	None	SAUSALITO	CA	94965	2031	21	06041	37.85622054	-122.4851277	Marin County
256990	Fee-for-Service	1063429066	1063429066	1	1	WALGREEN CO	3/14/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	30015 DATE PALM DR	None	CATHEDRAL CITY	CA	92234	2822	33	06065	33.829983	-116.4582285	Riverside County
256998	Fee-for-Service	1760434195	1760434195	1	1	WRIGHT, PETER M MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71682	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
257002	Fee-for-Service	1134268006	1134268006	1	1	WOLFF, JAMES D MD	8/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102690	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
257007	Fee-for-Service	1043538770	1043538770	1	1	WANG, JADELYN T LMFT	10/19/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
257033	Fee-for-Service	1093764359	1093764359	1	1	WISHINGRAD, MARC MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69602	10	Gastroenterology (M.D. only)	0	In state provider	None	2001 SANTA MONICA BLVD	#360W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
257089	Fee-for-Service	1104908094	1104908094	1	1	WHITE, MALIK O MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62461	None	None	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
257098	Fee-for-Service	1568561561	1568561561	1	1	WARDEN, WILLIAM R MD	12/5/1996	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	44691	40	Pediatrics	0	In state provider	None	1160 CIRBY WAY	None	ROSEVILLE	CA	95661	4422	31	06061	38.72946765	-121.274199	Placer County
257127	Fee-for-Service	1548236235	1548236235	1	1	WILLIS, TED MD	7/26/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	179483	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
257147	Fee-for-Service	1407093016	1407093016	1	1	WANG, CORINA H MD	4/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102522	41	Internal Medicine	0	In state provider	None	3801 HOWE ST.	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
257202	Fee-for-Service	1770887614	1770887614	1	1	WALGREEN CO	6/6/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	700 TWELVE BRIDGES DR	None	LINCOLN	CA	95648	8824	31	06061	38.85127671	-121.2882649	Placer County
257204	Fee-for-Service	1538808936	1538808936	1	1	WESTBROOK PHARMACY LLC	6/27/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10212 WESTMINSTER AVE	SUITE 109	GARDEN GROVE	CA	92843	4800	30	06059	33.75947657	-117.9513797	Orange County
257248	Fee-for-Service	1336437219	1336437219	1	1	WISNIEWSKI, DAWN LMFT	3/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	440 E HUNTINGTON DR STE	None	ARCADIA	CA	91006	3775	19	06037	34.14014147	-118.0220265	Los Angeles County
257253	Fee-for-Service	1003127986	1003127986	1	1	WORKU, ASSEFA MD	10/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109678	41	Internal Medicine	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
257262	Fee-for-Service	1649370487	1649370487	1	1	WECHSLER, CATHRYN J MD	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	23593	40	Pediatrics	0	In state provider	None	1135 S SUNSET AVE	None	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
257272	Fee-for-Service	1205663861	1205663861	1	1	WILBUR RX INC	10/28/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5620 WILBUR AVE	STE 100	TARZANA	CA	91356	1308	19	06037	34.17282089	-118.5446783	Los Angeles County
257292	Fee-for-Service	1003436064	1003436064	1	23	WS AUDIOLOGY (CALIFORNIA), P	6/6/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	716 FREEMAN LANE	SUITE D	GRASS VALLEY	CA	95949	9652	29	06057	39.20195627	-121.0635127	Nevada County
257339	Fee-for-Service	1023003423	1023003423	1	1	WEISS, GERALD A MD	1/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	37092	22	Pathology (M.D. only)	0	In state provider	None	675 E SANTA CLARA ST	None	SAN JOSE	CA	95112	1932	43	06085	37.34275712	-121.8768207	Santa Clara County
257385	Fee-for-Service	1326099318	1326099318	1	1	WELLAND-AKONG, CHRISTAUR	9/1/2001	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	990 HIGHLAND DR	STE 103	SOLANA BEACH	CA	92075	2409	37	06073	32.9802331	-117.2569446	San Diego County
257520	Fee-for-Service	1639239833	1639239833	1	1	WANG, RICARDO MD	12/1/1997	2085R0001X	NA	Other	026	PHYSICIANS	61006	78	Neoplastic Diseases/Oncology	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
257544	Fee-for-Service	1396050332	1396050332	1	1	WU, XIN MD	6/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136251	30	Radiology	0	In state provider	None	1001 POTRERO AVENUE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
257580	Fee-for-Service	1003436064	1003436064	1	23	WS AUDIOLOGY (CALIFORNIA), P	11/12/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	716 FREEMAN LANE	SUITE D	GRASS VALLEY	CA	95949	9652	29	06057	39.20195627	-121.0635127	Nevada County
257595	Fee-for-Service	1811195969	1811195969	1	1	WEITLAUF, JULIE C PHD	5/10/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTUER DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
257615	Fee-for-Service	1689647414	1689647414	1	1	WONG, WALTER A OD	1/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3162 CAMPUS DR	None	SAN MATEO	CA	94403	3123	41	06081	37.53363194	-122.3277714	San Mateo County
257616	Fee-for-Service	1356384770	1356384770	1	1	WYMAN, STEVEN MD	3/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 S EAGLE RD	None	MERIDIAN	ID	83642	6351	00	None	43.600527	-116.3518425	Ada County
257619	Fee-for-Service	1578872925	1578872925	1	1	WAL-MART STORES, INC	8/3/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1375 N DAVIS RD	None	SALINAS	CA	93907	1991	27	06053	36.70578	-121.668822	Monterey County
257627	Fee-for-Service	1023003423	1023003423	1	1	WEISS, GERALD A MD	1/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	37092	66	Emergency Medicine (Urgent Care)	0	In state provider	None	675 E SANTA CLARA ST	None	SAN JOSE	CA	95112	1932	43	06085	37.34275712	-121.8768207	Santa Clara County
257668	Fee-for-Service	1154572527	1154572527	1	1	WECKER, LAUREN E PSYD	5/25/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	23365	-	NOT APPLICABLE	0	In state provider	None	5675 WEST OLYMPIC BLVD	None	LOS ANGELES	CA	90036	4712	19	06037	34.05742688	-118.3532118	Los Angeles County
257675	Fee-for-Service	1568877413	1568877413	1	1	WONGRAKPANICH, SUPAKANYA MD	7/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153678	41	Internal Medicine	0	In state provider	None	225 N JACKSON AVENUE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
257715	Fee-for-Service	1124061296	1124061296	1	1	WETZEL, GIHAN MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	7357	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1111 W LA PALMA AVE	None	ANAHEIM	CA	92801	2804	30	06059	33.84718298	-117.933758	Orange County
257782	Fee-for-Service	1508278466	1508278466	1	1	WONG, ALLEN C MD	5/16/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	160385	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
257807	Fee-for-Service	1639239833	1639239833	1	1	WANG, RICARDO MD	12/1/1997	2085R0001X	NA	Other	026	PHYSICIANS	61006	30	Radiology	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
257823	Fee-for-Service	1275764706	1275764706	1	1	WOORI MEDICAL GROUP	9/28/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PROFESSIONAL CORP	7825 ENGINEER RD	STE 101	SAN DIEGO	CA	92111	1901	37	06073	32.82639677	-117.1533615	San Diego County
257845	Fee-for-Service	1811099534	1811099534	1	1	WIENER, GREGORY J MD	9/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	41749	66	Emergency Medicine (Urgent Care)	0	In state provider	None	353 CHURCH AVE	None	CHULA VISTA	CA	91910	3906	37	06073	32.63971988	-117.0781089	San Diego County
257884	Fee-for-Service	1174606511	1174606511	1	1	WESTERN PATHOLOGY	6/1/1999	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	MEDICAL ASSOCIATES	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
257888	Fee-for-Service	1891815486	1891815486	1	1	WALKER- JONES, MITCHELENE L	1/29/2025	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CSW	100 N BRAND BLVD	STE 223	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
257891	Fee-for-Service	1497867329	1497867329	1	1	WELLMAN'S PHARMACY	10/30/1987	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1053 STOCKTON ST	None	SAN FRANCISCO	CA	94108	1109	38	06075	37.79557886	-122.4081954	San Francisco County
257961	Fee-for-Service	1912938572	1912938572	1	1	WILLMAN, SUSAN P MD	9/26/2019	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	42847	15	Obstetrics (D.O. only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
257969	Fee-for-Service	1073528345	1073528345	1	1	WALGREEN CO	11/26/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	33975 DATE PALM DR	None	CATHEDRAL CITY	CA	92234	4736	33	06065	33.80200337	-116.4581495	Riverside County
257973	Fee-for-Service	1871607937	1871607937	1	1	WOODBURY, ROBERT O MD	3/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	77680	02	General Surgery	0	In state provider	None	3883 AIRWAY DR	STE 100	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
257979	Fee-for-Service	1780726653	1780726653	1	1	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	11902 ROSECRANS AVE	SUITE A & D	NORWALK	CA	90650	4116	19	06037	33.90212464	-118.079675	Los Angeles County
258041	Fee-for-Service	1649532557	1649532557	1	1	WINN, JUSTIN N MD	8/6/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	155924	30	Radiology	0	In state provider	None	6305 COYLE AVE	None	CARMICHAEL	CA	95608	0438	34	06067	38.668248	-121.3181415	Sacramento County
258050	Fee-for-Service	1588848659	1588848659	1	1	WU, DAVID P MD	11/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125814	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
258058	Fee-for-Service	1679625362	1679625362	1	1	WEXLER, RICHARD J MD	8/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37612	41	Internal Medicine	0	In state provider	None	10861 CHERRY ST	STE 302	LOS ALAMITOS	CA	90720	5403	30	06059	33.80465174	-118.0680053	Orange County
258066	Fee-for-Service	1841634144	1841634144	2	1	WELLBOUND OF MODESTO LLC	5/1/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4207 BANGS AVE	SUITE 200	MODESTO	CA	95356	8714	50	06099	37.70451139	-121.0723422	Stanislaus County
258069	Fee-for-Service	1073072724	1073072724	1	1	WADHWA, RITAMBHARA DO	8/23/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	21469	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
258074	Fee-for-Service	1801833900	1801833900	1	1	WEST HILLS REG MED CTR	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
258124	Fee-for-Service	1699752444	1699752444	1	1	WANG, YAN	3/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	56020	07	Dermatology	0	In state provider	None	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	37	06073	32.99706	-117.05544	San Diego County
258131	Fee-for-Service	1811099534	1811099534	1	1	WIENER, GREGORY J MD	9/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	41749	10	Gastroenterology (M.D. only)	0	In state provider	None	353 CHURCH AVE	None	CHULA VISTA	CA	91910	3906	37	06073	32.63971988	-117.0781089	San Diego County
258145	Fee-for-Service	1134139538	1134139538	1	1	WILEY PERKINS, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
258158	Fee-for-Service	1033205778	1033205778	1	1	WOIWODE, NORA F MD	5/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85369	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
258170	Fee-for-Service	1609397405	1609397405	1	1	WARD, DEVON B MD	7/28/2020	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	158273	40	Pediatrics	0	In state provider	None	3636 N. FIRST STREET	120-121	FRESNO	CA	93726	6818	10	06019	36.78322578	-119.7724022	Fresno County
258174	Fee-for-Service	1750319190	1750319190	1	1	WAI, MAUNG T MD	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	80746	08	Family Practice	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
258214	Fee-for-Service	1457472177	1457472177	1	1	WEST OAKLAND HEALTH CTR	6/9/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	700 ADELINE ST	None	OAKLAND	CA	94607	2608	01	06001	37.80430011	-122.2879962	Alameda County
258252	Fee-for-Service	1205808433	1205808433	1	1	WALD, MOSHE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
258261	Fee-for-Service	1871607937	1871607937	1	1	WOODBURY, ROBERT O MD	3/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	77680	89	Surgery-Traumatic	0	In state provider	None	3883 AIRWAY DR	STE 100	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
258267	Fee-for-Service	1780726653	1780726653	1	1	WESTERN PACIFIC MED-CORP	1/15/1988	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	11902 ROSECRANS AVE	SUITE A & D	NORWALK	CA	90650	4116	19	06037	33.90212464	-118.079675	Los Angeles County
258358	Fee-for-Service	1821289943	1821289943	1	1	WERTHEIM, JASON A MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107012	02	General Surgery	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
258443	Fee-for-Service	1457403396	1457403396	1	1	WATTS, KIRSTEN R	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
258450	Fee-for-Service	1477385474	1477385474	1	1	WILLIAMS, DAVINA CD	8/26/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
258471	Fee-for-Service	1699979633	1699979633	1	1	WICKREMASINGHE, ANDREA C MD	6/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112471	40	Pediatrics	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
258490	Fee-for-Service	1720070113	1720070113	1	1	WU, JAMES C MD INC	9/26/2007	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	91181	04	Otology, Laryngology, Rhinology	0	In state provider	None	1800 SULLIVAN AVE	STE 411	DALY CITY	CA	94015	2224	41	06081	37.68077723	-122.4728941	San Mateo County
258521	Fee-for-Service	1174926976	1174926976	1	1	WAL-MART STORES, INC.	6/8/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	778 E ARROW HWY	None	POMONA	CA	91767	2270	19	06037	34.08993071	-117.7377185	Los Angeles County
258536	Fee-for-Service	1124023999	1124023999	1	1	WRIGHT-SCOTT, SHEILA L	9/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	45401	18	Ophthalmology	0	In state provider	MD AMC	43845 10TH ST W	STE 1D	LANCASTER	CA	93534	4800	19	06037	34.68012017	-118.1479449	Los Angeles County
258546	Fee-for-Service	1013931039	1013931039	1	1	WANG, SAMUEL MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69484	41	Internal Medicine	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
258550	Fee-for-Service	1871607937	1871607937	1	1	WOODBURY, ROBERT O MD	3/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	77680	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3883 AIRWAY DR	STE 100	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
258553	Fee-for-Service	1790044964	1790044964	1	1	WILLARD, KIMBERLY J MD	10/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120972	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
258561	Fee-for-Service	1760498166	1760498166	1	1	WALGREEN CO	12/29/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	2801 S 4TH AVE	None	YUMA	AZ	85364	8125	00	None	32.676318	-114.624153	Yuma County
258564	Fee-for-Service	1235140229	1235140229	1	1	WASHOWICH, TIMOTHY L MD	8/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	86145	30	Radiology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
258597	Fee-for-Service	1730198615	1730198615	1	1	WOOD, IAN O DO	10/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
258603	Fee-for-Service	1043384829	1043384829	1	1	WATSON, LUKE R MD INC	10/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	60383	22	Pathology (M.D. only)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
258621	Fee-for-Service	1417246489	1417246489	1	1	WONG, NANCY S NP	5/30/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
258643	Fee-for-Service	1386082808	1386082808	2	1	WELLNESS SPECIALTY PHARMACY	8/9/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	19944 VENTURA BLVD	N/A	WOODLAND HILLS	CA	91364	0000	19	06037	34.17210517	-118.5671657	Los Angeles County
258645	Fee-for-Service	1528000783	1528000783	1	1	WISBACH, GORDON G III MD	1/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75212	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
258687	Fee-for-Service	1982952941	1982952941	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2240 S BRADLEY RD	None	SANTA MARIA	CA	93455	1348	42	06083	34.918875	-120.4190775	Santa Barbara County
258716	Fee-for-Service	1306070289	1306070289	1	1	WALMART INC.	2/22/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	100 W RIVERSIDE DR	None	PARKER	AZ	85344	5205	00	None	34.15616741	-114.2757529	La Paz County
258774	Fee-for-Service	1881658920	1881658920	1	1	WHITNEY, FRANK E MD	5/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	33455	02	General Surgery	0	In state provider	None	940 SYLVA LN	STE E	SONORA	CA	95370	5969	55	06109	37.98764779	-120.3681842	Tuolumne County
258779	Fee-for-Service	1720070113	1720070113	1	1	WU, JAMES C MD INC	9/26/2007	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	91181	84	Surgery-Head and Neck	0	In state provider	None	1800 SULLIVAN AVE	STE 411	DALY CITY	CA	94015	2224	41	06081	37.68077723	-122.4728941	San Mateo County
258832	Fee-for-Service	1043417264	1043417264	1	1	WEISE, MAURICE R MD	6/20/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	28604	-	NOT APPLICABLE	0	In state provider	None	12021 S WILMINGTON AVE	LOT C	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
258835	Fee-for-Service	1013931039	1013931039	1	1	WANG, SAMUEL MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69484	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
258910	Fee-for-Service	1871754507	1871754507	1	1	WIN, THIDA MD	4/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	105869	77	Infectious Disease	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
258914	Fee-for-Service	1073659447	1073659447	1	1	WINDSOR THE RIDGE	4/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION CTR LLC	350 IRIS DR	None	SALINAS	CA	93906	3514	27	06053	36.69347517	-121.6574161	Monterey County
258943	Fee-for-Service	1831454891	1831454891	1	1	WEBB, LORRE A LCSW	12/11/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	76282	-	NOT APPLICABLE	0	In state provider	None	1401 L ST	None	BAKERSFIELD	CA	93301	4522	15	06029	35.37071435	-119.0164657	Kern County
258971	Fee-for-Service	1912968231	1912968231	1	1	WESTCOM RADIOLOGY MED	7/1/1994	193200000X	NA	Other	022	PHYSICIANS GROUP	-	35	Pediatric Cardiology (M.D. only)	0	In state provider	GROUP INC	6245 DE LONGPRE AVE	None	HOLLYWOOD	CA	90028	8253	19	06037	34.0962065	-118.325178	Los Angeles County
258981	Fee-for-Service	1881690972	1881690972	1	1	WILSON, RICK Q PHD	9/22/2005	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
258985	Fee-for-Service	1518404441	1518404441	1	1	WOMENS HEALTH CARE RESEARCH	2/1/2017	261QM2500X	NA	Other	026	PHYSICIANS	62869	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	CORPORATION	3750 CONVOY ST	STE 311	SAN DIEGO	CA	92111	3741	37	06073	32.81201122	-117.1531108	San Diego County
258987	Fee-for-Service	1851591432	1851591432	1	1	WOJTOWICZ, ELIZABETH A NP	11/4/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	780 SHADOWRIDGE RD	None	VISTA	CA	92083	7986	37	06073	33.16632768	-117.2212175	San Diego County
259020	Fee-for-Service	1083670475	1083670475	1	1	WINTER, ADRIA O MD	2/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82458	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 OLD RIVER RD	None	BAKERSFIELD	CA	93311	9781	15	06029	35.351487	-119.1143025	Kern County
259060	Fee-for-Service	1881658920	1881658920	1	1	WHITNEY, FRANK E MD	5/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	33455	20	Orthopedic Surgery	0	In state provider	None	940 SYLVA LN	STE E	SONORA	CA	95370	5969	55	06109	37.98764779	-120.3681842	Tuolumne County
259070	Fee-for-Service	1275557100	1275557100	1	1	WEISKOPF, MANUEL MD INC	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	42837	05	Anesthesiology	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
259088	Fee-for-Service	1922013010	1922013010	1	1	WALGREEN CO	8/27/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1800 W SLAUSON AVE	None	LOS ANGELES	CA	90047	1126	19	06037	33.98910151	-118.3119255	Los Angeles County
259092	Fee-for-Service	1568593580	1568593580	1	1	WAECHTER, NEAL R MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91608	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
259139	Fee-for-Service	1801924477	1801924477	1	1	WALTER JAYASINGHE MD APC	1/1/1981	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	LOS ANGELES MEDICAL CTR	2010 WILSHIRE BLVD	STE 2000	LOS ANGELES	CA	90057	3592	19	06037	34.05748989	-118.2750432	Los Angeles County
259193	Fee-for-Service	1972819282	1972819282	1	1	WILLIAMS, GREGORY V MD	8/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118641	08	Family Practice	0	In state provider	None	3687 MT DIABLO BLVD	#200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
259209	Fee-for-Service	1679588768	1679588768	1	1	WALGREEN CO.	2/25/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	721 GREGORY LN	None	PLEASANT HILL	CA	94523	2763	07	06013	37.94794151	-122.0819175	Contra Costa County
259221	Fee-for-Service	1245641828	1245641828	1	1	WOZENCROFT, APRIL S LMFT	7/23/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
259302	Fee-for-Service	1750400784	1750400784	1	1	WHITE, REBEKAH R MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143450	02	General Surgery	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
259314	Fee-for-Service	1154315273	1154315273	1	1	WASHINGTON, ELEBY R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53301	20	Orthopedic Surgery	0	In state provider	None	4644 LINCOLN BLVD	STE 101	MARINA DEL REY	CA	90292	6374	19	06037	33.98210351	-118.4405172	Los Angeles County
259316	Fee-for-Service	1871934687	1871934687	1	1	WELTY, STEPHANIE S NP	8/17/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
259321	Fee-for-Service	1023346459	1023346459	1	1	WANG, YI-CHIUN MD	5/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110705	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
259328	Fee-for-Service	1003838095	1003838095	1	1	WERTHEIMER, JEFFREY C PHD	10/1/2010	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
259401	Fee-for-Service	1114312329	1114312329	1	1	WANG, JENNIFER Y MD	11/18/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	144108	07	Dermatology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
259427	Fee-for-Service	1801924477	1801924477	1	1	WALTER JAYASINGHE MD APC	1/1/1981	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	LOS ANGELES MEDICAL CTR	2010 WILSHIRE BLVD	STE 2000	LOS ANGELES	CA	90057	3592	19	06037	34.05748989	-118.2750432	Los Angeles County
259430	Fee-for-Service	1538300041	1538300041	1	1	WECHSLER, STACEY C	7/9/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9466 BLACK MTN RD	STE 100	SAN DIEGO	CA	92126	4550	37	06073	32.89448076	-117.123457	San Diego County
259442	Fee-for-Service	1366590853	1366590853	1	1	WEISSBROD, PHILIP A MD	10/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118221	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
259461	Fee-for-Service	1730682592	1730682592	1	1	WENRU SUN ACUPUNCTURE CLINIC	3/7/2024	261Q00000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATIO	2040 FOREST AVE	4	SAN JOSE	CA	95128	4810	43	06085	37.3270506	-121.9347674	Santa Clara County
259469	Fee-for-Service	1659085884	1659085884	1	1	WRIGHT, QAASHUNTAE NP	1/8/2024	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
259489	Fee-for-Service	1326119165	1326119165	1	1	WICKWIRE, WILLIAM J MD	9/30/1990	207N00000X	NA	Dermatology	026	PHYSICIANS	65083	07	Dermatology	0	In state provider	DBA BEACH CITIES DERM	520 N PROSPECT AVE	STE 302	REDONDO BEACH	CA	90277	3043	19	06037	33.8529819	-118.3802954	Los Angeles County
259492	Fee-for-Service	1609247667	1609247667	1	1	WAL-MART STORES, INC	1/13/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	859 W FLORIDA AVE	None	HEMET	CA	92543	4070	33	06065	33.7473867	-116.9799325	Riverside County
259556	Fee-for-Service	1598220543	1598220543	1	1	WHITAKER, CHELSEA R PT	8/26/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
259564	Fee-for-Service	1457860470	1457860470	1	1	WANJALA, BUTSINA M NP	6/21/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
259599	Fee-for-Service	1063571156	1063571156	1	1	WINKELS, ROBERT R LCSW	1/29/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2854 OLIVE HIGHWAY	SUITE E	OROVILLE	CA	95966	6112	04	06007	39.50347297	-121.5404768	Butte County
259643	Fee-for-Service	1780981076	1780981076	1	1	WINTER, GREG I MD	6/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118810	08	Family Practice	0	In state provider	None	2110 N BELLFLOWER AVE	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
259654	Fee-for-Service	1588723316	1588723316	1	1	WHEELER, JONATHAN H MD	3/4/2009	174400000X	NA	Other	026	PHYSICIANS	61174	01	General Practice	0	In state provider	None	351 HOSPITAL RD	STE 611	NEWPORT BEACH	CA	92663	3508	30	06059	33.62579141	-117.9299554	Orange County
259678	Fee-for-Service	1114932449	1114932449	1	1	WALGREEN CO	2/7/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	25011 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	4312	33	06065	33.91720845	-117.2256545	Riverside County
259685	Fee-for-Service	1154409969	1154409969	1	1	WAMMACK, KARIN E MD	11/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	48739	01	General Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
259686	Fee-for-Service	1215165444	1215165444	1	2	WOMACH, JOHN O MD INC	12/31/1983	193400000X	NA	Other	026	PHYSICIANS	24835	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1995 ZINFANDEL DR	STE 204	RANCHO CORDOVA	CA	95670	2862	34	06067	38.612124	-121.27131	Sacramento County
259715	Fee-for-Service	1801924477	1801924477	1	1	WALTER JAYASINGHE MD APC	1/1/1981	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	LOS ANGELES MEDICAL CTR	2010 WILSHIRE BLVD	STE 2000	LOS ANGELES	CA	90057	3592	19	06037	34.05748989	-118.2750432	Los Angeles County
259730	Fee-for-Service	1407386055	1407386055	1	1	WOLGAMOTT, LAURA MD	5/7/2024	207T00000X	NA	General Surgery	026	PHYSICIANS	None	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
259746	Fee-for-Service	1871510289	1871510289	1	1	WAL-MART STORES, INC	2/26/1999	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALMART PHARMACY 10-2553	6650 HEMBREE LN	None	WINDSOR	CA	95492	9739	49	06097	38.52787447	-122.7914366	Sonoma County
259833	Fee-for-Service	1568442671	1568442671	1	1	WEBER, PAUL R MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37980	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2865 ATLANTIC AVE	STE 25	LONG BEACH	CA	90806	1740	19	06037	33.809418	-118.185058	Los Angeles County
259866	Fee-for-Service	1821514332	1821514332	1	1	WELLBEINGS FAMILY THERAPY, I	4/9/2021	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3840 WOODRUFF AVE	STE 209	LONG BEACH	CA	90808	2149	19	06037	33.828786	-118.1165535	Los Angeles County
259894	Fee-for-Service	1851394209	1851394209	1	1	WELLS, PHILLIP R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	80312	84	Surgery-Head and Neck	0	In state provider	None	675 CAMINO DE LOS MARES	STE 420	SAN CLEMENTE	CA	92673	2837	30	06059	33.45710369	-117.6474248	Orange County
259898	Fee-for-Service	1730592635	1730592635	1	1	WASHINGTON, TAMARA N MD	12/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	150287	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
259976	Fee-for-Service	1477629756	1477629756	1	1	WALTER, JOSEPH F	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17607	30	Radiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
259980	Fee-for-Service	1629210695	1629210695	1	1	WRIGHT, RENEE	2/25/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	106 S C ST	A, B, AND C	LOMPOC	CA	93436	7339	42	06083	34.63853189	-120.4514745	Santa Barbara County
259989	Fee-for-Service	1336230192	1336230192	1	1	WELCOME, RICHARD M MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	590 EUREKA AVE	None	RENO	NV	89512	3425	00	None	39.53407902	-119.8048858	Washoe County
259997	Fee-for-Service	1528085750	1528085750	1	1	WAL-MART STORES INC	8/24/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 103522	3250 BIG DALTON AVE	None	BALDWIN PARK	CA	91706	5107	19	06037	34.07208016	-117.964206	Los Angeles County
260043	Fee-for-Service	1043587009	1043587009	1	1	WALKER, GAY M MD	1/31/1988	207R00000X	NA	Other	026	PHYSICIANS	63605	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
260105	Fee-for-Service	1497203566	1497203566	1	1	WONDERLAB	4/7/2020	261QR0400X	NA	Physical Therapist	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	10431 COMMERCE ST STE A	None	REDLANDS	CA	92374	0110	36	06071	34.06427678	-117.2416506	San Bernardino County
260121	Fee-for-Service	1740295039	1740295039	1	1	WALGREEN CO	8/14/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	24081 EL TORO RD	None	LAGUNA HILLS	CA	92653	3103	30	06059	33.61279466	-117.7127914	Orange County
260146	Fee-for-Service	1841236171	1841236171	1	1	WAYNE, ALAN S MD	2/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	89458	68	Hematology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
260154	Fee-for-Service	1821514332	1821514332	1	1	WELLBEINGS FAMILY THERAPY, I	4/9/2021	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3840 WOODRUFF AVE	STE 209	LONG BEACH	CA	90808	2149	19	06037	33.828786	-118.1165535	Los Angeles County
260161	Fee-for-Service	1275898553	1275898553	1	1	WAL-MART STORES INC	2/22/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1120 S ANAHEIM BLVD	None	ANAHEIM	CA	92805	5810	30	06059	33.81935438	-117.9084695	Orange County
260167	Fee-for-Service	1619919941	1619919941	1	1	WASSEF, HEIDI R MD	8/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	8451	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
260182	Fee-for-Service	1851394209	1851394209	1	1	WELLS, PHILLIP R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	80312	04	Otology, Laryngology, Rhinology	0	In state provider	None	675 CAMINO DE LOS MARES	STE 420	SAN CLEMENTE	CA	92673	2837	30	06059	33.45710369	-117.6474248	Orange County
260193	Fee-for-Service	1235631672	1235631672	1	1	WELLS, TAELOR LMFT	10/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
260219	Fee-for-Service	1942211701	1942211701	1	1	WANG, NATALIE Y MD APC	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	80797	05	Anesthesiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
260274	Fee-for-Service	1609049741	1609049741	1	1	WERNIG, GERLINDE MD	8/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119554	22	Pathology (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
260307	Fee-for-Service	1134353154	1134353154	1	2	WAHEB, YUSRA	3/26/2020	183700000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1013 S CENTRAL AVE	None	GLENDALE	CA	91204	3910	19	06037	34.13423915	-118.2578904	Los Angeles County
260319	Fee-for-Service	1154304301	1154304301	1	1	WOODRUFF, LISSA MD A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3219 CENTRAL AVE	None	KEARNEY	NE	68847	2949	00	None	40.70899516	-99.08221814	Buffalo County
260409	Fee-for-Service	1518012954	1518012954	1	1	WILLIAMS, DAVID T MD	11/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	86619	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 SOUTH GRAND AVENUE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
260411	Fee-for-Service	1497200950	1497200950	1	1	WALKER, ELIZABETH M	3/14/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
260435	Fee-for-Service	1841236171	1841236171	1	1	WAYNE, ALAN S MD	2/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	89458	78	Neoplastic Diseases/Oncology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
260436	Fee-for-Service	1316441694	1316441694	1	1	WEIA, BENJAMIN C MD	6/7/2021	207R00000X	NA	Other	026	PHYSICIANS	163611	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
260504	Fee-for-Service	1982054656	1982054656	1	1	WADHWANI, SUMEET H MD	9/12/2019	208M00000X	NA	Other	026	PHYSICIANS	162182	None	None	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.2206967	-118.5342638	Los Angeles County
260551	Fee-for-Service	1669821567	1669821567	1	1	WISKE, CLAY P MD	10/6/2023	2086S0129X	NA	General Surgery	026	PHYSICIANS	191244	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
260576	Fee-for-Service	1770622664	1770622664	1	1	WINDSOR UNIFIED SD	10/9/2002	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9291 OLD REDWOOD HWY	BLDG 500	WINDSOR	CA	95492	8089	49	06097	38.54971089	-122.8138213	Sonoma County
260639	Fee-for-Service	1558371435	1558371435	1	1	WEINER, DANIEL M DO	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7931	08	Family Practice	0	In state provider	None	3184 CHURN CREEK RD	None	REDDING	CA	96002	2122	45	06089	40.56138796	-122.3531253	Shasta County
260678	Fee-for-Service	1447322243	1447322243	1	1	WHITMORE, CASSANDRA L MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68131	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
260685	Fee-for-Service	1225470354	1225470354	1	1	WON, ROY P MD	8/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134883	02	General Surgery	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
260828	Fee-for-Service	1871698563	1871698563	1	1	WOMACK, PAMELA J NP	1/26/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
260864	Fee-for-Service	1770622664	1770622664	1	1	WINDSOR UNIFIED SD	1/1/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	9291 OLD REDWOOD HWY	BLDG 500	WINDSOR	CA	95492	8089	49	06097	38.54971089	-122.8138213	Sonoma County
260937	Fee-for-Service	1609804350	1609804350	1	1	WALLACE, OLUKEMI A MD	10/8/2008	174400000X	NA	Other	026	PHYSICIANS	48240	68	Hematology	0	In state provider	HEALING HANDS ONCOLOGY	4455 W 117TH ST	STE 402	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
261027	Fee-for-Service	1013949700	1013949700	1	1	WORLEDGE, JAMES N MD	3/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140089	36	Psychiatry	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
261047	Fee-for-Service	1831456342	1831456342	1	1	WEAVER, KAREN M LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	SUITE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
261063	Fee-for-Service	1285910935	1285910935	1	1	WINGER, SARA E NP	3/12/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
261085	Fee-for-Service	1164416772	1164416772	1	1	WRIGHT, DELBERT L MD	9/30/1991	207L00000X	NA	Other	026	PHYSICIANS	47956	05	Anesthesiology	0	In state provider	None	1900 POINT WEST WAY	STE 222	SACRAMENTO	CA	95815	4704	34	06067	38.599677	-121.431447	Sacramento County
261118	Fee-for-Service	1750611026	1750611026	1	1	WEITZ, KRISTEN P CCC-SLP	3/23/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	16800 ASTON	STE 175	IRVINE	CA	92606	4820	30	06059	33.70035445	-117.8435881	Orange County
261153	Fee-for-Service	1194418012	1194418012	1	1	WILCOX, MICHELLE NP	9/23/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95025923	-	NOT APPLICABLE	0	In state provider	None	1240 BROADWAY	None	EL CAJON	CA	92021	4994	37	06073	32.80773552	-116.9384985	San Diego County
261170	Fee-for-Service	1497252753	1497252753	1	1	WANG, BRANDON MD	5/26/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184481	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
261229	Fee-for-Service	1609804350	1609804350	1	1	WALLACE, OLUKEMI A MD	10/8/2008	174400000X	NA	Other	026	PHYSICIANS	48240	41	Internal Medicine	0	In state provider	HEALING HANDS ONCOLOGY	4455 W 117TH ST	STE 402	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
261310	Fee-for-Service	1972040095	1972040095	1	1	WEAL INC A PROFESSIONAL PSYC	11/8/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	HOLOGICAL CORP	65 MADISON	STE 707	PASADENA	CA	91101	2046	19	06037	34.14705803	-118.1384317	Los Angeles County
261320	Fee-for-Service	1518281161	1518281161	1	1	WALTER, JESSICA J MD	11/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145067	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
261325	Fee-for-Service	1598857898	1598857898	1	1	WAY, TIN A MD	5/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85038	18	Ophthalmology	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
261345	Fee-for-Service	1487691051	1487691051	1	1	WAWRO, PETER A S MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	44719	33	Thoracic Surgery	0	In state provider	None	801 N TUSTIN AVE	STE 305	SANTA ANA	CA	92705	3601	30	06059	33.752286	-117.8341735	Orange County
261379	Fee-for-Service	1881250702	1881250702	1	1	WHITE DOVE HOSPICE INC	10/21/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14351 RED HILL AVENUE	STE A	TUSTIN	CA	92780	6271	30	06059	33.72948962	-117.8194882	Orange County
261414	Fee-for-Service	1730492646	1730492646	1	1	WATSON, CHRISTA L PHD	10/26/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
261431	Fee-for-Service	1194345116	1194345116	1	1	WHEELER, LAUREN M DO	8/29/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20180	None	None	0	In state provider	None	8078 E SANTA ANA CANYON	None	ANAHEIM	CA	92808	1108	30	06059	33.86628	-117.750789	Orange County
261508	Fee-for-Service	1417962796	1417962796	1	1	WALGREEN CO.	3/22/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	780 E SANTA CLARA ST	None	SAN JOSE	CA	95112	1909	43	06085	37.34353562	-121.8749754	Santa Clara County
261577	Fee-for-Service	1134363393	1134363393	1	1	WHITMAN, MEGAN H MD	9/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149230	41	Internal Medicine	0	In state provider	None	1020 29TH STREET	STE 120	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
261593	Fee-for-Service	1326117052	1326117052	1	1	WINTONS PROF PHCY	1/1/1979	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1377 E HERNDON AVE	STE 102	FRESNO	CA	93720	3022	10	06019	36.83704387	-119.7641113	Fresno County
261611	Fee-for-Service	1447481619	1447481619	1	1	WALGREEN CO	10/15/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2589 JENSEN AVE	None	SANGER	CA	93657	2251	10	06019	36.7067485	-119.5739611	Fresno County
261632	Fee-for-Service	1487691051	1487691051	1	1	WAWRO, PETER A S MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	44719	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	801 N TUSTIN AVE	STE 305	SANTA ANA	CA	92705	3601	30	06059	33.752286	-117.8341735	Orange County
261635	Fee-for-Service	1730533506	1730533506	1	1	WASSIE, MAEREG MD	8/7/2019	207R00000X	NA	Other	026	PHYSICIANS	156422	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
261655	Fee-for-Service	1073824397	1073824397	1	1	WONG, JUSTIN C L MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	89992	-	NOT APPLICABLE	0	In state provider	None	5628 E SLAUSON AVENUE	None	COMMERCE	CA	90040	2922	19	06037	33.98593459	-118.163681	Los Angeles County
261657	Fee-for-Service	1326112053	1326112053	1	2	WELLS, JOSEPH S DPM	4/15/2020	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	24640 JEFFERSON AVE STE	None	MURRIETA	CA	92562	9027	33	06065	33.56027016	-117.2095112	Riverside County
261661	Fee-for-Service	1518081942	1518081942	1	1	WESTBY TRENT, ADRIANA A PHD	6/23/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3325 PALO VERDE AVENUE,	SUITE 201	LONG BEACH	CA	90808	4132	19	06037	33.81701249	-118.1078791	Los Angeles County
261668	Fee-for-Service	1881250702	1881250702	1	1	WHITE DOVE HOSPICE INC	10/21/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14351 RED HILL AVENUE	STE A	TUSTIN	CA	92780	6271	30	06059	33.72948962	-117.8194882	Orange County
261685	Fee-for-Service	1881665586	1881665586	1	1	WALDMAN, GLENN E MD	9/1/2000	174400000X	NA	Other	026	PHYSICIANS	62183	04	Otology, Laryngology, Rhinology	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
261744	Fee-for-Service	1285794834	1285794834	1	1	WAHL, BRYAN W MD	7/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	74763	41	Internal Medicine	0	In state provider	None	3010 COLBY ST	STE 221	BERKELEY	CA	94705	2056	01	06001	37.85492078	-122.2576101	Alameda County
261766	Fee-for-Service	1689689952	1689689952	1	1	WALGREENS CO	6/26/1990	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5437 CLAYTON RD	None	CLAYTON	CA	94517	1039	07	06013	37.95146238	-121.955678	Contra Costa County
261768	Fee-for-Service	1770610040	1770610040	1	1	WYLY, LISA L LCSW	6/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6412 LAUREL AVE	None	LAKE ISABELLA	CA	93240	9529	15	06029	35.63564004	-118.407037	Kern County
261860	Fee-for-Service	1265660542	1265660542	1	1	WHETSELL, WILLIAM M MD	6/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114277	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
261871	Fee-for-Service	1053803478	1053803478	1	1	WANG, ALLEN MD	8/1/2022	207L00000X	NA	Other	026	PHYSICIANS	175405	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
261889	Fee-for-Service	1659849073	1659849073	1	1	WIMBOPRASETYO, WURI RCP	6/10/2024	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
261897	Fee-for-Service	1477039535	1477039535	1	1	WITTMANN, AMANDA CRNA	1/17/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
261914	Fee-for-Service	1376620393	1376620393	1	1	WONG, JADENE L MD	3/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	80090	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
261917	Fee-for-Service	1407996002	1407996002	1	1	WESTCARE CALIFORNIA, INC	12/11/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	601-625 E BELMONT AVENUE	None	FRESNO	CA	93701	1502	10	06019	36.75042845	-119.803617	Fresno County
261950	Fee-for-Service	1740339100	1740339100	1	1	WANG, ZUI-SHIANG MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32142	40	Pediatrics	0	In state provider	None	11360 MOUNTAIN VIEW AVE	STE B	LOMA LINDA	CA	92354	3834	36	06071	34.04666844	-117.2436991	San Bernardino County
261986	Fee-for-Service	1518499920	1518499920	1	1	WANG, JESSE MD	9/15/2022	282N00000X	NA	Hospitals	026	PHYSICIANS	171794	None	None	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
262031	Fee-for-Service	1235107038	1235107038	1	1	WISE, MATTHEW J MD	2/17/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	55031	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	153 PIONEER LANE	STE B	BISHOP	CA	93514	2517	14	06027	37.3624356	-118.4073711	Inyo County
262067	Fee-for-Service	1689134769	1689134769	1	1	WANG, DIANA M MD	7/5/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	176882	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
262167	Fee-for-Service	1588021752	1588021752	1	1	WANCHEK, GABRIELLE	8/7/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	117115	-	NOT APPLICABLE	0	In state provider	None	1869-1871 9TH ST	None	SANTA MONICA	CA	90404	4501	19	06037	34.01309593	-118.4821062	Los Angeles County
262187	Fee-for-Service	1740637834	1740637834	1	2	WILLIAMS SPEECH THERAPY SERV	8/4/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ICES INC.	15928 VENTURA BLVD	STE 218	ENCINO	CA	91436	4413	19	06037	34.15585301	-118.4801465	Los Angeles County
262242	Fee-for-Service	1912063199	1912063199	1	1	WARD, PAMELA R CNM	2/7/2014	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
262264	Fee-for-Service	1255711305	1255711305	1	1	WANG, JANE S	8/29/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4221 WILSHIRE BLVD	STE 230	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
262306	Fee-for-Service	1215945704	1215945704	1	1	WU, YAW MD INC	2/1/2000	207L00000X	NA	Other	026	PHYSICIANS	45029	05	Anesthesiology	0	In state provider	None	438 W LAS TUNAS DR	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
262395	Fee-for-Service	1902105000	1902105000	1	1	WARNER, THOMAS L	5/9/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	765 W COLLEGE ST	None	LOS ANGELES	CA	90012	1181	19	06037	34.0661756	-118.2435934	Los Angeles County
262429	Fee-for-Service	1093773616	1093773616	1	1	WADE, JEFFREY F MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61453	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1701 SANTA ANITA AVE	None	SOUTH EL MONTE	CA	91733	3411	19	06037	34.04810648	-118.0424794	Los Angeles County
262446	Fee-for-Service	1689616823	1689616823	1	2	WANG, ENDI MD	5/5/2023	207ZH0000X	NA	Other	026	PHYSICIANS	69339	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
262472	Fee-for-Service	1730718461	1730718461	1	1	WALL, MATTHEW J MD	8/21/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
262475	Fee-for-Service	1740637834	1740637834	1	2	WILLIAMS SPEECH THERAPY SERV	8/4/2021	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ICES INC.	15928 VENTURA BLVD	STE 218	ENCINO	CA	91436	4413	19	06037	34.15585301	-118.4801465	Los Angeles County
262494	Fee-for-Service	1295829562	1295829562	1	1	WONG, EDWARD K JR MD	8/21/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	19891	18	Ophthalmology	0	In state provider	None	19732 MACARTHUR BLVD	None	IRVINE	CA	92612	2419	30	06059	33.65659666	-117.8624166	Orange County
262503	Fee-for-Service	1831379122	1831379122	1	1	WIEGNER, ELLEN A MD	8/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105233	30	Radiology	0	In state provider	None	3000 Q ST	None	SACRAMENTO	CA	94816	7058	34	06067	38.564991	-121.4696565	Sacramento County
262518	Fee-for-Service	1528116464	1528116464	1	1	WALL, JOHN K MD	11/13/2007	207P00000X	NA	Other	026	PHYSICIANS	77998	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	LOS ANGELES	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
262564	Fee-for-Service	1093276149	1093276149	1	1	WILLIAM, PHEBEE NP	1/15/2020	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1652 WEST AVE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1602957	Los Angeles County
262578	Fee-for-Service	1629330436	1629330436	1	1	WONOPRABOWO, JEFFREY E MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126969	41	Internal Medicine	0	In state provider	None	11370 ANDERSON	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
262591	Fee-for-Service	1518103779	1518103779	1	1	WORDEN, CATHERINE L MD	2/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96378	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
262595	Fee-for-Service	1215945704	1215945704	1	1	WU, YAW MD INC	2/1/2000	207L00000X	NA	Other	026	PHYSICIANS	45029	01	General Practice	0	In state provider	None	438 W LAS TUNAS DR	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
262621	Fee-for-Service	1366467425	1366467425	1	1	WINN, WILLIAM RICHARD MD	9/1/1996	207RP1001X	NA	Pulmonology	026	PHYSICIANS	8235	41	Internal Medicine	0	In state provider	None	202 W WILLOW AVE	None	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
262669	Fee-for-Service	1730192063	1730192063	1	1	WINKLER, BRYAN L MD	8/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89752	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
262681	Fee-for-Service	1245277979	1245277979	1	1	WILSON, JEFFREY G PHD	6/30/2014	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	20 CORPORATE PARK	STE 125	IRVINE	CA	92606	5182	30	06059	33.68973111	-117.8293989	Orange County
262708	Fee-for-Service	1164841532	1164841532	1	1	WANG, DAVID C MD	5/14/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	149014	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
262765	Fee-for-Service	1740637834	1740637834	1	2	WILLIAMS SPEECH THERAPY SERV	8/4/2021	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ICES INC.	15928 VENTURA BLVD	STE 218	ENCINO	CA	91436	4413	19	06037	34.15585301	-118.4801465	Los Angeles County
262779	Fee-for-Service	1033799242	1033799242	1	1	WATTERSON, JOANNA MD	9/19/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
262781	Fee-for-Service	1972518256	1972518256	1	1	WALGREEN CO.	7/16/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15500 WASHINGTON AVE	None	SAN LEANDRO	CA	94579	1839	01	06001	37.68575579	-122.1388804	Alameda County
262787	Fee-for-Service	1932934445	1932934445	1	1	WHITNEY GUERRERO MD INC	11/13/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	2021 22ND ST	None	BAKERSFIELD	CA	93301	3802	15	06029	35.37907949	-119.025603	Kern County
262788	Fee-for-Service	1831379122	1831379122	1	1	WIEGNER, ELLEN A MD	8/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105233	78	Neoplastic Diseases/Oncology	0	In state provider	None	3000 Q ST	None	SACRAMENTO	CA	94816	7058	34	06067	38.564991	-121.4696565	Sacramento County
262805	Fee-for-Service	1801613450	1801613450	1	1	WILLIAMS, SHEA K NP	10/14/2024	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
262830	Fee-for-Service	1760745947	1760745947	1	1	WARDI, SIOBHAN M NP	9/19/2016	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
262844	Fee-for-Service	1245859131	1245859131	1	1	WRAY, WENDELLA LMFT	4/24/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4193 FLAT ROCK DR	STE 200	RIVERSIDE	CA	92505	7113	33	06065	33.90361212	-117.4930456	Riverside County
262858	Fee-for-Service	1316285190	1316285190	1	1	WALLACE, JAIMIE L	2/4/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11105 KNOTT AVE	STE A-B	CYPRESS	CA	90630	5137	30	06059	33.80083909	-118.0111199	Orange County
262883	Fee-for-Service	1679640551	1679640551	1	1	WEISS, MARC D MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60142	04	Otology, Laryngology, Rhinology	0	In state provider	ATTN MGA OFFICE	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
262896	Fee-for-Service	1194734715	1194734715	1	1	WONG, IRA G MD	1/1/1982	207W00000X	NA	Ophthalmology	026	PHYSICIANS	27700	18	Ophthalmology	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
262902	Fee-for-Service	1679950794	1679950794	1	1	WANG, JEREMY MD	10/19/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	144903	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
262903	Fee-for-Service	1942790480	1942790480	1	1	WRIGHT, SUSANNA LCSW	8/1/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6961 MEADOWBROOK DR	None	CLEARLAKE	CA	95422	9064	17	06033	38.93442568	-122.6272399	Lake County
262907	Fee-for-Service	1366467425	1366467425	1	1	WINN, WILLIAM RICHARD MD	9/1/1996	207RP1001X	NA	Pulmonology	026	PHYSICIANS	8235	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	202 W WILLOW AVE	None	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
262974	Fee-for-Service	1104200922	1104200922	1	1	WONG, KEITH MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145273	01	General Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
262995	Fee-for-Service	1528183746	1528183746	1	1	WANG, OLIVER J MD	10/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117264	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
263011	Fee-for-Service	1932288412	1932288412	1	1	WARDEN, III, DAVID R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	7533	00	None	43.470198	-111.9901955	Bonneville County
263045	Fee-for-Service	1013452440	1013452440	1	1	WILCOXEN, ARIEL LPCC	1/31/2025	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
263046	Fee-for-Service	1740229293	1740229293	1	1	WILSON, MICHAEL A MD	5/31/1993	207R00000X	NA	Other	026	PHYSICIANS	75159	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3600	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
263064	Fee-for-Service	1255674958	1255674958	1	1	WONG, JOSHUA W MD	7/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148926	05	Anesthesiology	0	In state provider	None	531 W COLLEGE ST	None	LOS ANGELES	CA	90012	2315	19	06037	34.0645892	-118.2391033	Los Angeles County
263077	Fee-for-Service	1710931464	1710931464	1	1	WAKIL, FRED W MD	9/1/1984	207PE0004X	NA	Other	026	PHYSICIANS	49172	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1701 SANTA ANITA AVE	None	SOUTH EL MONTE	CA	91733	3411	19	06037	34.04810648	-118.0424794	Los Angeles County
263083	Fee-for-Service	1073824397	1073824397	1	2	WONG, JUSTIN C L MFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
263128	Fee-for-Service	1578884524	1578884524	1	1	WERNER, DIANA A DPM	6/30/2011	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1001 POTRERO AVENUE	RM 3A36	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
263168	Fee-for-Service	1679640551	1679640551	1	1	WEISS, MARC D MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60142	84	Surgery-Head and Neck	0	In state provider	ATTN MGA OFFICE	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
263205	Fee-for-Service	1891891875	1891891875	1	1	WALLS, DONALD W MD INC	11/15/1990	207L00000X	NA	Other	026	PHYSICIANS	24834	05	Anesthesiology	0	In state provider	None	23201 LAKE CENTER DR	STE 320	EL TORO	CA	92630	6808	30	06059	33.6255281	-117.7160257	Orange County
263229	Fee-for-Service	1386643575	1386643575	1	1	WILKES, PAUL T MD	3/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	1	Border provider	None	9280 W SUNSET RD	STE 236	LAS VEGAS	NV	89148	4861	00	None	36.07027746	-115.29495	Clark County
263284	Fee-for-Service	1821197138	1821197138	1	1	WARM SPRINGS ROAD CVS, L.L.C	11/7/2024	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	3758 LAS VEGAS BLVD S	None	LAS VEGAS	NV	89109	4312	00	None	36.10566	-115.1731855	Clark County
263301	Fee-for-Service	1689846065	1689846065	1	1	WONG, CURTIS E DO	4/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9863	08	Family Practice	0	In state provider	None	502 TORRANCE BLVD	None	REDONDO	CA	90277	3498	19	06037	33.83783749	-118.3832414	Los Angeles County
263325	Fee-for-Service	1275624942	1275624942	1	1	WONG, SANDRA C DO	8/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8000	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
263346	Fee-for-Service	1508187600	1508187600	1	1	WILLIAMS, IRINA V MD	11/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130826	05	Anesthesiology	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
263471	Fee-for-Service	1295050102	1295050102	1	1	WINTER, ASHLEY G MD	10/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140875	34	Urology and Urological Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
263479	Fee-for-Service	1912993809	1912993809	1	1	WINSTON, NUTAN P MD	10/16/2019	207L00000X	NA	Other	026	PHYSICIANS	162073	05	Anesthesiology	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
263497	Fee-for-Service	1295409654	1295409654	1	1	WENG, CHARLIE PT	3/7/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
263509	Fee-for-Service	1356433692	1356433692	1	1	WATSON, SUSAN K LMFT	1/22/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5871 PINE AVE	SUITE 230	CHINO HILLS	CA	91709	6545	36	06071	33.94767013	-117.6754339	San Bernardino County
263619	Fee-for-Service	1558335471	1558335471	1	1	WAREHAM, GERALD D MD	7/12/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	57743	30	Radiology	0	In state provider	None	44274 GEORGE CUSHMAN CT	108	TEMECULA	CA	92592	5945	33	06065	33.48313254	-117.0888293	Riverside County
263630	Fee-for-Service	1730335548	1730335548	1	1	WAHBA, DAVID K MD	8/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133718	05	Anesthesiology	0	In state provider	None	2601 OSWELL STREET	SUITE 101	BAKERSFIELD	CA	93306	3173	15	06029	35.39259632	-118.9496489	Kern County
263747	Fee-for-Service	1801810825	1801810825	1	1	WESTOVER, CHARLES J MD	9/30/1982	2080P0203X	NA	Other	026	PHYSICIANS	43120	05	Anesthesiology	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
263827	Fee-for-Service	1427204957	1427204957	1	1	WESTERN HEALTH COMMUNITY	7/30/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CLINICS	1647 WEST ANAHEIM STREET	None	HARBOR CITY	CA	90710	3213	19	06037	33.78621735	-118.3058946	Los Angeles County
263858	Fee-for-Service	1467526236	1467526236	1	1	WYLES, GLADYS L MD	5/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	71924	01	General Practice	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
263932	Fee-for-Service	1164080214	1164080214	1	1	WIJESINGHE, THUSHARI	10/26/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177017	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
264010	Fee-for-Service	1003846692	1003846692	1	1	WINKLER, MICHAEL A MD	6/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73912	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
264019	Fee-for-Service	1184801573	1184801573	1	1	WILKINSON, NORKA I MD	6/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107664	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
264032	Fee-for-Service	1477903144	1477903144	1	1	WELDER, CHRISTOPHER R MD	10/29/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
264045	Fee-for-Service	1134114382	1134114382	1	2	WIELAND, MARK RALPH MD	8/31/1989	207W00000X	NA	Ophthalmology	026	PHYSICIANS	48482	18	Ophthalmology	0	In state provider	RETINA-VITREOUS ASSOC	2485 HOSPITAL DR	STE 200	MOUNTAIN VIEW	CA	94040	4123	43	06085	37.368918	-122.081761	Santa Clara County
264049	Fee-for-Service	1508156852	1508156852	1	1	WALGREEN CO	7/6/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	416 W OLIVE AVE	None	PORTERVILLE	CA	93257	3332	54	06107	36.06603822	-119.0266182	Tulare County
264053	Fee-for-Service	1902893977	1902893977	1	1	WELSH, JOSEPH DO	10/2/2020	207L00000X	NA	Other	026	PHYSICIANS	13084	05	Anesthesiology	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
264059	Fee-for-Service	1952836587	1952836587	1	1	WANG, YING MD	8/22/2023	207R00000X	NA	Other	026	PHYSICIANS	179636	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
264062	Fee-for-Service	1033280078	1033280078	1	1	WOLFF, CHARLES A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35972	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
264114	Fee-for-Service	1053046060	1053046060	1	1	WENCHE CHUNG, MD & KUOTING L	4/23/2023	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	EE, LAC A PROFESSIONAL C	909 S SANTA ANITA AVE ST	None	ARCADIA	CA	91006	2363	19	06037	34.13038016	-118.0313646	Los Angeles County
264131	Fee-for-Service	1992877229	1992877229	1	1	WONG, REX YEN-PING MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	62964	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
264195	Fee-for-Service	1508182064	1508182064	1	1	WONG, WENDY MD	4/5/2018	2086S0122X	NA	General Surgery	026	PHYSICIANS	118781	None	None	0	In state provider	None	910 MAJOR SHERMAN LN	305	MONTEREY	CA	93940	4642	27	06053	36.59263528	-121.8922329	Monterey County
264226	Fee-for-Service	1750565032	1750565032	1	1	WINARKO, JONATHAN MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102571	18	Ophthalmology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
264240	Fee-for-Service	1194867226	1194867226	1	1	WOODS, LEWIS O JR MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	13867	01	General Practice	0	In state provider	None	700 ADELINE ST	None	OAKLAND	CA	94607	2608	01	06001	37.80430011	-122.2879962	Alameda County
264242	Fee-for-Service	1265516330	1265516330	1	1	WEISS, STEPHEN ADAM	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	63318	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
264249	Fee-for-Service	1912494717	1912494717	1	1	WILSON, CHRISTOPHER E DO	7/26/2023	207L00000X	NA	Other	026	PHYSICIANS	19647	None	None	0	In state provider	None	9802 STOCKDALE HWY	SUITE 105	BAKERSFIELD	CA	93311	3653	15	06029	35.3544067	-119.1113372	Kern County
264350	Fee-for-Service	1295053437	1295053437	1	1	WALTHER, ASHLEY MD	9/6/2019	2086S0120X	NA	General Surgery	026	PHYSICIANS	149220	02	General Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
264375	Fee-for-Service	1811053044	1811053044	1	1	WAY, NANCY B MD	6/22/2020	208600000X	NA	General Surgery	026	PHYSICIANS	65538	02	General Surgery	0	In state provider	None	801 N. TUSTIN AVE.	303	SANTA ANA	CA	92705	3612	30	06059	33.752286	-117.8341735	Orange County
264410	Fee-for-Service	1871146977	1871146977	1	1	WINTER, AARON MD	3/1/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	173256	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
264438	Fee-for-Service	1700940186	1700940186	1	1	WAI, THYNN T MD	9/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55701	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
264479	Fee-for-Service	1093207953	1093207953	1	1	WATTS, DIANA LCSW	3/5/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
264488	Fee-for-Service	1851740435	1851740435	1	1	WAGNER, BENJAMIN R MD	8/3/2021	207RN0300X	NA	Nephrology	026	PHYSICIANS	171392	None	None	0	In state provider	None	1595 SOQUEL DRIVE	STE 110	SANTA CRUZ	CA	95065	1717	44	06087	36.98879599	-121.9826354	Santa Cruz County
264533	Fee-for-Service	1144740804	1144740804	1	1	WU, JINGSHING MD	6/4/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169420	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
264622	Fee-for-Service	1952328361	1952328361	1	1	WALMART STORES INC	1/7/1991	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	201 E BOWMAN RD	None	RIDGECREST	CA	93555	6315	15	06029	35.6078307	-117.6681848	Kern County
264623	Fee-for-Service	1306134929	1306134929	1	1	WILSON, KIMBERLEE V DO	10/2/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	18572	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
264631	Fee-for-Service	1205367539	1205367539	1	1	WILEY, EVAN M MD	7/7/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169840	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
264721	Fee-for-Service	1730508045	1730508045	1	1	WUBESHET, MARAMAWIT MD	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140055	40	Pediatrics	0	In state provider	None	747 52ND STREET	ROOM 245	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
264776	Fee-for-Service	1518224880	1518224880	1	1	WAJDA, NIKOLAI A MD	11/24/2019	208M00000X	NA	Other	026	PHYSICIANS	138295	41	Internal Medicine	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
264876	Fee-for-Service	1215391859	1215391859	1	1	WHITE, YASMINE MD	4/17/2022	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	161870	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
264923	Fee-for-Service	1588998603	1588998603	1	1	WALKER, ADRIA D LCSW	11/30/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
264941	Fee-for-Service	1356636450	1356636450	1	1	WHITE, JESSICA M MD	9/16/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	157322	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
264949	Fee-for-Service	1104818590	1104818590	1	1	WANG, QINGPING MD	6/30/2021	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	146170	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
264994	Fee-for-Service	1376638692	1376638692	1	1	WROOLIE, TONITA E PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	378 CAMBRIDGE AVE	SUITE B	PALO ALTO	CA	94306	1544	43	06085	37.4274024	-122.1453506	Santa Clara County
265028	Fee-for-Service	1073170528	1073170528	1	1	WAHLIG, STEPHEN G MD	6/6/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	181018	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
265078	Fee-for-Service	1386842318	1386842318	1	1	WONG, SERENA M MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128397	36	Psychiatry	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
265085	Fee-for-Service	1811220411	1811220411	1	1	WALGREEN CO	8/13/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4771 W ASHLAN AVE	None	FRESNO	CA	93722	4307	10	06019	36.79349651	-119.8796918	Fresno County
265099	Fee-for-Service	1174266423	1174266423	1	1	WEAVER, AMANDA R LMFT	4/26/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
265140	Fee-for-Service	1366671612	1366671612	1	1	WRIGHT, FLORENCE A J MD	3/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139157	30	Radiology	0	In state provider	None	200 UCLA MEDICAL PLAZA	SUITE B265	LOS ANGELES	CA	90095	0001	19	06037	34.065126	-118.446237	Los Angeles County
265172	Fee-for-Service	1700843174	1700843174	1	1	WOLFSON, BRAD ALAN MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	61080	34	Urology and Urological Surgery	0	In state provider	None	555 E TACHEVAH DR	STE 2W101	PALM SPRINGS	CA	92262	5748	33	06065	33.83753681	-116.5424435	Riverside County
265266	Fee-for-Service	1114951696	1114951696	1	1	WALKER, JOHN F MD JR	6/30/1990	207L00000X	NA	Other	026	PHYSICIANS	70121	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
265356	Fee-for-Service	1225550874	1225550874	1	1	WELLSPACE HEALTH	12/22/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	11333 PROSPECT DRIVE	None	MARTELL	CA	95654	9998	03	06005	38.3716103	-120.8004838	Amador County
265371	Fee-for-Service	1245258185	1245258185	1	1	WIRTH, DAMON S MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77600	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
265427	Fee-for-Service	1366671612	1366671612	1	1	WRIGHT, FLORENCE A J MD	3/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139157	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 UCLA MEDICAL PLAZA	SUITE B265	LOS ANGELES	CA	90095	0001	19	06037	34.065126	-118.446237	Los Angeles County
265448	Fee-for-Service	1033217617	1033217617	1	1	WHEELCHAIR CITY INC	4/16/2001	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	WHEELCHAIR CITY	41610 DATE ST	STE 105	MURRIETA	CA	92562	7091	33	06065	33.52785641	-117.1771236	Riverside County
265503	Fee-for-Service	1699829937	1699829937	1	1	WHITTINGTON, ROBERT A MD	5/25/2022	207L00000X	NA	Other	026	PHYSICIANS	88617	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
265515	Fee-for-Service	1437387347	1437387347	1	1	WALGREENS CO	8/28/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3019 FLOYD AVE	None	MODESTO	CA	95355	9604	50	06099	37.67818978	-120.9390119	Stanislaus County
265516	Fee-for-Service	1417403098	1417403098	1	1	WALGREEN CO	11/9/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11440 WINDEMERE PKWY	None	SAN RAMON	CA	94582	5179	07	06013	37.76322364	-121.9047731	Contra Costa County
265552	Fee-for-Service	1336112085	1336112085	1	1	WONG, GARRETT B MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71922	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
265556	Fee-for-Service	1912401993	1912401993	1	1	WU, KAREN MD	8/2/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173723	08	Family Practice	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
265576	Fee-for-Service	1285941559	1285941559	1	1	WHITE, RACHEL I MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118522	41	Internal Medicine	0	In state provider	None	11165 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1113	19	06037	34.2738618	-118.4678337	Los Angeles County
265622	Fee-for-Service	1962945089	1962945089	1	1	WANG, JOSEPH X NP	10/8/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
265630	Fee-for-Service	1588615140	1588615140	1	1	WALTZ, KATHLEEN DO	6/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7331	08	Family Practice	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
265643	Fee-for-Service	1225550874	1225550874	1	1	WELLSPACE HEALTH	5/7/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	11333 PROSPECT DRIVE	None	MARTELL	CA	95654	9998	03	06005	38.3716103	-120.8004838	Amador County
265687	Fee-for-Service	1003229329	1003229329	1	1	WANG, TIANNAN MD	7/9/2020	207ZP0102X	NA	Other	026	PHYSICIANS	149981	22	Pathology (M.D. only)	0	In state provider	None	2025 ZONAL AVE	None	LOS ANGELES	CA	90089	0110	19	06037	34.05998665	-118.2058023	Los Angeles County
265708	Fee-for-Service	1013084821	1013084821	1	1	WATROUS, ROBERT W MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	81561	41	Internal Medicine	0	In state provider	None	2829 WATT AVE	None	SACRAMENTO	CA	95821	6200	34	06067	38.615247	-121.383558	Sacramento County
265718	Fee-for-Service	1134190689	1134190689	1	3	WAMPLER, MATTHEW L OD	12/9/2021	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2101 STONE BLVD	SUITE 150	WEST SACRAMENTO	CA	95691	4054	57	06113	38.56318049	-121.5379228	Yolo County
265725	Fee-for-Service	1669499919	1669499919	1	1	WAL-MART STORES INC	9/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-3464	3943 GRAND AVE	None	CHINO	CA	91710	5440	36	06071	33.995241	-117.7193205	San Bernardino County
265742	Fee-for-Service	1053575936	1053575936	1	2	WILSON, JENNIFER K	5/7/2019	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	64309	-	NOT APPLICABLE	0	In state provider	None	455 K STREET	None	CRESCENT CITY	CA	95531	8301	08	06015	41.75468313	-124.1960818	Del Norte County
265745	Fee-for-Service	1588679674	1588679674	1	1	WALGREEN CO.	4/7/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	29910A MURRIETA HT SP RD	None	MURRIETA	CA	92563	0000	33	06065	33.55260793	-117.1393739	Riverside County
265766	Fee-for-Service	1235234634	1235234634	1	1	WENDEL, ROBERT MD	12/31/1983	207W00000X	NA	Ophthalmology	026	PHYSICIANS	43291	18	Ophthalmology	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
265791	Fee-for-Service	1265092324	1265092324	1	1	WANG, CYNTHIA MD	10/16/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	191273	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
265794	Fee-for-Service	1760863625	1760863625	1	1	WONG, MICHAEL DO	3/24/2022	207L00000X	NA	Other	026	PHYSICIANS	16509	None	None	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
265805	Fee-for-Service	1700986858	1700986858	1	1	WATSON, JACK R MD	6/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65310	08	Family Practice	0	In state provider	None	550 WATER ST	STE A	SANTA CRUZ	CA	95060	4126	44	06087	36.98046158	-122.018718	Santa Cruz County
265807	Fee-for-Service	1689647414	1689647414	1	2	WONG, WALTER A OD	3/25/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1880 S. NORFOLK ST.	None	SAN MATEO	CA	94403	1102	41	06081	37.55447624	-122.2920483	San Mateo County
265822	Fee-for-Service	1659542637	1659542637	1	1	WONG, VICTOR Y MD	10/19/2010	390200000X	NA	Other	026	PHYSICIANS	109255	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
265825	Fee-for-Service	1063499325	1063499325	1	1	WONG, RICHARD C MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64059	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
265849	Fee-for-Service	1982634846	1982634846	1	1	WHITE CHRISTOPHER D MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62976	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
265861	Fee-for-Service	1780242305	1780242305	1	1	WHYTE, ASHLEY LCSW	1/21/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
265930	Fee-for-Service	1225550874	1225550874	1	1	WELLSPACE HEALTH	12/22/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	11333 PROSPECT DRIVE	None	MARTELL	CA	95654	9998	03	06005	38.3716103	-120.8004838	Amador County
265944	Fee-for-Service	1528204344	1528204344	1	1	WILLIS, RENEE LCSW	2/25/2019	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	SUITE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
265993	Fee-for-Service	1013084821	1013084821	1	1	WATROUS, ROBERT W MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	81561	01	General Practice	0	In state provider	None	2829 WATT AVE	None	SACRAMENTO	CA	95821	6200	34	06067	38.615247	-121.383558	Sacramento County
266020	Fee-for-Service	1003962796	1003962796	1	1	WEINER, DAVID M MD	10/1/1998	2084N0400X	NA	Neurology	026	PHYSICIANS	64132	13	Neurology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
266030	Fee-for-Service	1104831478	1104831478	1	1	WALGREEN CO	1/21/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 MARKET ST	None	SAN FRANCISCO	CA	94103	1307	38	06075	37.77705793	-122.4168419	San Francisco County
266062	Fee-for-Service	1477649119	1477649119	1	4	WATTS HEALTHCARE	10/16/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3501 WEST JEFFERSON BLVD	None	LOS ANGELES	CA	90018	3234	19	06037	34.02562051	-118.3340385	Los Angeles County
266093	Fee-for-Service	1346615374	1346615374	1	1	WANG, ANN A MD	12/13/2022	208M00000X	NA	Other	026	PHYSICIANS	177390	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
266098	Fee-for-Service	1730317603	1730317603	1	1	WANG, WILLIAM MD	6/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130943	20	Orthopedic Surgery	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
266111	Fee-for-Service	1962565127	1962565127	1	1	WILDEN, JESSICA A MD	7/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119746	14	Neurological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
266165	Fee-for-Service	1558377440	1558377440	1	1	WEST, EDWARD M JR MD	1/31/1984	207P00000X	NA	Other	026	PHYSICIANS	41613	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
266180	Fee-for-Service	1538583232	1538583232	1	1	WALGREEN CO	4/29/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#15987	1020 29TH ST	SUITE 140	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
266181	Fee-for-Service	1801994629	1801994629	1	1	WADE R TALLEY MD	11/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 3RD AVE SW	None	MINOT	ND	58701	3880	00	None	48.23336909	-101.2951165	Ward County
266194	Fee-for-Service	1629475090	1629475090	1	1	WORLDWIDE HOSPICE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12235 BEACH BLVD	SUITE 109	GARDEN GROVE	CA	90680	3943	30	06059	33.784425	-117.9930265	Orange County
266203	Fee-for-Service	1245259050	1245259050	1	1	WATERS, LINDA MD	5/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	49723	24	Plastic Surgery	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
266252	Fee-for-Service	1104010248	1104010248	1	1	WILSHIRE DISTRICT MEDICAL	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	69991	None	None	0	In state provider	GROUP INC	13521 TELEGRAPH ROAD	STE B	WHITTIER	CA	90605	3462	19	06037	33.93794608	-118.0431223	Los Angeles County
266274	Fee-for-Service	1528116308	1528116308	1	1	WOHLMUTH, JOE MD	9/30/1985	207R00000X	NA	Other	026	PHYSICIANS	58354	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1509 WILSON TER	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
266293	Fee-for-Service	1982269809	1982269809	1	1	WINGS OF COURAGE FAMILY	11/30/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES COUNSELING & PR	4413 RIVERSIDE DRIVE	STE F	CHINO	CA	91710	3949	36	06071	34.01890606	-117.708813	San Bernardino County
266300	Fee-for-Service	1861419186	1861419186	1	1	WAL-MART STORES, INC	5/7/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101963	2111 FULKERTH RD	None	TURLOCK	CA	95380	9515	50	06099	37.50939	-120.8729835	Stanislaus County
266324	Fee-for-Service	1700850286	1700850286	1	1	WOMENS HEALTH CARE INC	5/30/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3750 CONVOY ST	SUITE 312	SAN DIEGO	CA	92111	9741	37	06073	32.81201122	-117.1531108	San Diego County
266347	Fee-for-Service	1477649119	1477649119	1	4	WATTS HEALTHCARE	10/16/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3501 WEST JEFFERSON BLVD	None	LOS ANGELES	CA	90018	3234	19	06037	34.02562051	-118.3340385	Los Angeles County
266375	Fee-for-Service	1396749743	1396749743	1	1	WOOLEY,MICHAEL W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7950 FLOYD CURL DR	STE# 620	SAN ANTONIO	TX	78229	0000	00	None	29.51244802	-98.57663128	Bexar County
266388	Fee-for-Service	1275866931	1275866931	1	1	WONG, STEVEN C MD APC	10/20/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	90357	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2180	37	06073	32.75034388	-117.161023	San Diego County
266479	Fee-for-Service	1629475090	1629475090	1	1	WORLDWIDE HOSPICE CARE INC	12/6/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12235 BEACH BLVD	SUITE 109	GARDEN GROVE	CA	90680	3943	30	06059	33.784425	-117.9930265	Orange County
266496	Fee-for-Service	1649522400	1649522400	1	1	WALLACE, AYESHA D LCSW	4/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	79411	-	NOT APPLICABLE	0	In state provider	None	710 E 111TH PLACE	None	LOS ANGELES	CA	90059	1518	19	06037	33.93454026	-118.2626368	Los Angeles County
266515	Fee-for-Service	1871934869	1871934869	1	1	WILLETT, JESSICA K MD	6/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138328	None	None	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
266548	Fee-for-Service	1982665840	1982665840	1	1	WONG, JONATHAN T MD	6/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	53471	02	General Surgery	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
266555	Fee-for-Service	1043841869	1043841869	1	1	WEST VALLEY ADULT DAY HEALTH	2/8/2022	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	6110 VARIEL AVE	None	WOODLAND HILLS	CA	91367	3721	19	06037	34.18146693	-118.5927504	Los Angeles County
266616	Fee-for-Service	1073560249	1073560249	1	1	WONG, RIDGLEY F	3/30/1990	207L00000X	NA	Other	026	PHYSICIANS	67149	05	Anesthesiology	0	In state provider	None	6500 QUAIL AVE	None	SACRAMENTO	CA	95608	0000	34	06067	38.39055052	-121.4220633	Sacramento
266625	Fee-for-Service	1629210695	1629210695	1	2	WRIGHT, RENEE	3/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
266634	Fee-for-Service	1073644811	1073644811	1	1	WRIGHT, GARY B DC	7/21/2020	111NS0005X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	50 S. ANAHEIM BLVD.	250	ANAHEIM	CA	92805	2931	30	06059	33.83588032	-117.9138111	Orange County
266653	Fee-for-Service	1972863611	1972863611	1	1	WILMINGTON URGENT CARE AND	1/10/2013	261QU0200X	NA	Other	026	PHYSICIANS	97561	None	None	0	In state provider	FAMILY CLINIC INC	714 N AVALON BLVD	None	WILMINGTON	CA	90744	5809	19	06037	33.77897659	-118.2623373	Los Angeles County
266671	Fee-for-Service	1275866931	1275866931	1	1	WONG, STEVEN C MD APC	10/20/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	90357	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2180	37	06073	32.75034388	-117.161023	San Diego County
266678	Fee-for-Service	1588639538	1588639538	2	1	WANG, YUH-HUEY MD	1/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55694	41	Internal Medicine	0	In state provider	None	1106 S DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	4447	19	06037	34.00226972	-117.8102362	Los Angeles County
266698	Fee-for-Service	1427440221	1427440221	1	1	WERTHEIMER, ALEX DO	11/23/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18390	08	Family Practice	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
266728	Fee-for-Service	1033280060	1033280060	1	1	WU, ALEX T MD	1/7/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71037	08	Family Practice	0	In state provider	None	15082 IMPERIAL HWY	None	LA MIRADA	CA	90638	1301	19	06037	33.91704669	-118.0092197	Los Angeles County
266771	Fee-for-Service	1437652286	1437652286	1	1	WOLFE, MICHAEL T MD	9/2/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	180302	None	None	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
266791	Fee-for-Service	1679623730	1679623730	1	1	WONG, EDMOND Y MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	61834	08	Family Practice	0	In state provider	None	251 TURNPIKE DR	None	FOLSOM	CA	95630	0000	34	06067	38.654946	-121.170537	Sacramento County
266798	Fee-for-Service	1962417238	1962417238	1	1	WALGREEN CO.	1/1/1966	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	121 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2701	43	06085	37.37959628	-122.071458	Santa Clara County
266806	Fee-for-Service	1972844371	1972844371	1	1	WILLIAMS, KELLY A NP	2/19/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
266861	Fee-for-Service	1255587549	1255587549	1	1	WONG, DUSTIN T DO	12/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10514	41	Internal Medicine	0	In state provider	None	16455 MAIN ST	None	HESPERIA	CA	92345	3554	36	06071	34.42186386	-117.3038021	San Bernardino County
266899	Fee-for-Service	1821122516	1821122516	1	1	WELLS, CARL S PHD	1/16/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16168 BEACH BLVD	STE 241	HUNTINGTON BEACH	CA	92647	6204	30	06059	33.728283	-117.9891305	Orange County
266910	Fee-for-Service	1710245907	1710245907	1	1	WHITAKER, ERIN L MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127626	41	Internal Medicine	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
266954	Fee-for-Service	1134190689	1134190689	1	2	WAMPLER, MATTHEW L OD	12/9/2021	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	RE OPTOMETRY	2101 STONE BLVD	SUITE 150	WEST SACRAMENTO	CA	95691	4054	57	06113	38.56318049	-121.5379228	Yolo County
266963	Fee-for-Service	1205418613	1205418613	1	1	WONG, WAH DO	9/17/2024	207R00000X	NA	Other	026	PHYSICIANS	20971	41	Internal Medicine	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
267023	Fee-for-Service	1427147016	1427147016	1	1	WAL-MART STORES, INC	10/26/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-4488	150 BEACH RD	None	MARINA	CA	93933	2513	27	06053	36.69467258	-121.8010408	Monterey County
267030	Fee-for-Service	1598961351	1598961351	1	1	WAARVIK, DIANE J. RN	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 CHICAGO AVE	None	MINNEAPOLIS	MN	55404	4518	00	None	44.95666589	-93.26255996	Hennepin County
267096	Fee-for-Service	1699017079	1699017079	1	1	WILK, JAMES D	10/17/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
267100	Fee-for-Service	1306317961	1306317961	1	1	WOUND HEALING CARE SPECIALIS	1/10/2025	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	TS, INC.	10621 CHURCH ST	STE 120	RANCHO CUCAMONGA	CA	91730	6862	36	06071	34.11289206	-117.5715772	San Bernardino County
267118	Fee-for-Service	1205984283	1205984283	1	1	WILLIAMS-COTTON, CAROL	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65541	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
267142	Fee-for-Service	1134767767	1134767767	1	1	WISDOM ADULT DAY PARTNERS	10/29/2020	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	2225 S DEPOT ST	None	SANTA MARIA	CA	93455	1216	42	06083	34.9196973	-120.4435419	Santa Barbara County
267348	Fee-for-Service	1912294364	1912294364	1	1	WALGREEN CO	8/29/2011	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	210 AMERICAN CANYON RD	None	AMERICAN CANYON	CA	94503	3004	28	06055	38.16545742	-122.2517389	Napa County
267370	Fee-for-Service	1922013259	1922013259	1	1	WALGREEN CO.	4/13/1998	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	934 N HACIENDA BLVD	None	LA PUENTE	CA	91744	2845	19	06037	34.03680643	-117.9498888	Los Angeles County
267386	Fee-for-Service	1316975337	1316975337	1	1	WONG, JOE MD	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	61080	05	Anesthesiology	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
267387	Fee-for-Service	1285730275	1285730275	1	1	WILNER, GERALD P MD	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	20943	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
267406	Fee-for-Service	1952486912	1952486912	1	1	WILLIAMSON, RUTH C MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	70785	78	Neoplastic Diseases/Oncology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
267424	Fee-for-Service	1598843328	1598843328	1	1	WICKHAM, ROBERT A. MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	53715	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
267460	Fee-for-Service	1245442904	1245442904	1	1	WEST COUNTY MEDICAL	1/26/1998	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CLINIC	100 E MARKET ST	None	LONG BEACH	CA	90805	5924	19	06037	33.85427352	-118.193571	Los Angeles County
267465	Fee-for-Service	1497176903	1497176903	1	1	WILSON, JONATHAN P LMFT	2/17/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14075 HESPERIA ROAD	SUITE 101	VICTORVILLE	CA	92395	4500	36	06071	34.50679185	-117.296399	San Bernardino County
267475	Fee-for-Service	1780090480	1780090480	1	1	WEINER, ABBY LCSW	8/3/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
267489	Fee-for-Service	1053777268	1053777268	1	1	WILDFEUER, MOLLY M LPCC	6/22/2021	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
267536	Fee-for-Service	1306075890	1306075890	1	1	WALGREEN CO	10/26/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9728 WINTER GARDENS BLVD	None	LAKESIDE	CA	92040	3809	37	06073	32.854545	-116.9311485	San Diego County
267543	Fee-for-Service	1366252173	1366252173	1	1	WILLIAMS, VERONICA A BIRTH D	1/13/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	42	06083	0	0	None
267565	Fee-for-Service	1518078971	1518078971	1	1	WU, VEDA C MD	4/17/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	56011	40	Pediatrics	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
267669	Fee-for-Service	1184644262	1184644262	1	1	WARD, KATHERINE T MD	6/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75695	None	None	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
267687	Fee-for-Service	1952486912	1952486912	1	1	WILLIAMSON, RUTH C MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	70785	32	Radiation Therapy (D.O. only)	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
267704	Fee-for-Service	1619123395	1619123395	1	1	WANG, DAN-YU DO	9/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11737	41	Internal Medicine	0	In state provider	None	450 E HUNTINGTON DR	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
267713	Fee-for-Service	1609881937	1609881937	1	1	WALGREEN CO	9/27/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 N IMPERIAL AVE	None	EL CENTRO	CA	92243	2809	13	06025	32.79344238	-115.5699452	Imperial County
267764	Fee-for-Service	1992711543	1992711543	1	1	WALGREEN CO #03476	5/14/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 W WALNUT AVE	None	VISALIA	CA	93277	5367	54	06107	36.313209	-119.292516	Tulare County
267844	Fee-for-Service	1205969482	1205969482	1	1	WALTMAN, WANDA D	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
268014	Fee-for-Service	1053708107	1053708107	1	1	WISE HEALTHCARE SERVICES INC	11/8/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	171 S ANITA DR	SUITE 200-E	ORANGE	CA	92868	3319	30	06059	33.78663427	-117.8811524	Orange County
268045	Fee-for-Service	1700235280	1700235280	1	1	WINSLOW, NOLAN K MD	6/27/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	184166	None	None	0	In state provider	None	101 CITY DR S	STE 313	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
268068	Fee-for-Service	1144664947	1144664947	1	1	WOOD, BRIAN M MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132690	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
268083	Fee-for-Service	1366513798	1366513798	1	1	WALGREEN CO	11/30/2006	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #10002	1418 E PROSPERITY AVE	None	TULARE	CA	93274	8054	54	06107	36.22602747	-119.325726	Tulare County
268092	Fee-for-Service	1427242080	1427242080	1	1	WEST ELK GROVE DIALYSIS LLC	8/27/2008	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2208 KAUSEN DRIVE	STE 100	ELK GROVE	CA	95758	7115	34	06067	38.427552	-121.4856315	Sacramento County
268146	Fee-for-Service	1417450248	1417450248	1	1	WOODHOUSE, LOGAN M MD	8/1/2023	207LP2900X	NA	Other	026	PHYSICIANS	165135	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
268162	Fee-for-Service	1780794123	1780794123	1	1	WEINER, BENNETT AARON OD	3/15/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1339 W WHITTIER BLVD	None	LA HABRA	CA	90631	3612	30	06059	33.93933652	-117.9612375	Orange County
268191	Fee-for-Service	1811371032	1811371032	1	1	WANG, XUAN MD	8/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152555	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
268217	Fee-for-Service	1447268966	1447268966	1	2	WENSTRUP, THOMAS R	11/14/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	55290	-	NOT APPLICABLE	0	In state provider	None	1904 RICHLAND AVE	None	CERES	CA	95307	9440	50	06099	37.60031128	-120.9658226	Stanislaus County
268351	Fee-for-Service	1841233285	1841233285	1	1	WITT, PETER D MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	44774	46	Hand Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
268407	Fee-for-Service	1629519988	1629519988	1	1	WU, BRYAN B MD	7/14/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	169416	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
268423	Fee-for-Service	1205000957	1205000957	1	1	WARMUTH, MARK J CO	12/31/1984	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	4517 MARKET ST	# 4	VENTURA	CA	93003	7710	56	06111	34.25728623	-119.2321419	Ventura County
268430	Fee-for-Service	1780951079	1780951079	1	1	WEATHERS, CINDY	3/6/2025	225400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
268442	Fee-for-Service	1710987706	1710987706	1	1	WILSHIRE ONCOLOGY MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GRP INC	935 S SUNSET AVE	None	WEST COVINA	CA	91790	3408	19	06037	34.06431388	-117.9431184	Los Angeles County
268446	Fee-for-Service	1366870651	1366870651	1	1	WOLFF, LEAH LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
268492	Fee-for-Service	1659423754	1659423754	1	1	WELLE, DANA M DO	8/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	7123	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1661 SOQUEL DR	STE A	SANTA CRUZ	CA	95065	1709	44	06087	36.98895429	-121.9821088	Santa Cruz County
268605	Fee-for-Service	1588746838	1588746838	1	1	WAINGOLD, ANDREA L MD	3/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96791	05	Anesthesiology	0	In state provider	None	PUEBLO AT BATH STREETS	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
268632	Fee-for-Service	1841233285	1841233285	1	1	WITT, PETER D MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	44774	02	General Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
268656	Fee-for-Service	1649348137	1649348137	1	1	WILDFIRE, GILA MD	6/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86112	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
268689	Fee-for-Service	1215410154	1215410154	1	1	WARMCARE HOME HEALTH INC	11/2/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	22048 SHERMAN WAY	SUITE 217	CANOGA PARK	CA	91303	1841	19	06037	34.20099048	-118.60776	Los Angeles County
268726	Fee-for-Service	1619232493	1619232493	1	1	WELSH, SEAN W MD	2/15/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	117868	01	General Practice	0	In state provider	None	7624 PAINTER AVE	STE 100	WHITTIER	CA	90602	2327	19	06037	33.972939	-118.032651	Los Angeles County
268737	Fee-for-Service	1710987706	1710987706	1	1	WILSHIRE ONCOLOGY MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GRP INC	935 S SUNSET AVE	None	WEST COVINA	CA	91790	3408	19	06037	34.06431388	-117.9431184	Los Angeles County
268760	Fee-for-Service	1104911395	1104911395	1	1	WU, SUSAN MD	8/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80501	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
268789	Fee-for-Service	1487760997	1487760997	1	1	WRUBEL, BRADLEY T. MD	1/31/2007	2084N0400X	NA	Neurology	026	PHYSICIANS	70997	13	Neurology (M.D. only)	0	In state provider	None	3000 COLBY ST	STE 201	BERKELEY	CA	94705	2058	01	06001	37.85473248	-122.2575793	Alameda County
268811	Fee-for-Service	1003836651	1003836651	1	1	WOHLGELERNTER, DANIEL MD	3/16/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	55314	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1301 20TH ST	STE 590	SANTA MONICA	CA	90404	2054	19	06037	34.02976782	-118.4812493	Los Angeles County
268855	Fee-for-Service	1083091318	1083091318	1	1	WANG, JENNIFER MD	9/14/2018	207R00000X	NA	Other	026	PHYSICIANS	147043	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
268862	Fee-for-Service	1083629356	1083629356	1	1	WALGREEN CO	4/22/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2680 UNION AVE	None	SAN JOSE	CA	95124	1348	43	06085	37.27315615	-121.9331705	Santa Clara County
268899	Fee-for-Service	1245730696	1245730696	1	1	WEBB, KIMBERLY CCC-SLP	10/11/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	556 N 1ST ST	SUITE 201	SAN JOSE	CA	95112	5300	43	06085	37.34591974	-121.8977166	Santa Clara County
268913	Fee-for-Service	1841233285	1841233285	1	1	WITT, PETER D MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	44774	24	Plastic Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
268933	Fee-for-Service	1730166406	1730166406	1	1	WANIA-GALICIA, LANA A MD	3/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80078	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
268953	Fee-for-Service	1649373739	1649373739	1	1	WATTS, ELI M MD	2/2/2022	207R00000X	NA	Other	026	PHYSICIANS	79383	None	None	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
268964	Fee-for-Service	1285390740	1285390740	1	1	WONG, HAYDEN PT	1/12/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1392 E PALOMAR ST	503	CHULA VISTA	CA	91913	1892	37	06073	32.62360793	-116.9969964	San Diego County
268987	Fee-for-Service	1902095854	1902095854	1	1	WAKSLAK, MENACHEM MD	2/11/2011	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	114088	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
269065	Fee-for-Service	1386223899	1386223899	1	1	WANG, ELLICE W MD	4/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184149	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
269090	Fee-for-Service	1619298965	1619298965	1	1	WEI, JUSTIN MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119317	30	Radiology	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
269097	Fee-for-Service	1215371893	1215371893	1	1	WARD, JUSTIN T MD	6/8/2021	207L00000X	NA	Other	026	PHYSICIANS	152932	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
269171	Fee-for-Service	1366794372	1366794372	1	2	WRIGHT, COURTNEY	11/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123022	01	General Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
269178	Fee-for-Service	1265828081	1265828081	1	1	WOLMAN, DYLAN N MD	5/12/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	143817	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
269212	Fee-for-Service	1235438482	1235438482	1	1	WANG, DEAN MD	7/24/2019	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	124076	20	Orthopedic Surgery	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
269224	Fee-for-Service	1083148936	1083148936	1	1	WAGNER, SAMUEL J MD	1/24/2022	207P00000X	NA	Other	026	PHYSICIANS	169300	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
269245	Fee-for-Service	1114474863	1114474863	1	1	WU, ZHAO PT	1/25/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
269373	Fee-for-Service	1588907836	1588907836	1	1	WALTHER, AKO M MD	1/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124467	01	General Practice	0	In state provider	None	2175 ROSALINE AVENUE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
269397	Fee-for-Service	1427000926	1427000926	1	1	WATTS, ROBERT MD	3/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33217	40	Pediatrics	0	In state provider	None	3001 HIGH ST	STE D	OAKLAND	CA	94619	1860	01	06001	37.78440322	-122.2005713	Alameda County
269410	Fee-for-Service	1275685208	1275685208	1	1	WILLIAMS, WILFRED A MD	11/14/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77079	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
269438	Fee-for-Service	1548208606	1548208606	1	1	WATSON, CRAIG MD	1/1/1982	2084N0400X	NA	Neurology	026	PHYSICIANS	37194	13	Neurology (M.D. only)	0	In state provider	None	2600 CAPITOL AVE	STE 211	SACRAMENTO	CA	95816	5914	34	06067	38.570805	-121.473162	Sacramento County
269451	Fee-for-Service	1366794372	1366794372	1	2	WRIGHT, COURTNEY	11/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123022	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
269467	Fee-for-Service	1780735233	1780735233	1	1	WESTMINSTER SCHOOL DIST	5/22/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	HEALTH SVS	14121 CEDARWOOD ST	None	WESTMINSTER	CA	92683	4499	30	06059	33.7575225	-117.9941774	Orange County
269468	Fee-for-Service	1477649119	1477649119	1	5	WATTS HEALTHCARE	7/27/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTEMITTENT	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	19	06037	33.94274917	-118.2461916	Los Angeles County
269535	Fee-for-Service	1619157864	1619157864	1	1	WOLFARTH-DAVIS, SARAH E PHD	7/8/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	516 OAKLAND AVE	101	OAKLAND	CA	94611	5429	01	06001	37.81940802	-122.2530212	Alameda County
269588	Fee-for-Service	1538626114	1538626114	1	1	WANG, JULIE LAC	3/12/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	33428 ALVARADO NILES RD	None	UNION CITY	CA	94587	3110	01	06001	37.59183257	-122.0377067	Alameda County
269657	Fee-for-Service	1902025851	1902025851	1	1	WALSH, RYAN P LMFT	2/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	251 AUBURN RAVINE RD	210	AUBURN	CA	95603	3719	31	06061	38.90561908	-121.0746639	Placer County
269703	Fee-for-Service	1285634527	1285634527	1	1	WEST OAKS CORPORATION	4/24/1997	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WEST OAK CORPORATION	18368 CLARK ST	None	TARZANA	CA	91356	3502	19	06037	34.16975482	-118.5331876	Los Angeles County
269725	Fee-for-Service	1275851354	1275851354	1	1	WIN, SITHU MD	6/11/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	154328	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
269746	Fee-for-Service	1477649119	1477649119	1	5	WATTS HEALTHCARE	7/27/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTEMITTENT	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	19	06037	33.94274917	-118.2461916	Los Angeles County
269770	Fee-for-Service	1407879596	1407879596	1	1	WYNDHAMSMITH, DAVID R MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	72018	05	Anesthesiology	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
269796	Fee-for-Service	1295740389	1295740389	1	1	WALGREEN CO	7/14/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4009 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	5613	19	06037	33.99022878	-118.4476363	Los Angeles County
269806	Fee-for-Service	1306033865	1306033865	1	1	WALGREEN CO.	11/30/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14780 HARLAN ROAD	None	LATHROP	CA	95330	9719	39	06077	37.82739316	-121.2866038	San Joaquin County
269809	Fee-for-Service	1235246828	1235246828	1	1	WU, BECHIEN U MD	7/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115397	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
269891	Fee-for-Service	1710092580	1710092580	1	1	WINSOR, DAVID W MD	10/1/1983	207U00000X	NA	Other	026	PHYSICIANS	15320	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
269966	Fee-for-Service	1083632509	1083632509	1	1	WEISSMAN, DAVID B MD	6/21/2000	207L00000X	NA	Other	026	PHYSICIANS	43531	05	Anesthesiology	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
269987	Fee-for-Service	1366831695	1366831695	1	1	WILSON, DONALD L	11/1/2021	344600000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3712 CENTINELLA DR	None	NORTH HIGHLANDS	CA	95660	3738	34	06067	38.687967	-121.3783155	Sacramento County
270015	Fee-for-Service	1235540360	1235540360	1	1	WALTHER, CURTIS K MD	10/10/2018	390200000X	NA	Other	026	PHYSICIANS	143362	05	Anesthesiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
270036	Fee-for-Service	1538446117	1538446117	1	1	WAGNER, KATHERINE A NP	4/19/2019	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
270065	Fee-for-Service	1962690669	1962690669	1	1	WOMEN'S HLTH AND REPRO	10/8/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	CENTER A MEDICAL GRP INC	10861 CHERRY ST	STE 109	LOS ALAMITOS	CA	90720	5400	30	06059	33.80465174	-118.0680053	Orange County
270069	Fee-for-Service	1730298431	1730298431	1	1	WEINSTEIN, LESLIE R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	76353	04	Otology, Laryngology, Rhinology	0	In state provider	None	1800 SULLIVAN AVE	RM 603	DALY CITY	CA	94015	2226	41	06081	37.68077723	-122.4728941	San Mateo County
270140	Fee-for-Service	1477710820	1477710820	1	1	WANG, CHRIS Y MD	7/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110514	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18321 CLARK STREET	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
270150	Fee-for-Service	1710092580	1710092580	1	1	WINSOR, DAVID W MD	10/1/1983	207U00000X	NA	Other	026	PHYSICIANS	15320	42	Nuclear Medicine	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
270166	Fee-for-Service	1801809660	1801809660	1	1	WHITE, ANNE V DO	5/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	7336	41	Internal Medicine	0	In state provider	None	51 HITCHCOCK WAY	None	SANTA BARBARA	CA	93105	3110	42	06083	34.43833587	-119.7444336	Santa Barbara County
270167	Fee-for-Service	1639267263	1639267263	1	1	WEATHERWAX, SCOTT W MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	58975	05	Anesthesiology	0	In state provider	None	11190 WARNER AVE	STE 212	FOUNTAIN VALLEY	CA	92708	4045	30	06059	33.714	-117.9333585	Orange County
270195	Fee-for-Service	1598864357	1598864357	1	1	WHITESIDE MANOR, INC	9/22/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2743, 2709, 2759 ORANGE	None	RIVERSIDE	CA	92501	2538	33	06065	33.99094851	-117.3667964	Riverside County
270215	Fee-for-Service	1427530195	1427530195	1	1	WINSLOW, DANETTE J LCSW	4/29/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21660 COPLEY DR	SUITE 210	DIAMOND BAR	CA	91765	4109	19	06037	33.99822893	-117.8340403	Los Angeles County
270220	Fee-for-Service	1558494534	1558494534	1	1	WALIA, MANDEEP DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	5955 MIRA MESA BLVD	SUITE D	SAN DIEGO	CA	92121	4304	37	06073	32.90069181	-117.1883127	San Diego County
270230	Fee-for-Service	1629627914	1629627914	1	1	WHITHAM, SIENA E	1/23/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2131 ASHTON AVE	None	MENLO PARK	CA	94025	6501	41	06081	37.43205327	-122.2036961	San Mateo County
270254	Fee-for-Service	1841259298	1841259298	1	1	WEISZ, JONATHON M MD	6/30/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	74937	40	Pediatrics	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
270260	Fee-for-Service	1306498811	1306498811	1	1	WOHLWEND, CATHERINE M LMFT	7/13/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
270269	Fee-for-Service	1467902502	1467902502	1	1	WHITESIDE MANOR	10/19/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4750 PALM AVE	None	RIVERSIDE	CA	92501	4012	33	06065	33.97640504	-117.3909384	Riverside County
270312	Fee-for-Service	1275821720	1275821720	1	1	WANG, YAWEN MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150344	13	Neurology (M.D. only)	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
270342	Fee-for-Service	1396824173	1396824173	1	1	WIGGINTON, NANCY H MD	6/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76070	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
270353	Fee-for-Service	1932162419	1932162419	1	1	WEINERT, ASHLEY K MD	8/8/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	76709	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1400 MEDICAL CENTER DR	None	ROHNERT PARK	CA	94928	2924	49	06097	38.34761053	-122.682654	Sonoma County
270359	Fee-for-Service	1356488605	1356488605	1	1	WRIGHT, KIMBERLY H MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112555	30	Radiology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
270372	Fee-for-Service	1699780973	1699780973	1	1	WALGREEN CO.	8/2/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	333 EL CAMINO REAL	None	SAN BRUNO	CA	94066	4839	41	06081	37.62052886	-122.411011	San Mateo County
270383	Fee-for-Service	1174681340	1174681340	1	1	WHITNEY, PAUL B	2/26/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9449	48	06095	38.38851772	-121.9382798	Solano County
270400	Fee-for-Service	1780777433	1780777433	1	1	WELLS, LESLIE L MD	5/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	50756	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
270418	Fee-for-Service	1346253283	1346253283	1	1	WESTBROOK, STEVEN D MD	8/31/1987	207ZP0102X	NA	Other	026	PHYSICIANS	61726	41	Internal Medicine	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
270467	Fee-for-Service	1144268624	1144268624	1	1	WOODMANSEE, DONALD P JR MD	9/15/2010	207R00000X	NA	Other	026	PHYSICIANS	62189	03	Allergy	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
270469	Fee-for-Service	1639696610	1639696610	1	1	WELLS, DEIDRA LMFT	11/5/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
270477	Fee-for-Service	1528060340	1528060340	1	1	WILSON, HUGH ELLIOTT MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	54542	22	Pathology (M.D. only)	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
270517	Fee-for-Service	1215390315	1215390315	1	2	WILDOMAR PSYCHOTHERAPY CENTE	9/9/2018	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	29995 TECHNOLOGY DR.	103	MURRIETA	CA	92563	2633	33	06065	33.56041691	-117.1370428	Riverside County
270566	Fee-for-Service	1679013890	1679013890	1	1	WOODLAND, SEAN C PHD	8/11/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
270609	Fee-for-Service	1164599171	1164599171	1	1	WONG, KEVIN A MD	10/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	77547	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
270612	Fee-for-Service	1811902190	1811902190	1	1	WALGREEN CO	10/19/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12001 EUCLID ST	None	GARDEN GROVE	CA	92840	3332	30	06059	33.78758768	-117.941271	Orange County
270619	Fee-for-Service	1861491490	1861491490	1	1	WEST ESCONDIDO HEALTHCARE	7/1/2003	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	201 N FIG ST	None	ESCONDIDO	CA	92025	3416	37	06073	33.12619044	-117.0734702	San Diego County
270620	Fee-for-Service	1659638823	1659638823	1	1	WEISS, CHRISTOPHER V MD	9/5/2019	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	129358	01	General Practice	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	19	06037	34.28200485	-118.4030797	Los Angeles County
270663	Fee-for-Service	1427204486	1427204486	1	1	WELSH, NICOLE C MD	1/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	36	Psychiatry	1	Border provider	None	15 MCCABE DR	SUITE 100	RENO	NV	89511	4815	00	None	39.42666928	-119.762324	Washoe County
270793	Fee-for-Service	1770599334	1770599334	1	1	WALGREEN CO	10/6/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1306 S MARY AVE	STE 66	SUNNYVALE	CA	94087	3130	43	06085	37.35157944	-122.0505128	Santa Clara County
270872	Fee-for-Service	1548275829	1548275829	1	1	WALGREENS CO	3/30/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #05478	6701 CARNELIAN ST	None	RANCHO CUCAMONGA	CA	91701	4556	36	06071	34.13214	-117.6161915	San Bernardino County
270917	Fee-for-Service	1265605273	1265605273	1	1	WEYERS, EARL W MD	8/1/2018	207L00000X	NA	Other	026	PHYSICIANS	155953	05	Anesthesiology	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
270921	Fee-for-Service	1548559974	1548559974	1	1	WILNAI ZISKIND, YAEL MD	3/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124542	01	General Practice	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
270940	Fee-for-Service	1427204486	1427204486	1	1	WELSH, NICOLE C MD	1/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	15 MCCABE DR	SUITE 100	RENO	NV	89511	4815	00	None	39.42666928	-119.762324	Washoe County
270941	Fee-for-Service	1972689537	1972689537	1	1	WIGGINS, SHERRI K CRNA	7/1/2003	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
270969	Fee-for-Service	1427243427	1427243427	1	1	WILLIAM T CABULLO JR	1/14/2008	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	5875 MONTAUBAN AVE	None	STOCKTON	CA	95210	5632	39	06077	38.01140648	-121.2900438	San Joaquin County
271017	Fee-for-Service	1164570065	1164570065	1	1	WALLACE, DEBRA R NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11001 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1413	19	06037	34.26991066	-118.4671653	Los Angeles County
271046	Fee-for-Service	1164747721	1164747721	1	1	WALGREEN CO	7/29/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2400 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2914	19	06037	33.89386589	-118.3959255	Los Angeles County
271052	Fee-for-Service	1376672063	1376672063	1	1	WRIGHT, DANIEL J LP	3/14/2006	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	580 BEECH AVE	STE A	CARLSBAD	CA	92008	1657	37	06073	33.16283214	-117.3502553	San Diego County
271071	Fee-for-Service	1720311327	1720311327	1	1	WALGREEN CO	5/18/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11795 W OLYMPIC BLVD	None	LOS ANGELES	CA	90064	1211	19	06037	34.03340929	-118.4493238	Los Angeles County
271086	Fee-for-Service	1184274045	1184274045	1	1	WANG, RUBY F MD	7/6/2021	207L00000X	NA	Other	026	PHYSICIANS	160613	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
271115	Fee-for-Service	1265641088	1265641088	1	1	WEST COAST MOBILITY	5/19/1999	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	69 SAN JUAN AVE	None	SAN FRANCISCO	CA	94112	2615	38	06075	37.72447762	-122.4363688	San Francisco County
271121	Fee-for-Service	1790929792	1790929792	1	1	WEST COFFEE, CARLA S MD	9/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121097	02	General Surgery	0	In state provider	None	2200 TUOLUMNE STREET	None	VALLEJO	CA	94589	2523	48	06095	38.13006948	-122.2399634	Solano County
271265	Fee-for-Service	1538645635	1538645635	1	1	WILLIAMSON, DANIELLE E LCSW	3/19/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	673 S AUBURN ST	A,B,C,D	GRASS VALLEY	CA	95945	7576	29	06057	39.2060146	-121.0613316	Nevada County
271348	Fee-for-Service	1245702968	1245702968	1	1	WOODS, ALBERTONIA C NP	5/12/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
271376	Fee-for-Service	1215911235	1215911235	1	1	WISWALL, DANIELLE T	2/8/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	FOCUS PHYSICAL THERAPY	177 VULCAN DR	None	LOMPOC	CA	93436	1406	42	06083	34.70253294	-120.4644814	Santa Barbara County
271398	Fee-for-Service	1760498331	1760498331	1	1	WALGREEN COMPANY	11/1/2000	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3500 COFFEE RD	None	MODESTO	CA	95355	1344	50	06099	37.690002	-120.976061	Stanislaus County
271433	Fee-for-Service	1144200460	1144200460	1	1	WILLIAM KIMBALL MELLOR, M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1210 W FAIRVIEW ST	None	COLFAX	WA	99111	9552	00	None	46.86878819	-117.3752706	Whitman County
271467	Fee-for-Service	1205414679	1205414679	1	1	WEI, CHEN MD	8/12/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
271547	Fee-for-Service	1104924679	1104924679	1	1	WALIA, RAJEEV K MD	10/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82688	08	Family Practice	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
271550	Fee-for-Service	1477392561	1477392561	1	1	WELCOME TO AMERICA INC.	9/5/2024	251V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	17130 SEQUOIA ST	104	HESPERIA	CA	92345	1403	36	06071	34.46911749	-117.289755	San Bernardino County
271601	Fee-for-Service	1659361731	1659361731	1	1	WASSERMAN, CHARLES B PHD	1/1/1979	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYCH TREATMENT SRV INC	19543 MAYALL ST	None	NORTHRIDGE	CA	91324	1015	19	06037	34.25366574	-118.5594058	Los Angeles County
271626	Fee-for-Service	1639150022	1639150022	1	1	WITMER, BRUCE EDWARD MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	25	Physical Medicine and Rehabilitation	1	Border provider	None	555 N ARLINGTON AVE	None	RENO	NV	89503	4723	00	None	39.53124039	-119.8188498	Washoe County
271649	Fee-for-Service	1396189965	1396189965	1	1	WEST, PATRICIA B	12/2/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12001 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5801	19	06037	33.99760695	-118.4228296	Los Angeles County
271671	Fee-for-Service	1336166743	1336166743	1	1	WAL-MART STORES INC	4/1/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102598	3661 TRUXEL RD	None	SACRAMENTO	CA	95834	3604	34	06067	38.635866	-121.5054585	Sacramento County
271733	Fee-for-Service	1659796936	1659796936	1	1	WAL-MART STORES INC	6/13/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20226 AVALON BLVD	None	CARSON	CA	90746	3829	19	06037	33.84809328	-118.2646966	Los Angeles County
271739	Fee-for-Service	1669714754	1669714754	1	1	WIJEGUNARATNE, KANISHKA MD	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135131	41	Internal Medicine	0	In state provider	None	4650 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6309	19	06037	33.98160766	-118.4400667	Los Angeles County
271802	Fee-for-Service	1033201710	1033201710	1	1	WARVARIV, VASYL MD	2/8/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55115	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2340 CLAY ST	RM 413	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
271850	Fee-for-Service	1659428241	1659428241	1	1	WENG, WEN-KAI MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67728	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
271863	Fee-for-Service	1902961360	1902961360	1	1	WEISSENSEE, COURTNEY C	4/15/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
271866	Fee-for-Service	1396221172	1396221172	1	1	WU, KEVIN Y OD	10/15/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
271868	Fee-for-Service	1679591770	1679591770	1	1	WEITZ, JEFFREY J MD	11/21/2007	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	57218	30	Radiology	0	In state provider	None	230 S MAIN STREET	SUITE 101	ORANGE	CA	92660	3851	30	06059	33.785154	-117.867318	Orange County
271916	Fee-for-Service	1104995570	1104995570	2	1	WHITE, JEFFREY W OD	2/16/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	715 N IRWIN ST	None	HANFORD	CA	93230	3813	16	06031	36.33246623	-119.6476443	Kings County
271924	Fee-for-Service	1851307425	1851307425	1	1	WALGREENS CO	9/28/2001	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WALGREENS #06157	946 S BROOKHURST ST	None	ANAHEIM	CA	92804	4305	30	06059	33.818652	-117.958912	Orange County
271926	Fee-for-Service	1346237807	1346237807	1	1	WAHL, MICHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10101 RIDGEGATE PKWY	None	LONETREE	CO	80124	5522	00	None	39.529305	-104.870799	Douglas County
271931	Fee-for-Service	1063527091	1063527091	1	1	WELLMAN'S PHARMACY	9/16/1991	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	728 PACIFIC AVE	STE 110	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
271990	Fee-for-Service	1699983577	1699983577	1	1	WEDEMEYER, MATTHEW K MD	10/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87925	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
272013	Fee-for-Service	1881611291	1881611291	1	1	WAL-MART PHCY 10-1563	8/17/1990	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	44765 VALLEY CENTRAL WAY	None	LANCASTER	CA	93536	6531	19	06037	34.695684	-118.1721655	Los Angeles County
272020	Fee-for-Service	1477564862	1477564862	1	1	WANG, MATHEW Y MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	64190	18	Ophthalmology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
272063	Fee-for-Service	1568541225	1568541225	1	1	WANG,PEI-TSUI P MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70184	41	Internal Medicine	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
272079	Fee-for-Service	1033201710	1033201710	1	1	WARVARIV, VASYL MD	2/8/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55115	41	Internal Medicine	0	In state provider	None	2340 CLAY ST	RM 413	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
272082	Fee-for-Service	1215390315	1215390315	1	1	WILDOMAR PSYCHOTHERAPY CENTE	9/9/2018	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	29995 TECHNOLOGY DR.	103	MURRIETA	CA	92563	2633	33	06065	33.56041691	-117.1370428	Riverside County
272086	Fee-for-Service	1912181553	1912181553	1	1	WONG, AMY E MD	2/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	101197	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
272116	Fee-for-Service	1841701414	1841701414	1	1	WAWRZONEK, JUSTYNA M LCSW	4/27/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
272133	Fee-for-Service	1689768160	1689768160	1	1	WOODWARD, PAIGE M NP	1/9/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
272177	Fee-for-Service	1134757040	1134757040	1	1	WU, CHARLES MD	11/3/2023	207R00000X	NA	Other	026	PHYSICIANS	190523	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
272180	Fee-for-Service	1992768352	1992768352	1	1	WENSEL, JEFFREY P MD	10/16/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	54029	30	Radiology	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
272211	Fee-for-Service	1972620342	1972620342	1	1	WISMER, BARBARA A MD	5/31/1991	207P00000X	NA	Other	026	PHYSICIANS	77730	41	Internal Medicine	0	In state provider	RM 1E21	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
272273	Fee-for-Service	1780732768	1780732768	1	1	WOODWORTH, PAUL H MD	1/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65228	20	Orthopedic Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
272328	Fee-for-Service	1407499163	1407499163	1	1	WEST GARDENA CARE CENTER LLC	11/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	16530 S BROADWAY	None	GARDENA	CA	90248	2714	19	06037	33.8809767	-118.2781556	Los Angeles County
272330	Fee-for-Service	1083158653	1083158653	1	1	WHATLEY, CIERRA K PHD	11/8/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
272360	Fee-for-Service	1114439908	1114439908	1	1	WEITEKAMP, CHRISTOPHER W	8/14/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	0000	19	06037	34.06238259	-118.2030986	Los Angeles County
272399	Fee-for-Service	1366061772	1366061772	1	1	WANG, TONY H MD	10/19/2023	208M00000X	NA	Other	026	PHYSICIANS	191225	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
272412	Fee-for-Service	1689680548	1689680548	1	1	WANG, JIANGNAN MD	11/9/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	73460	None	None	0	In state provider	None	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	19	06037	33.929829	-118.157607	Los Angeles County
272424	Fee-for-Service	1982846820	1982846820	1	1	WEISBEIN, MICHAEL MD	7/17/2023	207L00000X	NA	Other	026	PHYSICIANS	170154	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
272435	Fee-for-Service	1437826617	1437826617	1	1	WILLIAMS, BROOKE A PSYD	1/28/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
272449	Fee-for-Service	1265486427	1265486427	1	3	WEST VALLEY RADIOLOGY MEDICA	8/15/2023	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	L GROUP, INC.	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
272464	Fee-for-Service	1023055829	1023055829	1	1	WERLHOF, VICTOR H MD	8/31/1994	207L00000X	NA	Other	026	PHYSICIANS	28118	05	Anesthesiology	0	In state provider	None	400 E MAIN ST	STE 200	STOCKTON	CA	95202	3000	39	06077	37.95344497	-121.2852303	San Joaquin County
272556	Fee-for-Service	1306878491	1306878491	1	1	WANG, STEWART MD INC	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85318	24	Plastic Surgery	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
272568	Fee-for-Service	1780837260	1780837260	1	1	WORSHAM, AUSTEN W	3/6/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172376	None	None	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
272590	Fee-for-Service	1336281997	1336281997	1	1	WOODEN, THOMAS	2/8/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	WOODWARD HEARING CNT	3425 EL CAMINO AVE	None	SACRAMENTO	CA	95821	6309	34	06067	38.610693	-121.384332	Sacramento County
272624	Fee-for-Service	1750540423	1750540423	1	1	WEITS, GENELLE I PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4565 RUFFNER ST	STE 108	SAN DIEGO	CA	92111	2258	37	06073	32.823771	-117.157283	San Diego County
272666	Fee-for-Service	1417173212	1417173212	1	1	WALSH, SALLY F	6/1/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1127 WILSHIRE BLVD	SUITE 1202	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
272715	Fee-for-Service	1427425065	1427425065	1	1	WALDRON, JONATHAN C PHD	5/11/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
272733	Fee-for-Service	1437536521	1437536521	1	1	WANG, TONY L MD	7/6/2020	207L00000X	NA	Other	026	PHYSICIANS	144789	05	Anesthesiology	0	In state provider	None	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
272766	Fee-for-Service	1649677147	1649677147	1	1	WESTCARE CALIFORNIA, INC	12/5/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1201 N DOUTY	5 & 7	HANFORD	CA	93230	3406	16	06031	36.3375952	-119.6460029	Kings County
272776	Fee-for-Service	1487866059	1487866059	1	1	WIEDENBECK, TROY L MD	6/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	1500 EAST 2ND STREET	SUITE 400	RENO	NV	89502	1198	00	None	39.52743427	-119.7932613	Washoe County
272827	Fee-for-Service	1306878491	1306878491	1	1	WANG, STEWART MD INC	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85318	02	General Surgery	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
272883	Fee-for-Service	1285824789	1285824789	1	1	WEINBERG, NICOLE M MD	5/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91086	42	Nuclear Medicine	0	In state provider	None	2001 SANTA MONICA BLVD	280 W	SANTA MONICA	CA	90404	2172	19	06037	34.02891163	-118.4797466	Los Angeles County
272914	Fee-for-Service	1851307250	1851307250	1	1	WALGREEN CO	3/31/1996	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	399 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	5923	41	06081	37.64585066	-122.4276651	San Mateo County
272923	Fee-for-Service	1225724826	1225724826	1	1	WOLFF, NEILA S LMFT	2/6/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
272931	Fee-for-Service	1992919823	1992919823	1	1	WONG, REGINA F	5/20/2009	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	98176	None	None	0	In state provider	None	210 CANAL STREET	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
272958	Fee-for-Service	1194016139	1194016139	1	1	WILLIAMS, DOLORES L LCSW	6/14/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	26155	-	NOT APPLICABLE	0	In state provider	None	13201 SAN PABLO AVE	STE 206	SAN PABLO	CA	94806	3592	07	06013	37.95165516	-122.3328786	Contra Costa County
272963	Fee-for-Service	1417726209	1417726209	1	1	WINNIE, NICOLE M CNP	3/5/2024	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1901 NTUSTIN AVE	None	SANTA ANA	CA	92705	7817	30	06059	33.76245307	-117.8350708	Orange County
272973	Fee-for-Service	1639358385	1639358385	1	1	WAGNER, BEATRIX S PSYD	4/9/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	30423 CANWOOD ST	SUITE 138	AGOURA HILLS	CA	91301	4315	19	06037	34.14710182	-118.7842501	Los Angeles County
272982	Fee-for-Service	1407367121	1407367121	1	1	WHELAN, JENNIFER A CCC-SLP	2/28/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
273033	Fee-for-Service	1205853553	1205853553	1	1	WAL-MART STORES, INC	12/7/1995	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102288	80 RIO RANCHO RD	None	POMONA	CA	91766	4771	19	06037	34.029117	-117.7577685	Los Angeles County
273040	Fee-for-Service	1669522629	1669522629	1	1	WARNELL, KATHY J LCSW	3/22/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
273056	Fee-for-Service	1063439479	1063439479	1	1	WAL-MART PHARMACY	8/15/1994	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#10-2099	180 NIBLICK RD	None	PASO ROBLES	CA	93446	4842	40	06079	35.612469	-120.6816525	San Luis Obispo County
273060	Fee-for-Service	1215927470	1215927470	1	2	WHITE MEMORIAL MED CTR	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
273068	Fee-for-Service	1588721583	1588721583	1	1	WAGNER, JANINE LMFT	11/27/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
273097	Fee-for-Service	1306878491	1306878491	1	1	WANG, STEWART MD INC	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85318	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
273111	Fee-for-Service	1124551494	1124551494	1	1	WOLFE-ROUBATIS, EMILY C CNM	3/31/2020	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
273199	Fee-for-Service	1407822331	1407822331	1	1	WILSON, RUTH D MD	7/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80389	41	Internal Medicine	0	In state provider	None	980 TRANCAS ST	STE 12	NAPA	CA	94558	2933	28	06055	38.32369771	-122.2951869	Napa County
273227	Fee-for-Service	1255783098	1255783098	1	1	WEI, XIN MD	8/8/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2900 WHIPPLE AVE	STE 230	REDWOOD CITY	CA	94062	2852	41	06081	37.4783072	-122.2551089	San Mateo County
273240	Fee-for-Service	1568832426	1568832426	1	1	WALLACE, KATHLEEN	1/28/2025	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	85 HARTNELL AVE STE 300	None	REDDING	CA	96002	1888	45	06089	40.56995266	-122.3694812	Shasta County
273268	Fee-for-Service	1417112392	1417112392	1	1	WONG, LINA L DO	8/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12219	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2141 N HARBOR BLVD	STE 25000	FULLERTON	CA	92835	3830	30	06059	33.89443025	-117.9288328	Orange County
273322	Fee-for-Service	1659448678	1659448678	1	1	WONG, SANSAN MD	9/15/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	68114	03	Allergy	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
273370	Fee-for-Service	1538403225	1538403225	1	1	WAL-MART STORES, INC	3/11/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16555 VON KARMAN AVE	STE A	IRVINE	CA	92606	4928	30	06059	33.698997	-117.83619	Orange County
273394	Fee-for-Service	1184094708	1184094708	1	1	WORTH, MICHELINE LMFT	12/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7571 BODEGA AVE	None	SEBASTOPOL	CA	95472	3655	49	06097	38.39878416	-122.8290115	Sonoma County
273403	Fee-for-Service	1710987706	1710987706	1	3	WILSHIRE ONCOLOGY MED	3/13/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GRP INC	1280 CORONA POINTE CT	None	CORONA	CA	92879	1770	33	06065	33.87039079	-117.5408442	Riverside County
273467	Fee-for-Service	1235271180	1235271180	1	2	WESTERN PACIFIC MED-CORP	9/30/2015	261QM2800X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4544 SAN FERNANDO ROAD	SUITE 201	GLENDALE	CA	91204	5015	19	06037	34.13475025	-118.2630831	Los Angeles County
273474	Fee-for-Service	1144378803	1144378803	1	1	WHITTIER CITY ELEMENTARY	9/27/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOL DISTRICT	7211 WHITTIER AVE	None	WHITTIER	CA	90602	1123	19	06037	33.97689082	-118.0432591	Los Angeles County
273668	Fee-for-Service	1710987706	1710987706	1	3	WILSHIRE ONCOLOGY MED	3/13/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GRP INC	1280 CORONA POINTE CT	None	CORONA	CA	92879	1770	33	06065	33.87039079	-117.5408442	Riverside County
273691	Fee-for-Service	1285033167	1285033167	1	1	WICHELHAUS, TILL P MD	11/27/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	147287	08	Family Practice	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
273698	Fee-for-Service	1043496276	1043496276	1	1	WICHELHAUS, CHRISTOP L MD	7/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104315	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
273700	Fee-for-Service	1144260811	1144260811	1	1	WELLBOUND OF STOCKTON,	7/5/2006	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	3555 DEER PARK DR	None	STOCKTON	CA	95219	2306	39	06077	37.98695468	-121.3523032	San Joaquin County
273725	Fee-for-Service	1053497347	1053497347	1	1	WILLSEN, JOHN J MD	2/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	36877	07	Dermatology	0	In state provider	None	3800 DALE RD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
273738	Fee-for-Service	1235271180	1235271180	1	2	WESTERN PACIFIC MED-CORP	3/1/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	4544 SAN FERNANDO ROAD	SUITE 201	GLENDALE	CA	91204	5015	19	06037	34.13475025	-118.2630831	Los Angeles County
273744	Fee-for-Service	1316331226	1316331226	1	1	WONG, ANDY MD	11/17/2019	207P00000X	NA	Other	026	PHYSICIANS	162243	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
273754	Fee-for-Service	1679805865	1679805865	1	1	WILLDORF, MEGAN LAC	7/2/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	521 PRECITA AVE	None	SAN FRANCISCO	CA	94110	4719	38	06075	37.7474725	-122.4098138	San Francisco County
273840	Fee-for-Service	1518024108	1518024108	1	1	WERNER, DARRYL J MD	12/31/1988	207PE0005X	NA	Other	026	PHYSICIANS	66730	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
273861	Fee-for-Service	1427361617	1427361617	1	1	WONG, KELLY D O INC	4/26/2011	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	10595	08	Family Practice	0	In state provider	None	711 W COLLEGE ST	STE 208	LOS ANGELES	CA	90012	1093	19	06037	34.06541412	-118.2414102	Los Angeles County
273871	Fee-for-Service	1134554710	1134554710	1	1	WEBB, KAREN S NP	6/27/2019	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
273881	Fee-for-Service	1891700167	1891700167	1	1	WALGREEN CO	6/19/1995	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	25 POINT LOBOS AVE	None	SAN FRANCISCO	CA	94121	1530	38	06075	37.77965192	-122.503515	San Francisco County
273915	Fee-for-Service	1225664279	1225664279	1	1	WORTHGE, SHANE	3/20/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	20516	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
273936	Fee-for-Service	1417128604	1417128604	1	1	WANG, YEE-HSIANG J MD	6/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92051	30	Radiology	0	In state provider	None	3700 CALIFORNIA STREET	#G350	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
273940	Fee-for-Service	1710987706	1710987706	1	3	WILSHIRE ONCOLOGY MED	3/13/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GRP INC	1280 CORONA POINTE CT	None	CORONA	CA	92879	1770	33	06065	33.87039079	-117.5408442	Riverside County
273951	Fee-for-Service	1033124318	1033124318	1	1	WALGREEN CO	4/15/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1718 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1306	44	06087	36.98138569	-122.002034	Santa Cruz County
273987	Fee-for-Service	1467496372	1467496372	1	1	WELLS, ROBERT E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	77 WEST FOREST AVENUE	SUITE #207	FLAGSTAFF	AZ	86001	1483	00	None	35.210619	-111.6436275	Coconino County
273999	Fee-for-Service	1043703507	1043703507	1	1	WANG, JING Z MD	8/1/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
274006	Fee-for-Service	1154556710	1154556710	1	1	WALGREEN CO	10/29/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1538 E CHAPMAN AVE	None	ORANGE	CA	92866	2231	30	06059	33.78779155	-117.8367795	Orange County
274023	Fee-for-Service	1477649119	1477649119	1	2	WATTS HEALTHCARE	2/4/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	316 E 111TH STREET	None	LOS ANGELES	CA	90061	3004	19	06037	33.93477147	-118.2689419	Los Angeles County
274029	Fee-for-Service	1548463359	1548463359	1	1	WARD, MARK A MD INC	7/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83686	01	General Practice	0	In state provider	None	1405 TERESA DR	None	MORRO BAY	CA	93442	2458	40	06079	35.36492306	-120.8250111	San Luis Obispo County
274030	Fee-for-Service	1073773966	1073773966	2	1	WATTS, SARA L LMFT	10/25/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2231 ST. GEORGE LN.	10	CHICO	CA	95926	1314	04	06007	39.75550435	-121.8462178	Butte County
274058	Fee-for-Service	1053412122	1053412122	1	1	WISHING U WELL MED INC	9/1/1998	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	S. BRUCE SANDLER	17507 CHATSWORTH ST	None	GRANADA HILLS	CA	91344	5720	19	06037	34.26488752	-118.515645	Los Angeles County
274073	Fee-for-Service	1003868753	1003868753	1	1	WASLEY, RICHARD J MD	8/31/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	78097	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
274096	Fee-for-Service	1679686653	1679686653	1	1	WINTER, SUSAN C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	41843	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
274107	Fee-for-Service	1255417069	1255417069	1	1	WONG, CHRISTOPHER JURN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4245 ROOSEVELT WAY NE	None	SEATTLE	WA	98105	6008	00	None	47.65883901	-122.3177928	King County
274115	Fee-for-Service	1164594982	1164594982	1	1	WAKERLIN, SUSAN H MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	48818	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
274116	Fee-for-Service	1215950316	1215950316	1	1	WANG, PETER C MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41272	40	Pediatrics	0	In state provider	None	1800 SULLIVAN AVE	RM 507	DALY CITY	CA	94015	2225	41	06081	37.68077723	-122.4728941	San Mateo County
274149	Fee-for-Service	1730357328	1730357328	1	1	WATSON, CAREY R MD	10/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101745	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
274204	Fee-for-Service	1588764526	1588764526	1	1	WADHWANI, SUNEEL H MD	4/30/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41761	08	Family Practice	0	In state provider	None	590 W PUTNAM AVE	STE 6	PORTERVILLE	CA	93257	3257	54	06107	36.06962449	-119.030337	Tulare County
274249	Fee-for-Service	1598838443	1598838443	1	1	WONG, CURTICE MD	1/29/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67954	66	Emergency Medicine (Urgent Care)	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
274264	Fee-for-Service	1043703507	1043703507	1	1	WANG, JING Z MD	8/1/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
274272	Fee-for-Service	1700929791	1700929791	1	1	WETTER, MICHAEL G PSYD	7/7/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 NORTH ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
274273	Fee-for-Service	1417052671	1417052671	1	1	WELLS, JAMES H MD	5/23/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	33481	24	Plastic Surgery	0	In state provider	None	010514TLANTIC AVE	STE 290	LONG BEACH	CA	90806	1716	19	06037	0	0	None
274296	Fee-for-Service	1588610661	1588610661	1	1	WIESE, JAMES A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RADIOLOGIC MED SERV PC	500 E. MARKET ST	None	IOWA CITY	IA	52245	0000	00	None	41.664114	-91.5284205	Johnson County
274300	Fee-for-Service	1194098798	1194098798	1	1	WALGREEN CO	10/16/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#15293	4940 VAN NUYS BLVD	STE 104	SHERMAN OAKS	CA	91403	1700	19	06037	34.160589	-118.4486715	Los Angeles County
274301	Fee-for-Service	1366604365	1366604365	1	1	WONG, CARRIE MD	9/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130415	10	Gastroenterology (M.D. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
274320	Fee-for-Service	1831175561	1831175561	1	1	WHITE, JAMES MD	10/4/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	189040	None	None	0	In state provider	None	4000 EMPIRE DR	STE 100	BAKERSFIELD	CA	93309	0401	15	06029	35.37480064	-119.0459033	Kern County
274348	Fee-for-Service	1336305382	1336305382	1	1	WONG, JASON H MD	3/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98241	01	General Practice	0	In state provider	None	700 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
274356	Fee-for-Service	1326196296	1326196296	1	1	WATTS, JUANITA L MD	1/31/1983	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	50758	01	General Practice	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
274370	Fee-for-Service	1982759395	1982759395	1	1	WU, CHOU MD INC	8/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65603	41	Internal Medicine	0	In state provider	None	1996 DEL PASO RD	SUITE 176	SACRAMENTO	CA	95834	7731	34	06067	38.654802	-121.506372	Sacramento County
274380	Fee-for-Service	1164594982	1164594982	1	1	WAKERLIN, SUSAN H MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	48818	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
274454	Fee-for-Service	1972755445	1972755445	1	1	WOLFE, DIANA S MD	2/16/2011	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	108770	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
274471	Fee-for-Service	1669808028	1669808028	1	2	WIECHERT, KAITLIN I LMFT	3/26/2025	No Taxonomy Provided	NA	None	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	473 CARNEGIE DR	SUITE 200	SAN BERNARDINO	CA	92408	4207	36	06071	34.06796019	-117.2749922	San Bernardino County
274513	Fee-for-Service	1902162845	1902162845	1	1	WOOD, STEPHANIE A MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127316	01	General Practice	0	In state provider	None	1264 HAWKS FLIGHT CT	None	EL DORADO HILLS	CA	95762	9364	09	06017	38.63773686	-121.0664492	El Dorado County
274637	Fee-for-Service	1982759395	1982759395	1	1	WU, CHOU MD INC	8/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65603	08	Family Practice	0	In state provider	None	1996 DEL PASO RD	SUITE 176	SACRAMENTO	CA	95834	7731	34	06067	38.654802	-121.506372	Sacramento County
274645	Fee-for-Service	1164594982	1164594982	1	1	WAKERLIN, SUSAN H MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	48818	38	Geriatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
274687	Fee-for-Service	1366559874	1366559874	1	1	WILLARD, DOUGLAS R MD	11/30/1984	207P00000X	NA	Other	026	PHYSICIANS	45938	66	Emergency Medicine (Urgent Care)	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
274700	Fee-for-Service	1831938232	1831938232	1	1	WILLIAM F RESH M.D. SKIN & S	9/10/2024	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	5222 BALBOA AVE	FL 5	SAN DIEGO	CA	92117	6963	37	06073	32.81873589	-117.1838368	San Diego County
274735	Fee-for-Service	1669808028	1669808028	1	2	WIECHERT, KAITLIN I LMFT	6/19/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	473 CARNEGIE DR	SUITE 200	SAN BERNARDINO	CA	92408	4207	36	06071	34.06796019	-117.2749922	San Bernardino County
274755	Fee-for-Service	1437208758	1437208758	1	1	WHITE, GARY M MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64333	07	Dermatology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
274757	Fee-for-Service	1861571572	1861571572	1	1	WANG, CHANGLIN MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61313	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
274796	Fee-for-Service	1518989987	1518989987	1	1	WALKER, STEPHEN B MFT	12/10/2014	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	708 ALHAMBRA BLVD	STE 100	SACRAMENTO	CA	95816	3851	34	06067	38.575764	-121.4642025	Sacramento County
274808	Fee-for-Service	1750317004	1750317004	1	1	WARA, DIANE W MD	6/10/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	23743	40	Pediatrics	0	In state provider	U C MED CTR	696 MOFFITT HOSP	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.73743268	-122.4331132	San Francisco County
274810	Fee-for-Service	1730423914	1730423914	1	1	WILLIAMS, PAMELA	6/11/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	90390	-	NOT APPLICABLE	0	In state provider	None	5190 ATLANTIC AVE	None	LONG BEACH	CA	90805	6510	19	06037	33.850449	-118.1848215	Los Angeles County
274856	Fee-for-Service	1467531277	1467531277	1	1	WILTURNER, SUSAN M MD	5/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	73954	None	None	0	In state provider	None	1100 LAS TABLAS ROAD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
274881	Fee-for-Service	1356591200	1356591200	1	1	WAROLIN, JOSHUA P DO	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	10563	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
274978	Fee-for-Service	1982619995	1982619995	1	1	WALGREEN CO	2/10/2005	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1145 S MAIN ST	None	RED BLUFF	CA	96080	4357	52	06103	40.16094613	-122.2271642	Tehama County
274980	Fee-for-Service	1023196185	1023196185	1	1	WEISS, MICHAEL MD	9/1/1995	207R00000X	NA	Other	026	PHYSICIANS	53602	None	None	0	In state provider	None	525 SOUTH DR	STE 211	MOUNTAIN VIEW	CA	94040	4211	43	06085	37.36726013	-122.0846207	Santa Clara County
275001	Fee-for-Service	1316090913	1316090913	1	1	WANG, MING J MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63359	05	Anesthesiology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
275016	Fee-for-Service	1841923125	1841923125	1	1	WOLF, SCOTT G BOCP	10/18/2024	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2039 N FINE AVE	None	FRESNO	CA	93727	1512	10	06019	36.76905227	-119.7285775	Fresno County
275018	Fee-for-Service	1437208758	1437208758	1	1	WHITE, GARY M MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64333	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
275039	Fee-for-Service	1750678421	1750678421	1	1	WARD, VICTORIA C MD	8/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122203	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
275085	Fee-for-Service	1467526350	1467526350	1	1	WONG, HAU S MD	8/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81585	04	Otology, Laryngology, Rhinology	0	In state provider	None	1201 W LA VETA AVE	STE 604	ORANGE	CA	92868	4211	30	06059	33.78034779	-117.8655767	Orange County
275142	Fee-for-Service	1356591200	1356591200	1	1	WAROLIN, JOSHUA P DO	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	10563	10	Gastroenterology (M.D. only)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
275151	Fee-for-Service	1073876694	1073876694	1	1	WHELAN, LISA L LCSW	1/7/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
275167	Fee-for-Service	1295122000	1295122000	1	1	WOODBURN, MIESTY MD	5/1/2020	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	167436	13	Neurology (M.D. only)	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
275194	Fee-for-Service	1316222458	1316222458	1	1	WILLIAMS, MARIA G LMFT	6/8/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15336 DEVONSHIRE	UNIT 6	MISSION HILLS	CA	91345	3205	19	06037	34.25726849	-118.4664285	Los Angeles County
275208	Fee-for-Service	1619926581	1619926581	1	1	WACHHORST, SCOTT P MD	12/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	55536	14	Neurological Surgery	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
275291	Fee-for-Service	1609862242	1609862242	1	1	WADA, JANE S MD	3/17/2010	207N00000X	NA	Dermatology	026	PHYSICIANS	30116	07	Dermatology	0	In state provider	None	2103 MONTROSE AVE	STE D	MONTROSE	CA	91020	1546	19	06037	34.206831	-118.224702	Los Angeles County
275314	Fee-for-Service	1386757094	1386757094	1	1	WOHLSTADTER, THOMAS C	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	5559	05	Anesthesiology	0	In state provider	INC	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
275367	Fee-for-Service	1255489126	1255489126	1	1	WHITTEN, CHRISTINE E MD	3/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	52866	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
275375	Fee-for-Service	1083052096	1083052096	1	1	WITHERSPOON, CORTLAND N	1/17/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11911 CENTRAL AVENUE	None	CHINO	CA	91710	1906	36	06071	34.03704117	-117.6893971	San Bernardino County
275411	Fee-for-Service	1366836504	1366836504	1	1	WANG, DANDAN MD	5/25/2021	207ZP0101X	NA	Other	026	PHYSICIANS	155363	None	None	0	In state provider	None	10833 LECONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
275412	Fee-for-Service	1417606849	1417606849	1	1	WAY OF WELLNESS HEALTHCARE I	8/17/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	NC.	940 SARATOGA AVE	SUITE 104	SAN JOSE	CA	95129	3409	43	06085	37.30938002	-121.9773594	Santa Clara County
275419	Fee-for-Service	1669761912	1669761912	1	1	WATERS, JAMES D MD	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	214 E 23RD STREET	None	CHEYENNE	WY	82001	3748	00	None	41.1402124	-104.8159812	Laramie County
275485	Fee-for-Service	1942709860	1942709860	1	1	WOLFE, HANNAH E LCSW	3/23/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
275513	Fee-for-Service	1437577046	1437577046	1	1	WONG, ANITA MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139775	08	Family Practice	0	In state provider	None	1920 COLORADO AVENUE	None	LOS ANGELES	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles
275537	Fee-for-Service	1144543364	1144543364	1	1	WONG, EUGENE W MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	124915	05	Anesthesiology	0	In state provider	None	531 W COLLEGE STREET	None	LOS ANGELES	CA	90012	2315	19	06037	34.0645892	-118.2391033	Los Angeles County
275549	Fee-for-Service	1366902041	1366902041	1	1	WANG, KELLY X DO	7/8/2022	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
275559	Fee-for-Service	1639294960	1639294960	1	2	WOLFSON, AVIVA M LMFT	5/31/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	690 E GREEN ST	SUITE 202	PASADENA	CA	91101	2197	19	06037	34.14449605	-118.1361004	Los Angeles County
275583	Fee-for-Service	1780621706	1780621706	1	1	WONG, CLIFFORD MD	7/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68265	41	Internal Medicine	0	In state provider	None	1999 MOWRY AVE	STE R	FREMONT	CA	94538	1723	01	06001	37.55783419	-121.9808484	Alameda County
275653	Fee-for-Service	1912435173	1912435173	1	1	WEST COAST MEDICINE AND CARD	11/16/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	IOLOGY INC	3155 KEARNEY ST	100	FREMONT	CA	94538	2268	01	06001	37.5490951	-121.974815	Alameda County
275698	Fee-for-Service	1851650626	1851650626	1	1	WILTON CARE PHARMACY	12/26/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5660 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90028	6810	19	06037	34.10169452	-118.313298	Los Angeles County
275777	Fee-for-Service	1255408142	1255408142	1	1	WEISER, WILLIAM M MD	8/23/1995	204D00000X	NA	Other	026	PHYSICIANS	55245	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
275839	Fee-for-Service	1780621706	1780621706	1	1	WONG, CLIFFORD MD	7/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68265	45	Nephrology (Renal-Kidney)	0	In state provider	None	1999 MOWRY AVE	STE R	FREMONT	CA	94538	1723	01	06001	37.55783419	-121.9808484	Alameda County
275895	Fee-for-Service	1114112331	1114112331	1	1	WILLIAMS, MAGGIE A MD	11/14/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	96387	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
275906	Fee-for-Service	1912435173	1912435173	1	1	WEST COAST MEDICINE AND CARD	11/16/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	IOLOGY INC	3155 KEARNEY ST	100	FREMONT	CA	94538	2268	01	06001	37.5490951	-121.974815	Alameda County
275921	Fee-for-Service	1598965147	1598965147	1	1	WHITE, ERICKA B LCSW	11/29/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
275927	Fee-for-Service	1417969932	1417969932	2	1	WEIR, PAUL D MD	3/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	62412	None	None	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
275942	Fee-for-Service	1003034018	1003034018	2	1	WILSON-CELESTINE, LYSTRA B M	2/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140538	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 SIERRA COLLEGE DR	STE 120	GRASS VALLEY	CA	95945	5763	29	06057	39.23410746	-121.0515391	Nevada County
275965	Fee-for-Service	1235191966	1235191966	1	1	WARD, GARRETT G MD	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130944	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
275971	Fee-for-Service	1750711503	1750711503	1	1	WHITE, JEANNE B LMFT	4/27/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4675 VIA LOS SANTOS	None	SANTA BARBARA	CA	93111	1346	42	06083	34.4561269	-119.7851783	Santa Barbara County
275978	Fee-for-Service	1659844439	1659844439	1	1	WISH HOME HEALTH CARE INC	12/16/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	500 E OLIVE AVE	SUITE 670	BURBANK	CA	91501	2197	19	06037	34.1845331	-118.3048131	Los Angeles County
275991	Fee-for-Service	1285195560	1285195560	1	1	WHALEN, KRISTEN S MD	4/8/2025	208200000X	NA	General Surgery	026	PHYSICIANS	None	24	Plastic Surgery	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
275992	Fee-for-Service	1992201867	1992201867	1	1	WEITZNER, ZACHARY N MD	5/12/2020	2086S0120X	NA	General Surgery	026	PHYSICIANS	164774	85	Surgery-Pediatric	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
276013	Fee-for-Service	1104144328	1104144328	1	1	WINDSOR, CAROL E LMFT	7/30/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	40680 HIGHWAY 41	SUITE D	OAKHURST	CA	93644	9657	20	06039	37.33849833	-119.6445197	Madera County
276115	Fee-for-Service	1033174057	1033174057	1	1	WEXLER, LEWIS MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	7866	30	Radiology	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
276333	Fee-for-Service	1972620342	1972620342	1	2	WISMER, BARBARA A MD	3/3/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	77730	-	NOT APPLICABLE	0	In state provider	None	230 GOLDEN GATE AVE	None	SAN FRANCISCO	CA	94102	3706	38	06075	37.78184696	-122.4142203	San Francisco County
276334	Fee-for-Service	1871737270	1871737270	1	1	WARD, SHAN L MD	7/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121494	40	Pediatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
276337	Fee-for-Service	1548316185	1548316185	1	1	WHITE, RODNEY MD	2/18/2022	2086S0129X	NA	General Surgery	026	PHYSICIANS	29967	None	None	0	In state provider	None	21840 S NORMANDIE AVE	STE 100A	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
276361	Fee-for-Service	1831249630	1831249630	1	2	WATERS, CHRISTY S MD	7/31/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52864	-	NOT APPLICABLE	0	In state provider	None	2603 CAMINO RAMON	STE 200	SAN RAMON	CA	94583	9137	07	06013	37.76856551	-121.9609999	Contra Costa County
276362	Fee-for-Service	1487681375	1487681375	1	1	WECHSLER, ELENA MD	7/23/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	149276	None	None	0	In state provider	None	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
276398	Fee-for-Service	1093777575	1093777575	1	1	WU, SANDY SHUHENG	10/29/1995	207ZC0500X	NA	Other	026	PHYSICIANS	82024	None	None	0	In state provider	None	17821 PIONEER BLVD	None	ARTESIA	CA	90701	3901	19	06037	33.8691791	-118.0823685	Los Angeles County
276429	Fee-for-Service	1558571323	1558571323	1	1	WEBER, KEVIN MD	1/7/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
276436	Fee-for-Service	1548331432	1548331432	1	1	WENZEL, STEVEN DEAN MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	63717	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
276448	Fee-for-Service	1891842548	1891842548	1	1	WELSH, CLARK T OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1635 DIVISADERO STREET	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
276492	Fee-for-Service	1669545513	1669545513	1	1	WANG, HOJIN P MD	10/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90764	None	None	0	In state provider	None	6760 N WEST AVE	STE 101	FRESNO	CA	93711	1396	10	06019	36.83680611	-119.8262508	Fresno County
276499	Fee-for-Service	1467466896	1467466896	1	1	WALGREEN CO	4/5/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19266 SOLEDAD CYN	None	SANTA CLARITA	CA	91351	3366	19	06037	34.41569352	-118.4717205	Los Angeles County
276529	Fee-for-Service	1801918743	1801918743	1	1	WOODBRIDGE MEDICAL GROUP	7/1/1994	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	2401 W TURNER RD	STE 450	LODI	CA	95242	2191	39	06077	38.14565233	-121.3055371	San Joaquin County
276540	Fee-for-Service	1982726329	1982726329	1	1	WILSON, LARA J LMFT	10/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 HUMBOLDT RD	SUITE 3	CHICO	CA	95928	8100	04	06007	39.73660489	-121.8115227	Butte County
276543	Fee-for-Service	1649342122	1649342122	1	1	WANG, THOMAS W MD	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85927	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
276553	Fee-for-Service	1659682714	1659682714	1	1	WIDDISON, JULIE MD	4/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3269 STOCKTON HILL ROAD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
276584	Fee-for-Service	1699955401	1699955401	1	1	WOLSEY,GILMAN MD	2/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	19829 N 27TH AVE	None	PHOENIX	AZ	85027	0000	00	None	33.665616	-112.116267	Maricopa County
276716	Fee-for-Service	1942590161	1942590161	1	1	WONG, STEPHANIE A MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142626	None	None	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
276729	Fee-for-Service	1265628622	1265628622	1	1	WAIT, CECILY L MD	7/5/2024	207R00000X	NA	Other	026	PHYSICIANS	119745	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
276733	Fee-for-Service	1558623371	1558623371	1	1	WOOMING, MICHAEL A MD	5/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	68371	01	General Practice	0	In state provider	None	380 W BADILLO ST	None	COVINA	CA	91723	1827	19	06037	34.0862457	-117.8963889	Los Angeles County
276745	Fee-for-Service	1619960457	1619960457	1	1	WILSON, HAROLD T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1638 OWEN DR	None	FAYETTEVILLE	NC	28304	3424	00	None	35.032329	-78.933186	Cumberland County
276854	Fee-for-Service	1194855510	1194855510	1	1	WU, TONY PHD	11/9/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	556 N DIAMOND BAR BLVD	307	DIAMOND BAR	CA	91765	4337	19	06037	34.0303603	-117.8097325	Los Angeles County
276875	Fee-for-Service	1487803623	1487803623	1	1	WIMETT, MARIE C NP	7/2/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3838 CALIFORNIA ST .	SUITE 805	SAN FRANCISCO	CA	94118	1510	38	06075	37.78591809	-122.4575439	San Francisco County
276910	Fee-for-Service	1649239294	1649239294	1	1	WIRTHWEIN, DARREN P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1125 GROVE ST	None	LOUDON	TN	37774	3251	00	None	35.73331941	-84.33434025	Loudon County
276916	Fee-for-Service	1316051998	1316051998	1	1	WISLER, THOMAS L MD	10/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27306	01	General Practice	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
276943	Fee-for-Service	1215203153	1215203153	1	1	WIERZBA, JULIE P OT	7/5/2020	225XP0019X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4131 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3101	38	06075	37.78096053	-122.4637512	San Francisco County
276987	Fee-for-Service	1356875157	1356875157	1	1	WILL FAMILY MEDICAL GROUP, A	10/24/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	PROFESSIONAL CORPORATIO	42575 WASHINGTON ST	None	PALM DESERT	CA	92211	8850	33	06065	33.739767	-116.3039465	Riverside County
277017	Fee-for-Service	1588689715	1588689715	1	1	WALSH, ERIC G JR MD	11/7/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	77058	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 204	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
277019	Fee-for-Service	1851635759	1851635759	1	1	WALGREEN CO	2/8/2013	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1620 FIRST ST	None	LIVERMORE	CA	94550	4363	01	06001	37.67959685	-121.7758608	Alameda County
277022	Fee-for-Service	1396717666	1396717666	1	1	WRUBLE, JILL DO	11/30/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	19173	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
277062	Fee-for-Service	1639695430	1639695430	1	1	WASHINGTON, DEZHA LCSW	8/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17000 S. HARLAN RD	None	LATHROP	CA	95330	8738	39	06077	37.80929182	-121.2956055	San Joaquin County
277073	Fee-for-Service	1710148861	1710148861	1	1	WU, JONATHAN A MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	109008	34	Urology and Urological Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
277130	Fee-for-Service	1831110071	1831110071	1	1	WANG, DORA L MD	7/15/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72211	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
277226	Fee-for-Service	1356089502	1356089502	1	1	WANG, LINA NP	4/25/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
277233	Fee-for-Service	1093881039	1093881039	1	1	WETHEY, MARTHA S LMFT	11/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1740 PLUM LN	STE B	REDLANDS	CA	92374	0109	36	06071	34.06899169	-117.2145582	San Bernardino County
277347	Fee-for-Service	1205815917	1205815917	1	1	WAGNER, BRIAN L MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91417	05	Anesthesiology	0	In state provider	None	3939 J ST	STE 310	SACRAMENTO	CA	95819	3666	34	06067	38.570211	-121.45374	Sacramento County
277379	Fee-for-Service	1821514332	1821514332	1	2	WELLBEINGS FAMILY THERAPY, I	4/13/2021	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2627 MISSION ST	None	SAN MARINO	CA	91108	1639	19	06037	34.11619262	-118.1375031	Los Angeles County
277395	Fee-for-Service	1598139289	1598139289	1	1	WANG, SI MD	10/16/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	177334	None	None	0	In state provider	None	501 J ST	None	SACRAMENTO	CA	95814	2325	34	06067	38.582118	-121.499325	Sacramento County
277471	Fee-for-Service	1801138763	1801138763	1	1	WYNEKEN, LISA M LCSW	2/6/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7851 MISSION CENTER CT	SUITE 110	SAN DIEGO	CA	92108	1326	37	06073	32.77338451	-117.1554925	San Diego County
277474	Fee-for-Service	1801224043	1801224043	1	1	WHITLEY, KATHERINE E NP	6/27/2019	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
277491	Fee-for-Service	1073605580	1073605580	1	1	WU, KE MD	8/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87671	41	Internal Medicine	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
277492	Fee-for-Service	1730423914	1730423914	1	2	WILLIAMS, PAMELA	5/31/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
277509	Fee-for-Service	1194105668	1194105668	1	1	WILLIAMS, STEPHANIE A MD	4/19/2022	207R00000X	NA	Other	026	PHYSICIANS	174952	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
277559	Fee-for-Service	1942736509	1942736509	1	1	WICHIANSON, JATTURONG R MD	8/23/2021	207L00000X	NA	Other	026	PHYSICIANS	160092	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
277569	Fee-for-Service	1780034678	1780034678	1	1	WORGUL, CHRISTOPHER A MD	8/7/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
277596	Fee-for-Service	1598260598	1598260598	1	1	WU, EUREKA DO	9/23/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19081	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
277624	Fee-for-Service	1821514332	1821514332	1	2	WELLBEINGS FAMILY THERAPY, I	4/13/2021	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2627 MISSION ST	None	SAN MARINO	CA	91108	1639	19	06037	34.11619262	-118.1375031	Los Angeles County
277632	Fee-for-Service	1295969855	1295969855	1	1	WATTS, ROBERT E MD	9/11/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171646	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
277825	Fee-for-Service	1528049996	1528049996	1	1	WATANABE, MITCHELL Y MD	3/1/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	44130	08	Family Practice	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
277842	Fee-for-Service	1710061262	1710061262	1	1	WINKLER, VICKIE L MD	11/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	61979	08	Family Practice	0	In state provider	None	115 LOCUST ST	None	SANTA CRUZ	CA	95060	3549	44	06087	36.97519309	-122.027024	Santa Cruz County
277908	Fee-for-Service	1417982695	1417982695	1	1	WEBBER, PAUL M MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91420	None	None	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
277997	Fee-for-Service	1922057918	1922057918	1	1	WOODHOUSE, EMMA S MD	3/24/2008	174400000X	NA	Other	026	PHYSICIANS	85064	20	Orthopedic Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
278073	Fee-for-Service	1306820410	1306820410	1	1	WILSHIRE LA JOLLA	5/10/2005	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY, INC	6360 WILSHIRE BLVD	LBBY	LOS ANGELES	CA	90048	5605	19	06037	34.06363617	-118.3676811	Los Angeles County
278121	Fee-for-Service	1013117654	1013117654	1	1	WONG, KARYN A	4/5/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
278138	Fee-for-Service	1578555058	1578555058	1	1	WRIGHT, STANLEY B MD	7/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72738	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	5301 F ST	STE 313	SACRAMENTO	CA	95819	3222	34	06067	38.571354	-121.4368695	Sacramento County
278151	Fee-for-Service	1306227392	1306227392	1	1	WAI, PATRICIA OD	12/3/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12721 MORENO BEACH DR	None	MORENO VALLEY	CA	92555	4411	33	06065	33.935742	-117.1819035	Riverside County
278177	Fee-for-Service	1699134965	1699134965	1	1	WENDY WONG, PLASTIC SURGERY	4/5/2018	208200000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	910 MAJOR SHERMAN LN	305	MONTEREY	CA	93940	4642	27	06053	36.59263528	-121.8922329	Monterey County
278191	Fee-for-Service	1700906641	1700906641	1	1	WU AND PAN MEDICAL ASSOC	12/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1740 FRUITRIDGE RD	None	SACRAMENTO	CA	95822	3037	34	06067	38.524374	-121.498542	Sacramento County
278195	Fee-for-Service	1073900163	1073900163	1	1	WONG, MORGAN DO	5/19/2022	207R00000X	NA	Other	026	PHYSICIANS	19361	None	None	0	In state provider	None	2331 MONTPELIER DRIVE	B	SAN JOSE	CA	95116	1673	43	06085	37.3649965	-121.8479359	Santa Clara County
278222	Fee-for-Service	1013958305	1013958305	1	1	WHITE, JEFFREY D MD	4/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	59992	05	Anesthesiology	0	In state provider	None	CASTRO & DUBOCE	None	SAN FRANCISCO	CA	94114	0000	38	06075	37.769049	-122.43582	San Francisco County
278242	Fee-for-Service	1801486600	1801486600	1	1	WEST COAST BONE HEALTH & WEL	9/8/2021	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LNESS CENTER	400 CAMARILLO RANCH RD	SUITE 101	CAMARILLO	CA	93012	5901	56	06111	34.220943	-119.0186825	Ventura County
278261	Fee-for-Service	1396273785	1396273785	1	1	WERTZ, BRITTANY F DO	11/12/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17144	None	None	0	In state provider	None	4959 PALO VERDE ST	SUITE 206A-5	MONTCLAIR	CA	91763	2342	36	06071	34.08129954	-117.6966135	San Bernardino County
278280	Fee-for-Service	1518132059	1518132059	1	1	WISE, BARTON L MD	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105770	83	Rheumatology	0	In state provider	None	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	34	06067	38.546127	-121.452669	Sacramento County
278295	Fee-for-Service	1699865741	1699865741	1	2	WONG, KELLY K	12/8/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	65226	40	Pediatrics	0	In state provider	None	728 PACIFIC AVE	703	SAN FRANCISCO	CA	94133	4457	38	06075	37.79687859	-122.4074282	San Francisco County
278318	Fee-for-Service	1932455979	1932455979	1	1	WALGREEN CO	12/3/2012	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	918 E FOOTHILL BLVD	None	RIALTO	CA	92376	5366	36	06071	34.10679947	-117.352134	San Bernardino County
278327	Fee-for-Service	1528281201	1528281201	1	1	WOMENS DIAGNOSTIC IMAGING	5/11/2010	261QR0206X	NA	Other	026	PHYSICIANS	29996	30	Radiology	0	In state provider	INC	333 S FAIR OAKS AVE	None	PASADENA	CA	91105	2541	19	06037	34.14000379	-118.1504517	Los Angeles County
278439	Fee-for-Service	1306863626	1306863626	1	1	WAL-MART STORES, INC	7/9/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101988	900 PLEASANT GROVE BLVD	None	ROSEVILLE	CA	95678	6126	31	06061	38.787921	-121.28976	Placer County
278444	Fee-for-Service	1093032641	1093032641	1	1	WILLIAMSON, BLAKE D LPCC	1/18/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
278482	Fee-for-Service	1891830170	1891830170	1	1	WHANG, TOM MD	8/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85964	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
278483	Fee-for-Service	1518985340	1518985340	1	1	WATSONVILLE PHARMACY,INC	9/1/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WATSONVILLE PHARMACY,INC	1433 FREEDOM BLVD	None	WATSONVILLE	CA	95076	2742	44	06087	36.92715888	-121.7653179	Santa Cruz County
278488	Fee-for-Service	1255490983	1255490983	1	1	WESNER, CAROL J CRNA	7/22/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
278519	Fee-for-Service	1518132059	1518132059	1	1	WISE, BARTON L MD	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105770	41	Internal Medicine	0	In state provider	None	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	34	06067	38.546127	-121.452669	Sacramento County
278540	Fee-for-Service	1891861217	1891861217	1	1	WONG, WEBSTER A MD	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77277	40	Pediatrics	0	In state provider	None	1711 ORANGE ST	None	REDLANDS	CA	92374	2254	36	06071	34.0796409	-117.1824145	San Bernardino County
278593	Fee-for-Service	1164983029	1164983029	1	1	WILKIE, ALEX C CRNA	11/24/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
278595	Fee-for-Service	1700448925	1700448925	1	2	WILLIAM Y. TO, O.D., INC	10/13/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ON	6000 BOLLINGER CANYON	STE 1104	SAN RAMON	CA	94583	2305	07	06013	37.76211845	-121.9586206	Contra Costa County
278653	Fee-for-Service	1609211978	1609211978	1	1	WEISER, ROCHELLE M LCSW	11/5/2018	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12630 STANTON AVE	None	TUSTIN	CA	92782	1027	30	06059	33.741759	-117.790853	Orange County
278662	Fee-for-Service	1306972534	1306972534	1	1	WONG, JAMIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3181 SW SAM JACKSON PARK	None	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
278688	Fee-for-Service	1942216346	1942216346	1	1	WALGREEN CO	3/13/1995	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 WEBSTER ST	STE 105	SAN FRANCISCO	CA	94115	2374	38	06075	37.7904826	-122.4324477	San Francisco County
278718	Fee-for-Service	1588729214	1588729214	1	1	WOLPE, ALLAN MD INC	9/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	45800	47	Miscellaneous	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
278727	Fee-for-Service	1255393435	1255393435	1	1	WESTERN LABS MED GRP	2/28/1986	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
278770	Fee-for-Service	1699780924	1699780924	1	1	WALGREEN CO	9/18/1986	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2494 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1526	38	06075	37.73017275	-122.4047033	San Francisco County
278819	Fee-for-Service	1902844160	1902844160	1	1	WEISS, RHONDA A MD	6/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	80458	25	Physical Medicine and Rehabilitation	0	In state provider	None	2885 KAISER DRIVE	None	SANTA CLARA	CA	95051	5061	43	06085	37.34192094	-121.9780412	Santa Clara County
278836	Fee-for-Service	1144396219	1144396219	1	1	WALPOLE, SARA L LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
278897	Fee-for-Service	1427684349	1427684349	1	1	WALLS-SMITH, LUKE T MD	7/1/2023	207P00000X	NA	Other	026	PHYSICIANS	183954	None	None	0	In state provider	None	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
278942	Fee-for-Service	1578656799	1578656799	1	1	WASHKOWIAK, KIM A MD	9/11/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	81183	None	None	0	In state provider	None	9850 GENESEE AVE	STE 600	LA JOLLA	CA	92037	1207	37	06073	32.882913	-117.226341	San Diego County
278946	Fee-for-Service	1255313417	1255313417	1	1	WESTENFIELD, ALEX M MD	7/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143714	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
278949	Fee-for-Service	1831391028	1831391028	1	1	WANG, ANTHONY C MD	7/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143353	14	Neurological Surgery	0	In state provider	None	300 STEIN PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
278952	Fee-for-Service	1588729214	1588729214	1	1	WOLPE, ALLAN MD INC	9/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	45800	40	Pediatrics	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
278955	Fee-for-Service	1215927470	1215927470	1	1	WHITE MEMORIAL MED CTR	12/1/1979	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2481	19	06037	34.04925	-118.2177405	Los Angeles County
279000	Fee-for-Service	1427510866	1427510866	1	1	WU, TRUDY C MD	4/10/2024	2085R0001X	NA	Other	026	PHYSICIANS	181029	30	Radiology	0	In state provider	None	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
279011	Fee-for-Service	1134114382	1134114382	1	1	WIELAND, MARK RALPH MD	8/31/1989	207W00000X	NA	Ophthalmology	026	PHYSICIANS	48482	18	Ophthalmology	0	In state provider	None	50 S SAN MATEO DR	None	SAN MATEO	CA	94401	3857	41	06081	37.56634141	-122.3261145	San Mateo County
279092	Fee-for-Service	1770279630	1770279630	1	1	WENDT, ELIZA B PT	10/24/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11750 SORRENTO VALLEY	STE 130	SAN DIEGO	CA	92121	1019	37	06073	32.91461387	-117.2343576	San Diego County
279138	Fee-for-Service	1497293070	1497293070	1	1	WINDSOR ARVIN HEALTHCARE, LL	10/14/2020	314000000X	NA	Skilled Nursing Facility	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	ARVIN	323 CAMPUS DRIVE	None	ARVIN	CA	93203	1047	15	06029	35.21223449	-118.833295	Kern County
279146	Fee-for-Service	1952043689	1952043689	1	1	WAGNER, JORDAN CRNA	7/10/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1117 E DEVONSHIRE AVE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
279191	Fee-for-Service	1215927470	1215927470	1	1	WHITE MEMORIAL MED CTR	1/1/1995	282N00000X	NA	Hospitals	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2481	19	06037	34.04925	-118.2177405	Los Angeles County
279194	Fee-for-Service	1972598910	1972598910	1	1	WANG-CHEN, CONNIE K OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2425 EAST ST	STE 4	CONCORD	CA	94520	1925	07	06013	37.98269056	-122.0340837	Contra Costa County
279201	Fee-for-Service	1285799288	1285799288	1	1	WINTERS, STANLEY D LMFT	9/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2829 WATT AVENUE	None	SACRAMENTO	CA	95821	6237	34	06067	38.615247	-121.383558	Sacramento County
279226	Fee-for-Service	1730614215	1730614215	1	1	WEI, MAGGIE MD	1/20/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	177672	None	None	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
279258	Fee-for-Service	1548213838	1548213838	1	1	WAN, LIJUN MD	5/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80359	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
279300	Fee-for-Service	1932542701	1932542701	1	1	WALKER, KYLE MD	9/29/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	187384	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
279338	Fee-for-Service	1124011457	1124011457	1	1	WASSER, LARRY MD	8/30/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	175141	None	None	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
279357	Fee-for-Service	1043486863	1043486863	1	1	WONG, YU MD	9/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	84001	03	Allergy	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
279397	Fee-for-Service	1396109864	1396109864	1	1	WEI, HUIXIA MD	9/16/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	160879	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
279529	Fee-for-Service	1104808161	1104808161	1	1	WONG, ERIC J MD	11/30/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	75361	40	Pediatrics	0	In state provider	None	15464 GOLDENWEST ST	None	WESTMINSTER	CA	92683	6149	30	06059	33.73784708	-118.0068331	Orange County
279537	Fee-for-Service	1124582754	1124582754	1	1	WHANG, MOONKYOUNG LAC	3/1/2021	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	URE CLINIC	341 EAST CENTER STREET	None	ANAHEIM	CA	92805	3263	30	06059	33.83613488	-117.9106873	Orange County
279589	Fee-for-Service	1700100906	1700100906	1	1	WEISS, JAMIE M MD	4/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111783	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3737 MARTIN LUTHER KING	JR BLVD STE 401	LYNWOOD	CA	90262	3534	19	06037	33.92872742	-118.2006921	Los Angeles County
279612	Fee-for-Service	1144625823	1144625823	1	2	WON, LUKE DPM	10/28/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	425 W BONITA AVE	SUITE 110	SAN DIMAS	CA	91773	2543	19	06037	34.10669347	-117.814932	Los Angeles County
279626	Fee-for-Service	1346315355	1346315355	1	1	WILKES, J THOMAS MD	10/30/1973	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	13654	08	Family Practice	0	In state provider	None	635 ANDERSON RD	STE 2	DAVIS	CA	95616	3505	57	06113	38.5487623	-121.7587554	Yolo County
279631	Fee-for-Service	1073048963	1073048963	1	1	WIDDER, JARED R DO	4/19/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	16655	None	None	0	In state provider	None	100 STEIN PLZ	None	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
279668	Fee-for-Service	1568469781	1568469781	1	1	WARNER, KIM MD	8/31/1992	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	72315	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1701 BROOKLYN AVE	STE 200	LOS ANGELES	CA	90033	2464	19	06037	34.040502	-118.191954	Los Angeles County
279736	Fee-for-Service	1497803332	1497803332	1	1	WONG, BRIAN A MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84866	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
279816	Fee-for-Service	1992836472	1992836472	1	1	WARREN, WENDY A MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	2801 DAGGETT AVENUE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25271647	-121.787181	Klamath County
279822	Fee-for-Service	1669706453	1669706453	1	1	WU, PEI-CHI DO	3/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	10934	01	General Practice	0	In state provider	None	2020 S BREA CANYON RD	STE A1	DIAMOND BAR	CA	91765	4012	19	06037	33.9852146	-117.8449156	Los Angeles County
279823	Fee-for-Service	1033144423	1033144423	1	1	WINSTON, GARY A MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30331	40	Pediatrics	0	In state provider	None	1075 1ST ST	STE 1	BENICIA	CA	94510	3200	48	06095	38.05286006	-122.1563776	Solano County
279894	Fee-for-Service	1417327297	1417327297	1	1	WERTZ, CORINNE E NP	12/4/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
279905	Fee-for-Service	1508944380	1508944380	1	1	WEINERT, MELVIN A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23325	01	General Practice	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
279907	Fee-for-Service	1073908976	1073908976	1	1	WA, CHRISTIANNE A MD	2/16/2021	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	144991	None	None	0	In state provider	None	5775 GREENBACK LANE	None	SACRAMENTO	CA	95841	2013	34	06067	38.682747	-121.327506	Sacramento County
279913	Fee-for-Service	1235591413	1235591413	1	1	WOLFINBARGER, SHANNON K CNM	3/15/2022	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
279999	Fee-for-Service	1790734192	1790734192	1	1	WHANG, WILLIAM W MD	8/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81829	20	Orthopedic Surgery	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
280008	Fee-for-Service	1285991430	1285991430	1	1	WONG, ANTHONY C MD	7/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150048	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
280019	Fee-for-Service	1700954708	1700954708	1	1	WOODARD, ERIC K MD	12/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73557	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
280028	Fee-for-Service	1679991699	1679991699	1	1	WANG, STEPHANI C MD	9/15/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	160866	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
280080	Fee-for-Service	1518201771	1518201771	1	1	WELCH, ANTHONY D DO	2/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6900 N DURANGO DR	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
280131	Fee-for-Service	1508944380	1508944380	1	1	WEINERT, MELVIN A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23325	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
280148	Fee-for-Service	1578229894	1578229894	1	1	WEIDANZ, CHRISTIANA LCSW	1/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
280159	Fee-for-Service	1801128343	1801128343	1	1	WINKLER, IRENE M S	7/6/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2835 S BRISTOL ST	SUITE B	SANTA ANA	CA	92704	6238	30	06059	33.70905039	-117.885413	Orange County
280163	Fee-for-Service	1457763518	1457763518	1	1	WADDLE, HEATHER LCSW	3/7/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
280239	Fee-for-Service	1437442308	1437442308	1	1	WALTERS, KRISTEN M MD	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129955	03	Allergy	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
280265	Fee-for-Service	1144598970	1144598970	1	1	WEIR, SIERRA D CCC-SLP	3/30/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3220 SACRAMENTO STREET	None	BERKELEY	CA	94702	2726	01	06001	37.84916151	-122.2781457	Alameda County
280274	Fee-for-Service	1669903126	1669903126	1	1	WERNE, ALEXANDER L MD	6/1/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160064	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
280346	Fee-for-Service	1497833420	1497833420	1	1	WALI, SOMA MD	2/22/2022	207R00000X	NA	Other	026	PHYSICIANS	60030	None	None	0	In state provider	None	27235 TOURNEY	2500	VALENCIA	CA	91355	5908	19	06037	34.41755702	-118.5772646	Los Angeles County
280430	Fee-for-Service	1730114968	1730114968	1	1	WATSON, TIMOTHY D MD	5/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79382	40	Pediatrics	0	In state provider	None	6926 BROCKTON AVE	STE 6	RIVERSIDE	CA	92506	3804	33	06065	33.947919	-117.3967225	Riverside County
280437	Fee-for-Service	1679755045	1679755045	1	1	WASSON, ELIZABETH MD	7/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126381	41	Internal Medicine	0	In state provider	None	465 W PUTNAM ST	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
280443	Fee-for-Service	1710998638	1710998638	1	1	WU, WENCHAO MD	2/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53789	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3630 EAST IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
280463	Fee-for-Service	1437442308	1437442308	1	1	WALTERS, KRISTEN M MD	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129955	41	Internal Medicine	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
280516	Fee-for-Service	1992956700	1992956700	1	1	WALGREEN CO.	12/4/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	#13434	640 UNIVERSITY AVE.	None	SAN DIEGO	CA	92103	3213	37	06073	32.74837353	-117.15894	San Diego County
280536	Fee-for-Service	1376552240	1376552240	1	1	WANG, ZHENG MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53823	05	Anesthesiology	0	In state provider	WANG, ZHENG MD INC	500 S MAIN ST	STE 1210	ORANGE	CA	92868	4556	30	06059	33.77991974	-117.8674745	Orange County
280546	Fee-for-Service	1679591614	1679591614	1	1	WENG, HAOLING MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87724	83	Rheumatology	0	In state provider	None	200 MED PLAZA	#365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
280563	Fee-for-Service	1316972201	1316972201	1	1	WONG, DAVID J	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84286	None	None	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
280590	Fee-for-Service	1124204920	1124204920	1	1	WHITCOMB, ROBERT L PSYD	2/2/2017	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	213 N POMONA AVE	None	FULLERTON	CA	92832	1926	30	06059	33.87195218	-117.9221152	Orange County
280594	Fee-for-Service	1346346616	1346346616	1	1	WAN, CHOK P MD	2/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	67228	41	Internal Medicine	0	In state provider	None	2153 PACIFIC AVE	None	LONG BEACH	CA	90806	4513	19	06037	33.796332	-118.1937995	Los Angeles County
280604	Fee-for-Service	1336523299	1336523299	1	1	WONG, MAGGIE M LMFT	5/31/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
280607	Fee-for-Service	1508816596	1508816596	1	1	WATTERS, THOMAS A MD	10/31/1988	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	50566	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	157 2ND AVE	None	SAN MATEO	CA	94401	3801	41	06081	37.56545786	-122.3244504	San Mateo County
280625	Fee-for-Service	1205165461	1205165461	1	1	WINDER-PATEL, BREANNA PHD	9/22/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
280658	Fee-for-Service	1790928810	1790928810	1	1	WALGREEN CO	6/9/2009	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10787 CAMINO RUIZ	None	SAN DIEGO	CA	92126	2304	37	06073	32.91489	-117.1438035	San Diego County
280831	Fee-for-Service	1003476508	1003476508	1	1	WILLIAM D. MOSIER MD INC	8/1/2023	193400000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	265 LAGUNA RD	None	FULLERTON	CA	92835	2515	30	06059	33.89613386	-117.9305457	Orange County
280844	Fee-for-Service	1760708796	1760708796	1	1	WANG, JOHN J MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118140	05	Anesthesiology	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
280849	Fee-for-Service	1124080544	1124080544	1	1	WARREN, LISA M DO	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11796	40	Pediatrics	0	In state provider	None	795 E SECOND ST	STE 5	POMONA	CA	91766	2007	19	06037	34.05845654	-117.7423951	Los Angeles County
280866	Fee-for-Service	1508817115	1508817115	1	1	WASHINGTON TOWNSHIP HOSPITAL	7/15/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	DEVELOPMENT CORPORATION	39101 CIVIC CENTER DR	None	FREMONT	CA	94538	5817	01	06001	37.55467054	-121.9770646	Alameda County
280870	Fee-for-Service	1972520385	1972520385	1	1	WALMART INC.	8/29/1994	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	29260 CENTRAL AVE	None	LAKE ELSINORE	CA	92532	2232	33	06065	33.69463178	-117.3345917	Riverside County
280879	Fee-for-Service	1861409815	1861409815	1	1	WILLIAMS, KEVIN MD	6/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	UNM MEDICAL GROUP INC	2211 LOMAS BLVD NE	MSC10 5530	ALBUQUERQUE	NM	87131	2745	00	None	35.08771808	-106.6192188	Bernalillo County
280884	Fee-for-Service	1215560461	1215560461	1	1	WARREN, JENNIFER M CNP	7/14/2020	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
280990	Fee-for-Service	1215031265	1215031265	2	1	WT HEALTHCARE INC	9/6/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	103 N. GARFIELD AVE	SUITE D	ALHAMBRA	CA	91801	3555	19	06037	34.0961716	-118.1275921	Los Angeles County
281103	Fee-for-Service	1023057833	1023057833	1	1	WEEKES, ARNOLD A MD	3/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88042	05	Anesthesiology	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	07	06013	37.98252	-121.8030615	Contra Costa County
281186	Fee-for-Service	1962493551	1962493551	2	1	WISEMAN, CHARLES L MD	8/5/2013	207RX0202X	NA	Oncology	026	PHYSICIANS	24132	68	Hematology	0	In state provider	None	8900 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	1958	19	06037	34.06703955	-118.3859235	Los Angeles County
281281	Fee-for-Service	1629262647	1629262647	1	1	WIN, HLA MD	10/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92904	67	Endocrinology	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
281329	Fee-for-Service	1952823841	1952823841	1	1	WHOLE HEALTH WEIGHT LOSS INS	8/18/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	TITUTE	1300 MAIN ST.	SUITE#200	NAPA	CA	94559	1905	28	06055	38.30170603	-122.2874874	Napa County
281370	Fee-for-Service	1629023999	1629023999	1	1	WAI, ALEXANDER C MD	9/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92505	30	Radiology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
281404	Fee-for-Service	1962493551	1962493551	2	1	WISEMAN, CHARLES L MD	8/5/2013	207RX0202X	NA	Oncology	026	PHYSICIANS	24132	48	Unknown	0	In state provider	None	8900 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	1958	19	06037	34.06703955	-118.3859235	Los Angeles County
281444	Fee-for-Service	1942353263	1942353263	1	1	WU, SHELLY M OD	4/15/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 COTTAGE AVE	STE 102	MANTECA	CA	95355	3359	39	06077	37.79956104	-121.1982472	San Joaquin County
281462	Fee-for-Service	1922491596	1922491596	1	1	WOJTANOWICZ, TODD MD	10/3/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	158817	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
281482	Fee-for-Service	1184202665	1184202665	1	1	WHITE, JOSHUA MD	9/5/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
281496	Fee-for-Service	1629262647	1629262647	1	1	WIN, HLA MD	10/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92904	41	Internal Medicine	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
281566	Fee-for-Service	1992951453	1992951453	1	1	WHITT, VIDETH E MD	2/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	111482	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
281588	Fee-for-Service	1194828707	1194828707	1	1	WU, PELEN MD	1/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75735	40	Pediatrics	0	In state provider	None	4 COUNTRY CLUB PLAZA	None	ORINDA	CA	94563	2308	07	06013	37.88568235	-122.1926427	Contra Costa County
281593	Fee-for-Service	1912321944	1912321944	1	1	WHITE ROSE HOSPICE INC	2/14/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	16200 VENTURA BLVD	STE 202	ENCINO	CA	91436	2205	19	06037	34.15659457	-118.485532	Los Angeles County
281632	Fee-for-Service	1437410966	1437410966	1	1	WYBORNY, TESSA M MD	9/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137750	40	Pediatrics	0	In state provider	None	1141 PEAR TREE LANE	None	NAPA	CA	94558	6484	28	06055	38.32125908	-122.2921523	Napa County
281646	Fee-for-Service	1558467522	1558467522	1	1	WOLGAST, JOHANNA M MD	5/11/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	71643	08	Family Practice	0	In state provider	None	1400 MEDICAL CENTER DR	None	ROHNERT PARK	CA	94928	2924	49	06097	38.34761053	-122.682654	Sonoma County
281661	Fee-for-Service	1013934355	1013934355	1	1	WAL-MART STORES INC	6/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-2735	4420 FLORIN RD	None	SACRAMENTO	CA	95823	2512	34	06067	38.494764	-121.454901	Sacramento County
281665	Fee-for-Service	1700857422	1700857422	1	1	WILLEN, GARY F MD	6/1/1986	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	53304	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	TAHOE WOMEN'S CARE	PO BOX 8439	None	SOUTH LAKE TAHOE	CA	96158	1439	09	06017	0	0	None
281678	Fee-for-Service	1194284992	1194284992	1	1	WONG, CHRISTINE MD	11/17/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	179147	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
281704	Fee-for-Service	1295723708	1295723708	1	1	WITTMAN, MARK H MD	3/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	45108	05	Anesthesiology	0	In state provider	None	5900 W OLYMPIC BOULEVARD	None	LOS ANGELES	CA	90036	4671	19	06037	34.05760692	-118.3604361	Los Angeles County
281783	Fee-for-Service	1083825624	1083825624	1	1	WONG, TIN-CHEU MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	56514	18	Ophthalmology	0	In state provider	None	420 N GARFIELD AVE	STE 208	MONTEREY PARK	CA	91754	1206	19	06037	34.0670077	-118.1228585	Los Angeles County
281808	Fee-for-Service	1912321944	1912321944	1	1	WHITE ROSE HOSPICE INC	2/14/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	16200 VENTURA BLVD	STE 202	ENCINO	CA	91436	2205	19	06037	34.15659457	-118.485532	Los Angeles County
281843	Fee-for-Service	1578099362	1578099362	1	1	WAITE, JENNIFER DO	12/18/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18430	None	None	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
281853	Fee-for-Service	1831267954	1831267954	1	1	WINFIELD, KATHY S	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
281891	Fee-for-Service	1083638332	1083638332	1	1	WEST, NANCY L MD	2/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	55309	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1530 RAILROAD AVE	None	SAINT HELENA	CA	94574	1106	28	06055	38.50733846	-122.4714652	Napa County
281904	Fee-for-Service	1629297734	1629297734	1	1	WALGREEN CO	10/16/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1065 S FORTUNA BLVD	None	FORTUNA	CA	95540	3010	12	06023	40.579398	-124.1466635	Humboldt County
281937	Fee-for-Service	1760643514	1760643514	1	1	WONG, YU-TUNG MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126098	04	Otology, Laryngology, Rhinology	0	In state provider	None	8635 W 3RD STREET	None	LOS ANGELES	CA	90048	6163	19	06037	34.07361928	-118.3803143	Los Angeles County
282041	Fee-for-Service	1417989344	1417989344	1	1	WEAVER, FRED A MD	1/31/1988	208600000X	NA	General Surgery	026	PHYSICIANS	57487	02	General Surgery	0	In state provider	None	2250 ALCAZAR ST	STE 107	LOS ANGELES	CA	90089	0274	19	06037	34.06313563	-118.1997071	Los Angeles County
282093	Fee-for-Service	1376626226	1376626226	1	1	WALNUT CREEK SURGICAL	10/23/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	ASSOCIATES INC	130 LA CASA VIA BLDG 3	STE 211	WALNUT CREEK	CA	94598	3405	07	06013	37.91170205	-122.0412378	Contra Costa County
282110	Fee-for-Service	1215100557	1215100557	1	1	WAHL, ELIZABETH R MD	10/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	127339	83	Rheumatology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
282116	Fee-for-Service	1770727802	1770727802	1	1	WALTER, MELISSA R LMFT	2/24/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
282158	Fee-for-Service	1205984135	1205984135	1	1	WAYDEMAN, HENRY B MD	10/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37693	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
282270	Fee-for-Service	1720094378	1720094378	1	1	WALGREEN CO	6/16/1999	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2145 MARKET ST	None	SAN FRANCISCO	CA	94114	1321	38	06075	37.76677904	-122.4297101	San Francisco County
282335	Fee-for-Service	1336896232	1336896232	1	1	WEISS, JENNIFER J	5/25/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
282360	Fee-for-Service	1831106491	1831106491	1	1	WOO, DERRICK E OD	11/23/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5532 WOODRUFF AVE	None	LAKEWOOD	CA	90713	1535	19	06037	33.857928	-118.1170415	Los Angeles County
282361	Fee-for-Service	1013190693	1013190693	1	1	WILD, YVETTE K MD	7/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102785	10	Gastroenterology (M.D. only)	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
282372	Fee-for-Service	1508444852	1508444852	1	1	WACHUKU, CHINENYE DPM	7/26/2024	213ES0131X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	16405 SAND CANYON AVE	STE 270	IRVINE	CA	92618	3792	30	06059	33.66098519	-117.7747816	Orange County
282386	Fee-for-Service	1417071317	1417071317	1	1	WOLTER, MARJORIE N LVN	1/17/2005	164X00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	840 W SIMPSON AVE	None	FRESNO	CA	93705	4041	10	06019	36.77838118	-119.8217134	Fresno County
282420	Fee-for-Service	1932510963	1932510963	1	1	WILSON, ILAVENIL MD	3/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143922	02	General Surgery	0	In state provider	None	4333 TORRANCE BLVD	None	TORRANCE	CA	90503	4401	19	06037	33.83759353	-118.360089	Los Angeles County
282477	Fee-for-Service	1588283766	1588283766	1	1	WONG, CHARLES MD	8/12/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
282533	Fee-for-Service	1437169463	1437169463	1	1	WONG, CAROLANNE L	5/15/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
282565	Fee-for-Service	1013190693	1013190693	1	1	WILD, YVETTE K MD	7/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102785	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
282587	Fee-for-Service	1417071317	1417071317	1	1	WOLTER, MARJORIE N LVN	3/3/2003	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	840 W SIMPSON AVE	None	FRESNO	CA	93705	4041	10	06019	36.77838118	-119.8217134	Fresno County
282637	Fee-for-Service	1124373683	1124373683	1	1	WANG, MICHAEL K DO	6/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15556	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
282641	Fee-for-Service	1669808028	1669808028	1	1	WIECHERT, KAITLIN I LMFT	8/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
282649	Fee-for-Service	1902207178	1902207178	1	1	WILLIAMS, JESSICA LCSW	5/8/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
282666	Fee-for-Service	1609924588	1609924588	1	1	WU, KUAN TEH MD	5/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	41750	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
282694	Fee-for-Service	1760402416	1760402416	1	1	WREN, SHERRY M MD	10/31/1993	208600000X	NA	General Surgery	026	PHYSICIANS	78891	02	General Surgery	0	In state provider	None	1510 SAN PABLO ST	STE 514	LOS ANGELES	CA	90033	5324	19	06037	34.06287152	-118.2029433	Los Angeles County
282718	Fee-for-Service	1952939910	1952939910	1	1	WANG, DANIEL L	5/2/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	190925	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
282736	Fee-for-Service	1669558821	1669558821	1	1	WONG, HUNG-KWONG MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	53969	08	Family Practice	0	In state provider	None	2020 FOREST AVE	STE 8	SAN JOSE	CA	95128	4805	43	06085	37.32700547	-121.933377	Santa Clara County
282738	Fee-for-Service	1982944492	1982944492	1	1	WASJUTIN, SILVIA M	12/10/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	621 W MICHELTORENA	STE B	SANTA BARBARA	CA	93101	4195	42	06083	34.41914194	-119.7157341	Santa Barbara County
282786	Fee-for-Service	1447493267	1447493267	1	1	WYSONG, ASHLEY MD	7/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113379	07	Dermatology	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
282803	Fee-for-Service	1598015745	1598015745	1	1	WIEDERHOLD, MARK D MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66151	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
282831	Fee-for-Service	1023151040	1023151040	1	1	WHITTIER FETTERLY MEDICAL	2/25/2008	193200000X	NA	Other	026	PHYSICIANS	40070	01	General Practice	0	In state provider	CLINIC INC	4762 WHITTIER BLVD	None	LOS ANGELES	CA	90022	3026	19	06037	34.02207006	-118.1653083	Los Angeles County
282834	Fee-for-Service	1124373683	1124373683	1	1	WANG, MICHAEL K DO	6/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15556	10	Gastroenterology (M.D. only)	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
282851	Fee-for-Service	1639448053	1639448053	1	1	WILLIAMS, REBECCA LMFT	8/14/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41880 KALMIA ST	STE 115	MURRIETA	CA	92562	8835	33	06065	33.55740114	-117.2157733	Riverside County
282861	Fee-for-Service	1609924588	1609924588	1	1	WU, KUAN TEH MD	5/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	41750	41	Internal Medicine	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
282931	Fee-for-Service	1265534572	1265534572	1	1	WOLFF, DAVID MD	12/11/2002	2084P0800X	NA	Psychiatry	026	PHYSICIANS	51683	36	Psychiatry	0	In state provider	None	9201 W SUNSET BLVD	STE 606	LOS ANGELES	CA	90069	3707	19	06037	34.09054375	-118.392295	Los Angeles County
282939	Fee-for-Service	1427063718	1427063718	1	1	WALGREEN CO	3/1/2002	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	643 SANTA CRUZ AVE	None	MENLO PARK	CA	94025	4502	41	06081	37.45242157	-122.183849	San Mateo County
283009	Fee-for-Service	1225236466	1225236466	1	1	WILLIAMS, DALE LMFT	6/18/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	631 TENNESSEE ST	STE 202	VALLEJO	CA	94590	4432	48	06095	38.10992398	-122.2522919	Solano County
283063	Fee-for-Service	1164600342	1164600342	1	1	WAGGONNER DAVID B MD	7/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103335	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	STE 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
283070	Fee-for-Service	1346454964	1346454964	1	1	WILLIAMS, LESLIE ANN E MD	2/5/2014	207R00000X	NA	Other	026	PHYSICIANS	127251	41	Internal Medicine	0	In state provider	None	85 SIERRA PARKS RD	None	MAMMOTH LAKES	CA	93546	2073	26	06051	37.64575895	-118.9638914	Mono County
283081	Fee-for-Service	1265557136	1265557136	1	1	WOLFSON, JENNA E LCSW	7/10/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NESS	6630 HIGHWAY 9	204	FELTON	CA	95018	9711	44	06087	37.05726381	-122.0760563	Santa Cruz County
283083	Fee-for-Service	1821591611	1821591611	1	1	WELSH, TRAVIS P MD	6/24/2024	207RR0500X	NA	Other	026	PHYSICIANS	178597	41	Internal Medicine	0	In state provider	None	6633 TELEPHONE RD	200, 210	VENTURA	CA	93003	5569	56	06111	34.26667679	-119.20405	Ventura County
283192	Fee-for-Service	1700979846	1700979846	1	1	WONG, KUAN POK MD INC	4/1/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	26255	41	Internal Medicine	0	In state provider	None	10230 ARTESIA BLVD	STE 102	BELLFLOWER	CA	90706	6768	19	06037	33.8728276	-118.1160403	Los Angeles County
283197	Fee-for-Service	1558891960	1558891960	1	1	WAITE, CHRISTOPHER W	11/13/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6591 COLLINS DR	STE E8	MOORPARK	CA	93021	1492	56	06111	34.2944564	-118.8424453	Ventura County
283273	Fee-for-Service	1821591611	1821591611	1	1	WELSH, TRAVIS P MD	6/24/2024	207RR0500X	NA	Other	026	PHYSICIANS	178597	83	Rheumatology	0	In state provider	None	6633 TELEPHONE RD	200, 210	VENTURA	CA	93003	5569	56	06111	34.26667679	-119.20405	Ventura County
283295	Fee-for-Service	1366107039	1366107039	1	1	WONG, KRYSTLE J CNP	4/6/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	26891 ALISO CREEK RD	None	ALISO VIEJO	CA	92656	3392	30	06059	33.5723715	-117.7235968	Orange County
283338	Fee-for-Service	1053575936	1053575936	1	1	WILSON, JENNIFER K MD	10/16/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	64309	-	NOT APPLICABLE	0	In state provider	None	720 WOOD ST	STE 118, 123, 127, 130	EUREKA	CA	95501	4413	12	06023	40.78118068	-124.1607622	Humboldt County
283384	Fee-for-Service	1275992463	1275992463	1	1	WAL-MART STORES INC	5/11/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9001 APOLLO WAY	None	DOWNEY	CA	90242	4033	19	06037	33.92303224	-118.1286645	Los Angeles County
283400	Fee-for-Service	1710987706	1710987706	1	2	WILSHIRE ONCOLOGY MED	2/28/1988	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	GROUP	8283 GROVE AVE	STE 207	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
283448	Fee-for-Service	1578997466	1578997466	1	1	WONG, ANDREW J PSYD	4/26/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
283498	Fee-for-Service	1780745216	1780745216	1	1	WARD, DAVID L MD	12/11/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	162756	30	Radiology	0	In state provider	None	10101 RIVERSIDE DR	None	TOLUCA LAKE	CA	91602	2517	19	06037	34.15223753	-118.3508865	Los Angeles County
283508	Fee-for-Service	1154941904	1154941904	1	1	WILKEY, CLARK J DO	8/20/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20550	None	None	0	In state provider	None	168 N BRENT ST	STE 502	VENTURA	CA	93003	2840	56	06111	34.27448266	-119.2572489	Ventura County
283559	Fee-for-Service	1093935249	1093935249	1	1	WANG, ZHEN J MD	3/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	86108	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
283577	Fee-for-Service	1174840680	1174840680	1	1	WICKRAMASINGHE, CHANAKA D MD	9/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130331	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
283591	Fee-for-Service	1790124345	1790124345	1	1	WESTBERG, JULIE M MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	133886	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
283627	Fee-for-Service	1801213186	1801213186	1	1	WOO, JENNIFER P MD	4/12/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	141101	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
283636	Fee-for-Service	1649242686	1649242686	1	1	WELLBOUND OF EMERYVILLE,	3/9/2005	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	2000 POWELL ST	STE 140	EMERYVILLE	CA	94608	1781	01	06001	37.83818902	-122.3004821	Alameda County
283681	Fee-for-Service	1811336068	1811336068	1	1	WARDENBURG, MARLA J MD	10/1/2019	208800000X	NA	Other	026	PHYSICIANS	162551	34	Urology and Urological Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
283700	Fee-for-Service	1639550965	1639550965	1	1	WOODS, ALEISHA J CNM	8/2/2021	363LP2300X	NA	Nurse Practitioner	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
283765	Fee-for-Service	1053508176	1053508176	1	1	WILLIAMS, GREGORY G MD INC	3/18/2008	261QM2500X	NA	Other	026	PHYSICIANS	73172	02	General Surgery	0	In state provider	None	1500 HAGGIN OAKS BLVD	STE 202	BAKERSFIELD	CA	93311	1333	15	06029	35.341758	-119.1011105	Kern County
283803	Fee-for-Service	1194867192	1194867192	1	1	WILLIAMS, MELODY A LMFT	7/19/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
283826	Fee-for-Service	1972749323	1972749323	1	1	WITT, TRACI	6/12/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8421 AUBURN BLVD	SUITE 110	CITRUS HEIGHTS	CA	95610	0359	34	06067	38.719026	-121.291335	Sacramento County
283859	Fee-for-Service	1487217808	1487217808	1	1	WESTRA, CHASE C MD	3/28/2023	207P00000X	NA	Other	026	PHYSICIANS	179447	None	None	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
283866	Fee-for-Service	1629759105	1629759105	1	1	WORLD RELIEF CORPORATION OF	2/19/2025	163WC0400X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	2233 WATT AVENUE	SUITE 110	SACRAMENTO	CA	95825	0524	34	06067	38.604789	-121.38399	Sacramento County
283887	Fee-for-Service	1578580825	1578580825	1	1	WAL-MART STORES INC	9/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARM 10-3248	1340 S BEACH BLVD	None	LA HABRA	CA	90631	6374	30	06059	33.914655	-117.9662805	Orange County
283892	Fee-for-Service	1912928557	1912928557	1	1	WEINER, PATRICE A MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	65159	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
283893	Fee-for-Service	1235771676	1235771676	1	1	WESTERSCHULTE, LAUREN C LMFT	11/17/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
283948	Fee-for-Service	1700448925	1700448925	1	1	WILLIAM Y. TO, O.D., INC	10/13/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	194 HILLSDALE SHOPPING C	None	SAN MATEO	CA	94403	3409	41	06081	37.53762668	-122.2995915	San Mateo County
283984	Fee-for-Service	1649378605	1649378605	1	1	WHANG, STEPHANIE J MD	1/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	63881	40	Pediatrics	0	In state provider	None	607 S GLENOAKS BLVD	None	BURBANK	CA	91502	1424	19	06037	34.17950025	-118.3013539	Los Angeles County
284004	Fee-for-Service	1871807784	1871807784	1	1	WALKER, TINA L MD	3/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113377	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
284032	Fee-for-Service	1902548696	1902548696	1	1	WELLSPRING SENIOR HOME CARE	10/21/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	18674 SAN FELIPE STREET	None	FOUNTAIN VALLEY	CA	92708	5234	30	06059	33.69162147	-117.9514033	Orange County
284066	Fee-for-Service	1205366077	1205366077	1	1	WILLIAM L METZ	6/12/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	929 JASONWAY AVE	None	COLUMBUS	OH	43214	2464	00	None	40.06233915	-83.04369682	Franklin County
284099	Fee-for-Service	1740670256	1740670256	1	1	WYROBEK, SONYA R CNM	7/26/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
284121	Fee-for-Service	1457537474	1457537474	1	1	WHITE, RACHAEL A MD	11/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	100248	67	Endocrinology	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94019	4346	41	06081	37.53039072	-122.2987772	San Mateo County
284209	Fee-for-Service	1134134463	1134134463	1	1	WALGREEN CO	1/26/1989	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1414 EL CAMINO REAL	None	SAN CARLOS	CA	94070	5102	41	06081	37.49716574	-122.2485578	San Mateo County
284227	Fee-for-Service	1891857421	1891857421	1	1	WILLIAM M MATRE, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS PLZ	None	DAYTON	OH	45404	1873	00	None	39.77357175	-84.16912266	Montgomery County
284296	Fee-for-Service	1457537474	1457537474	1	1	WHITE, RACHAEL A MD	11/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	100248	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94019	4346	41	06081	37.53039072	-122.2987772	San Mateo County
284321	Fee-for-Service	1437102100	1437102100	1	1	WONG, ELIZABETH CRNA	8/1/2002	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
284343	Fee-for-Service	1316204464	1316204464	1	1	WATSON, ASHLEY MD	2/27/2025	207ZP0102X	NA	Other	026	PHYSICIANS	169734	22	Pathology (M.D. only)	0	In state provider	None	4301 NORTHSTAR WAY	None	MODESTO	CA	95356	9535	50	06099	0	0	None
284352	Fee-for-Service	1316573926	1316573926	1	1	WEINSTEIN, DREW E MD	11/18/2024	207P00000X	NA	Other	026	PHYSICIANS	186310	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	07	06013	37.98252	-121.8030615	Contra Costa County
284375	Fee-for-Service	1194842625	1194842625	1	1	WHYTE, ROGELIO L MD	12/2/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	39717	-	NOT APPLICABLE	0	In state provider	None	2000 TYLER AVE	None	SOUTH EL MONTE	CA	91733	3543	19	06037	34.05228947	-118.0361765	Los Angeles County
284387	Fee-for-Service	1821261041	1821261041	1	1	WALGREEN CO.	6/18/2008	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2465 E PALM CANYON DR.	None	PALM SPRINGS	CA	92264	4872	33	06065	33.80127149	-116.521767	Riverside County
284540	Fee-for-Service	1528672508	1528672508	1	1	WISE HOME HEALTH INC	10/14/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	417 S SAN GABRIEL BLVD	STE F	SAN GABRIEL	CA	91776	1968	19	06037	34.09733977	-118.0909734	Los Angeles County
284659	Fee-for-Service	1114005964	1114005964	1	1	WHEATON, WENDY V MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	57419	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
284661	Fee-for-Service	1679665970	1679665970	1	1	WEST SIDE COMMUNITY HEALTHCA	5/1/1985	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	CE	531 HILLS FERRY RD	None	NEWMAN	CA	95360	9822	50	06099	37.31618399	-121.010568	Stanislaus County
284677	Fee-for-Service	1114932498	1114932498	1	1	WALGREEN CO	6/29/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3860 DECOTO RD	None	FREMONT	CA	94555	3112	01	06001	37.57147949	-122.031738	Alameda County
284703	Fee-for-Service	1821169707	1821169707	1	1	WEISS, DIANE M MD	11/30/1993	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76767	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
284719	Fee-for-Service	1134203102	1134203102	1	1	WACHSBERG, ABRAHAM MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	23878	40	Pediatrics	0	In state provider	None	4145 CLARES ST	None	CAPITOLA	CA	95010	2053	44	06087	36.97837345	-121.964319	Santa Cruz County
284724	Fee-for-Service	1194917310	1194917310	1	1	WINDOKUN, ADEJARE MD	7/28/2008	207L00000X	NA	Other	026	PHYSICIANS	90058	05	Anesthesiology	0	In state provider	None	2700 DOBLER STREET	None	EUREKA	CA	95501	4736	12	06023	40.80001927	-124.1446905	Humboldt County
284751	Fee-for-Service	1740856301	1740856301	1	1	WOODS, JAMI E LMFT	11/22/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
284762	Fee-for-Service	1780601252	1780601252	1	1	WILSON, BRETT II MD	2/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97199	None	None	0	In state provider	None	PUEBLO AT BATH	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
284817	Fee-for-Service	1992856819	1992856819	1	1	WAUKEGAN ILLINOIS HOSPITAL	2/15/2013	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COMPANY LLC	2615 WASHINGTON ST	None	WAUKEGAN	IL	60085	4980	00	None	42.357834	-87.866154	Lake County
284868	Fee-for-Service	1356429435	1356429435	1	1	WEAVER, MICHAEL W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33491	01	General Practice	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
284898	Fee-for-Service	1902008030	1902008030	1	1	WU, JENNY C MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13714	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
284941	Fee-for-Service	1609814854	1609814854	1	1	WARNER,LINDA M MD	12/22/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	6111	08	Family Practice	0	In state provider	None	11525 BROOKSHIRE AVE	STE 301	DOWNEY	CA	90241	4982	19	06037	33.93544635	-118.1318321	Los Angeles County
284956	Fee-for-Service	1609801216	1609801216	1	1	WAXMAN, NORMA MD	10/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67279	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3001 COLBY ST	None	BERKELEY	CA	94705	2039	01	06001	37.85496934	-122.2575642	Alameda County
284961	Fee-for-Service	1932166394	1932166394	1	1	WILBER, RICHARD R MD	6/30/1991	207ZP0102X	NA	Other	026	PHYSICIANS	34845	22	Pathology (M.D. only)	0	In state provider	None	COUNTY R. 99	None	DAVIS	CA	95616	0000	57	06113	0	0	None
284966	Fee-for-Service	1548644073	1548644073	1	1	WALKER, CHARISSA B LMFT	7/13/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1845 CHICAGO AVE	B	RIVERSIDE	CA	92507	2366	33	06065	33.994269	-117.3485375	Riverside County
284983	Fee-for-Service	1992856819	1992856819	1	1	WAUKEGAN ILLINOIS HOSPITAL	2/15/2013	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COMPANY LLC	2615 WASHINGTON ST	None	WAUKEGAN	IL	60085	4980	00	None	42.357834	-87.866154	Lake County
285024	Fee-for-Service	1205412756	1205412756	1	1	WRIGHT, BRENT	4/23/2024	390200000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
285056	Fee-for-Service	1043530819	1043530819	1	1	WILLSON, THOMAS D MD	6/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	129361	02	General Surgery	0	In state provider	None	200 MEDICAL PLAZA	STE 465	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
285072	Fee-for-Service	1194742445	1194742445	1	1	WAL-MART STORES, INC	4/1/1998	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 102495	13331 BEACH BLVD	None	WESTMINSTER	CA	92683	9207	30	06059	33.76829623	-117.9909955	Orange County
285187	Fee-for-Service	1285640649	1285640649	1	2	WEST BEVERLY PODIATRY GROUP,	7/25/2024	261QP1100X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	INC.	1417 WEST BEVERLY BLVD.	SUITE 104	MONTEBELLO	CA	90640	0000	19	06037	34.01879041	-118.1136083	Los Angeles County
285191	Fee-for-Service	1518423433	1518423433	1	1	WALSH, NATALIE A AU	8/1/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
285198	Fee-for-Service	1851567853	1851567853	1	1	WALL, HEATHER LMFT	12/22/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45312	-	NOT APPLICABLE	0	In state provider	None	160 N EL MOLINO AVE	None	PASADENA	CA	91101	1805	19	06037	34.14884154	-118.1368812	Los Angeles County
285215	Fee-for-Service	1346328234	1346328234	1	1	WIN, MYA-MYA MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55923	41	Internal Medicine	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
285274	Fee-for-Service	1851304513	1851304513	1	1	WARNECK, CHRISTINA M MD	5/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	40999	05	Anesthesiology	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
285330	Fee-for-Service	1831543685	1831543685	1	1	WANG, ALLEN F MD	10/23/2020	207P00000X	NA	Other	026	PHYSICIANS	167724	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
285347	Fee-for-Service	1700970464	1700970464	1	1	WONG, CYNTHIA ANNE MD	7/1/1996	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51754	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
285352	Fee-for-Service	1407944572	1407944572	1	1	WOLFE, RONALD	2/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 PINOLE VALLEY RD	None	PINOLE	CA	94564	1384	07	06013	37.9991883	-122.2867117	Contra Costa County
285391	Fee-for-Service	1255564845	1255564845	1	1	WARE, AMANDA	6/23/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 FAIRWAY VIEW PLACE	SUITE 101	RANCHO CUCAMONGA	CA	91730	0963	36	06071	34.084008	-117.560054	San Bernardino County
285419	Fee-for-Service	1255317947	1255317947	1	1	WEINBERG, STANLEY H MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	30952	08	Family Practice	0	In state provider	None	935 E PENNSYLVANIA AVE	None	ESCONDIDO	CA	92025	3467	37	06073	33.12805404	-117.0700077	San Diego County
285448	Fee-for-Service	1841363652	1841363652	1	1	WESTERN PACIFIC HEMATOLOGY	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	44844	78	Neoplastic Diseases/Oncology	0	In state provider	ONCOLOGY MEDICAL GROUP	9800 BRIMHALL RD	None	BAKERSFIELD	CA	93312	2783	15	06029	35.3688055	-119.1114495	Kern County
285454	Fee-for-Service	1164662128	1164662128	1	1	WILLIAMS, LYNELL H JR MD	6/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131010	05	Anesthesiology	0	In state provider	None	3687 MT DIABLO BLVD	200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
285487	Fee-for-Service	1609246651	1609246651	1	1	WILSON, AMY M CNP	6/1/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10889 WELLWORTH AVE	None	LOS ANGELES	CA	90024	4918	19	06037	34.05707768	-118.4424488	Los Angeles County
285508	Fee-for-Service	1366519407	1366519407	1	1	WOLZ, BIRGIT M LMFT	6/18/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3886 DEER MEADOW LN	STE 2	OCCIDENTAL	CA	95465	9287	49	06097	38.39699263	-122.9703762	Sonoma County
285509	Fee-for-Service	1740549831	1740549831	1	1	WINANS, KELLY E CRNA	4/25/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	20940 BURBANK BLVD	None	WOODLAND HILLS	CA	91365	6701	19	06037	34.1719401	-118.5881418	Los Angeles County
285558	Fee-for-Service	1912435173	1912435173	1	2	WEST COAST MEDICINE AND CARD	11/16/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	IOLOGY INC	27171 CALAROGA AVE	1-3	HAYWARD	CA	94545	4344	01	06001	37.63306553	-122.0897897	Alameda County
285576	Fee-for-Service	1255317947	1255317947	1	1	WEINBERG, STANLEY H MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	30952	66	Emergency Medicine (Urgent Care)	0	In state provider	None	935 E PENNSYLVANIA AVE	None	ESCONDIDO	CA	92025	3467	37	06073	33.12805404	-117.0700077	San Diego County
285657	Fee-for-Service	1164467320	1164467320	1	1	WALLACE, JOHN G JR MD	1/1/1982	207P00000X	NA	Other	026	PHYSICIANS	45690	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9700 LAS TUNAS DR	STE 110	TEMPLE CITY	CA	91780	2242	19	06037	34.10704578	-118.0579785	Los Angeles County
285662	Fee-for-Service	1528049145	1528049145	1	1	WONG, MICHAEL K MD	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54384	78	Neoplastic Diseases/Oncology	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
285692	Fee-for-Service	1396044657	1396044657	1	1	WEAVER, JESSICA MD	9/16/2019	2086S0102X	NA	General Surgery	026	PHYSICIANS	163176	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
285714	Fee-for-Service	1912435173	1912435173	1	2	WEST COAST MEDICINE AND CARD	11/16/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	IOLOGY INC	27171 CALAROGA AVE	1-3	HAYWARD	CA	94545	4344	01	06001	37.63306553	-122.0897897	Alameda County
285764	Fee-for-Service	1255727285	1255727285	1	1	WANG, JOANNE H MD	3/25/2022	2086S0105X	NA	General Surgery	026	PHYSICIANS	174739	None	None	0	In state provider	None	137 E THOUSAND OAKS BLVD	None	THOUSAND OAKS	CA	91360	1985	56	06111	34.17919939	-118.8745721	Ventura County
285825	Fee-for-Service	1811130594	1811130594	1	1	WALDON, ERIC G PHD	10/16/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1305 TOMMYDON STREET	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
285844	Fee-for-Service	1457418113	1457418113	1	1	WESSEL, MIKYONG LMFT	5/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
285960	Fee-for-Service	1952328379	1952328379	1	1	WAL-MART STORES, INC	10/7/1992	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 101877	1250 W HENDERSON AVE	None	PORTERVILLE	CA	93257	1455	54	06107	36.083385	-119.045394	Tulare County
285972	Fee-for-Service	1831249630	1831249630	1	1	WATERS, CHRISTY S MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	52864	41	Internal Medicine	0	In state provider	None	7415 WINDING WAY	None	FAIR OAKS	CA	95628	6701	34	06067	38.6446317	-121.2912597	Sacramento County
286009	Fee-for-Service	1770599615	1770599615	1	1	WILSON, MARY A CRNA	11/24/2003	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	RMC MOB2	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
286020	Fee-for-Service	1629140561	1629140561	1	1	WATERS, MICHAEL F MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78335	13	Neurology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
286055	Fee-for-Service	1316263726	1316263726	1	1	WALGREEN CO	12/3/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	475 HWY 49	None	SUTTER CREEK	CA	95685	9763	03	06005	38.37894268	-120.802646	Amador County
286064	Fee-for-Service	1609816958	1609816958	1	1	WALTHER, JOHN D MD	12/31/1990	207P00000X	NA	Other	026	PHYSICIANS	40705	None	None	0	In state provider	None	298 GREEN VALLEY RD	None	WATSONVILLE	CA	95076	1359	44	06087	36.94058779	-121.7696586	Santa Cruz County
286075	Fee-for-Service	1780735134	1780735134	1	1	WILSON, DAVID R PT	9/13/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	333 N PALM CANYON DR	SUITE # 114	PALM SPRINGS	CA	92262	5658	33	06065	33.827652	-116.5468485	Riverside County
286089	Fee-for-Service	1407291602	1407291602	1	1	WONG, KESTER I MD	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134660	01	General Practice	0	In state provider	None	301 INDUSTRIAL RD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
286147	Fee-for-Service	1770624538	1770624538	1	1	WEED, THOMAS M MD INC	6/18/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	39475	18	Ophthalmology	0	In state provider	None	436 E YOSEMITE AVE	STE A	MERCED	CA	95340	8489	24	06047	37.33211553	-120.461976	Merced County
286179	Fee-for-Service	1609385426	1609385426	1	1	WONG, MEI-LING C NP	11/20/2017	363LP0222X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
286187	Fee-for-Service	1881646545	1881646545	2	1	WU, GUOSHENG MD	12/10/2011	207L00000X	NA	Other	026	PHYSICIANS	86920	None	None	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
286192	Fee-for-Service	1962581694	1962581694	1	1	WONG, REYNOLD C MD	1/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	51891	07	Dermatology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
286219	Fee-for-Service	1710927231	1710927231	1	1	WHIDBEY ISLAND PUBLIC	10/17/2007	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	101 NORTH MAIN ST	None	COUPEVILLE	WA	98239	3413	00	None	48.213756	-122.686102	Island County
286238	Fee-for-Service	1487016952	1487016952	1	1	WEI, JEFFREY MD	5/5/2021	207RE0101X	NA	Endocrinology	026	PHYSICIANS	152472	None	None	0	In state provider	None	100 MOODY DRIVE	None	THOUSAND OAKS	CA	91360	6077	56	06111	34.17732532	-118.8654117	Ventura County
286242	Fee-for-Service	1659872026	1659872026	1	1	WOLFORD, KRISTINA F LCSW	2/22/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
286261	Fee-for-Service	1982751657	1982751657	1	1	WOLF, ALAN S LCSW	1/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
286312	Fee-for-Service	1366595332	1366595332	1	1	WOOD, ROGER J LMFT	11/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3424 E 4TH ST	None	LONG BEACH	CA	90814	1557	19	06037	33.77166254	-118.1517916	Los Angeles County
286333	Fee-for-Service	1497801062	1497801062	1	1	WARSAW, TERRY J MD	6/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	35426	41	Internal Medicine	0	In state provider	None	20211 W VALLEY BLVD	None	TEHACHAPI	CA	93561	6748	15	06029	35.12450952	-118.489509	Kern County
286339	Fee-for-Service	1982474615	1982474615	1	1	WILLSE, JESSIE NP	5/1/2024	363LN0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
286343	Fee-for-Service	1194990820	1194990820	1	1	WASSEF, FADY W MD	8/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120445	05	Anesthesiology	0	In state provider	None	1303 E HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
286365	Fee-for-Service	1356147177	1356147177	1	1	WYNN, TRACY	4/23/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	30	06059	0	0	None
286368	Fee-for-Service	1134373384	1134373384	1	1	WANG, YINGBING MD	8/2/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170523	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
286371	Fee-for-Service	1710927231	1710927231	1	1	WHIDBEY ISLAND PUBLIC	10/17/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	101 NORTH MAIN ST	None	COUPEVILLE	WA	98239	3413	00	None	48.213756	-122.686102	Island County
286377	Fee-for-Service	1437625761	1437625761	1	1	WORRALL, SAM D LMFT	7/20/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
286379	Fee-for-Service	1699919035	1699919035	1	1	WHITE, LUKE W M MD	9/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136815	36	Psychiatry	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
286455	Fee-for-Service	1851553374	1851553374	1	1	WILLIAMS, JOEL C MD	7/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110884	20	Orthopedic Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
286507	Fee-for-Service	1255632535	1255632535	1	1	WILLIAMS, LORI D PHD	1/21/2011	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1303 E HERNDON	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
286513	Fee-for-Service	1144455437	1144455437	1	1	WONG, CANDICE C MD PHD	11/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	64075	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
286586	Fee-for-Service	1306853122	1306853122	1	1	WHITE, JON I MD	3/24/2009	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	53411	20	Orthopedic Surgery	0	In state provider	#511	16300 SAND CANYON AVE	None	IRVINE	CA	92618	3711	30	06059	33.66115075	-117.7742405	Orange County
286630	Fee-for-Service	1841060126	1841060126	1	1	WALKER, MARQUIESA DOULA	1/8/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
286685	Fee-for-Service	1881934388	1881934388	1	1	WIGHTMAN, KIRSTEN I	7/20/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	582 S SUNNYVALE RD	None	SUNNYVALE	CA	94086	6215	43	06085	37.36886669	-122.0316101	Santa Clara County
286730	Fee-for-Service	1437367059	1437367059	1	1	WYNN, PAULA MD	11/4/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	103635	18	Ophthalmology	0	In state provider	None	1001 POTRERO AVE	RM 4M31	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
286732	Fee-for-Service	1043215130	1043215130	1	1	WATERBOR, ROBERT B MD	4/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29026	41	Internal Medicine	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
286739	Fee-for-Service	1033350756	1033350756	1	2	WIN, PETER HO MD INC	11/18/2011	193400000X	NA	Other	026	PHYSICIANS	85277	18	Ophthalmology	0	In state provider	None	18575 E GALE AVE	STE 218	CITY OF INDUSTRY	CA	91748	1346	19	06037	33.99560019	-117.8990859	Los Angeles County
286778	Fee-for-Service	1346275385	1346275385	1	1	WOOLARD, DEDORAH J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	317 MARTIN LUTHER KING J	None	TACOMA	WA	98405	4234	00	None	47.25960844	-122.4534238	Pierce County
286800	Fee-for-Service	1629129812	1629129812	1	1	WU, ANDREW MD	7/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	95606	41	Internal Medicine	0	In state provider	None	1661 SOQUEL DR	STE D	SANTA CRUZ	CA	95065	1709	44	06087	36.98895429	-121.9821088	Santa Cruz County
286823	Fee-for-Service	1346366101	1346366101	1	1	WOMACK, VANESSA D LMFT	6/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3815 W OLIVE AVE	STE 102	BURBANK	CA	91505	4623	19	06037	34.15087362	-118.3405416	Los Angeles County
286851	Fee-for-Service	1306200993	1306200993	1	1	WHITMAN, STEPHANIE A MD	10/26/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	141802	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
286921	Fee-for-Service	1417954546	1417954546	1	1	WALTER, JOHN P MD	1/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	30760	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
286974	Fee-for-Service	1922032077	1922032077	1	1	WESTROM, DALE R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	46342	07	Dermatology	0	In state provider	None	990 SONOMA AVE	None	SANTA ROSA	CA	95404	4802	49	06097	38.439729	-122.701545	Sonoma County
287005	Fee-for-Service	1801356290	1801356290	1	1	WU, JOHNNY MD	8/31/2022	207R00000X	NA	Other	026	PHYSICIANS	176391	None	None	0	In state provider	None	2141 N HARBOR BLVD	STE 25000	FULLERTON	CA	92835	3830	30	06059	33.89443025	-117.9288328	Orange County
287150	Fee-for-Service	1740458652	1740458652	1	1	WALKER, REBECCA D MD	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97318	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DRIVE	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
287169	Fee-for-Service	1700945300	1700945300	1	1	WOOD, THOMAS F MD	2/2/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78340	02	General Surgery	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
287182	Fee-for-Service	1851332969	1851332969	1	1	WEINSTEIN, DEBORAH	2/8/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	23521 PASEO DE VALENCIA	STE B15	LAGUNA HILLS	CA	92653	3145	30	06059	33.61113028	-117.7126684	Orange County
287196	Fee-for-Service	1427231729	1427231729	1	1	WATTERS, JESSICA L MD	6/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108160	08	Family Practice	0	In state provider	None	801 E STREET	None	PATTERSON	CA	95363	2670	50	06099	37.46668786	-121.1342171	Stanislaus County
287208	Fee-for-Service	1689605156	1689605156	1	1	WALKER, SHAKA M MD	8/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	78796	20	Orthopedic Surgery	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
287209	Fee-for-Service	1013521194	1013521194	1	1	WEST COAST VALLEY HOME	12/15/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	3575 CAHUENGA BLVD W	STE 670	LOS ANGELES	CA	90068	1366	19	06037	34.13401653	-118.3582603	Los Angeles County
287267	Fee-for-Service	1295178069	1295178069	1	1	WONG, FELIX S MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132884	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
287292	Fee-for-Service	1639955172	1639955172	1	1	WILLOWVIEW HOME TWO, LLC	9/26/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	44148 12TH ST WEST	None	LANCASTER	CA	93534	4242	19	06037	34.68530809	-118.1523342	Los Angeles County
287320	Fee-for-Service	1588722912	1588722912	1	1	WOODS,GORDON L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL	None	TUCSON	AZ	85724	0000	00	None	32.240493	-110.9460825	Pima County
287339	Fee-for-Service	1376630814	1376630814	1	1	WYLIE, CONSTANCE R RN	8/29/2007	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
287387	Fee-for-Service	1770660623	1770660623	1	1	WEI, SHUANG MD	10/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78459	41	Internal Medicine	0	In state provider	None	700 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5439	43	06085	37.43308793	-121.8951311	Santa Clara County
287424	Fee-for-Service	1043504681	1043504681	1	1	WELDER, JEFFREY D MD	7/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135745	18	Ophthalmology	0	In state provider	None	2524 WESTSIDE RD	None	YREKA	CA	96097	9129	47	06093	41.69301114	-122.6403046	Siskiyou County
287522	Fee-for-Service	1841592037	1841592037	1	1	WEAVIL, AMANDA S MD	4/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123236	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2175 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7024	09	06017	38.91234551	-119.9972565	El Dorado County
287525	Fee-for-Service	1134952484	1134952484	1	1	WILLIAMS, KERRINA	2/17/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
287528	Fee-for-Service	1114188646	1114188646	1	1	WATKINS, GARTH S MD	9/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121756	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
287568	Fee-for-Service	1750308011	1750308011	1	1	WAL-MART STORES INC	2/27/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WAL-MART PHARMACY 105032	8450 LA PALMA AVE	None	BUENA PARK	CA	90620	3210	30	06059	33.8466207	-117.9862725	Orange County
287584	Fee-for-Service	1609360148	1609360148	1	1	WAITROVICH, LAUREN LMFT	12/12/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	907 SAN RAMON VALLEY BLV	STE 202	DANVILLE	CA	94526	4036	07	06013	37.80813695	-121.9922024	Contra Costa County
287609	Fee-for-Service	1407254618	1407254618	1	1	WHITE, ELIZABETH LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
287692	Fee-for-Service	1326011461	1326011461	1	1	WHITE, PETER MD	1/31/1992	208VP0000X	NA	Other	026	PHYSICIANS	50653	05	Anesthesiology	0	In state provider	None	780 E GILBERT ST	None	SAN BERNARDINO	CA	92415	1003	36	06071	34.1268333	-117.2705634	San Bernardino County
287699	Fee-for-Service	1194892190	1194892190	1	1	WINE, NELAR MD	11/30/1995	207R00000X	NA	Other	026	PHYSICIANS	55204	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
287713	Fee-for-Service	1588609390	1588609390	1	1	WEAVER III, BURTON D MD	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	56422	08	Family Practice	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
287825	Fee-for-Service	1194892190	1194892190	1	1	WINE, NELAR MD	11/30/1995	207R00000X	NA	Other	026	PHYSICIANS	55204	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
287834	Fee-for-Service	1477553568	1477553568	2	1	WEINSTEIN, PHILIP B	3/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	31919	41	Internal Medicine	0	In state provider	None	16660 PARAMOUNT BLVD	SUITE 201	PARAMOUNT	CA	90723	5457	19	06037	33.882723	-118.1599535	Los Angeles County
287853	Fee-for-Service	1033287545	1033287545	1	1	WIESNER, KENNETH B MD	8/18/1975	207RR0500X	NA	Other	026	PHYSICIANS	26529	41	Internal Medicine	0	In state provider	INC	2222 SIERRA BLVD	STE E2	SACRAMENTO	CA	95825	4702	34	06067	38.57792592	-121.4138674	Sacramento County
287873	Fee-for-Service	1023431202	1023431202	1	1	WALGREENS CO	6/30/2014	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12184 PALMDALE ROAD	None	VICTORVILLE	CA	92392	8538	36	06071	34.50671077	-117.3988281	San Bernardino County
287912	Fee-for-Service	1235145616	1235145616	1	1	WALGREEN CO	7/24/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1815 HERNDON AVE	None	CLOVIS	CA	93611	6109	10	06019	36.8375745	-119.683476	Fresno County
287931	Fee-for-Service	1447525530	1447525530	1	1	WIN, KHINE Z MD	6/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154993	68	Hematology	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
287961	Fee-for-Service	1477553568	1477553568	2	1	WEINSTEIN, PHILIP B	3/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	31919	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	16660 PARAMOUNT BLVD	SUITE 201	PARAMOUNT	CA	90723	5457	19	06037	33.882723	-118.1599535	Los Angeles County
287999	Fee-for-Service	1265462154	1265462154	1	1	WHITERMORE, JAMES M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3333 RIVERBEND DR	None	SPRINGFIELD	OR	97477	8800	00	None	44.08199228	-123.0283538	Lane County
288030	Fee-for-Service	1083371314	1083371314	1	1	WOODARD, MICHAEL PT	11/29/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	585 SATURN	STE A	SAN DIEGO	CA	92154	4721	37	06073	32.586336	-117.088506	San Diego County
288054	Fee-for-Service	1447525530	1447525530	1	1	WIN, KHINE Z MD	6/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154993	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
288109	Fee-for-Service	1699865741	1699865741	1	1	WONG, KELLY K MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65226	40	Pediatrics	0	In state provider	None	950 STOCKTON ST	STE 205	SAN FRANCISCO	CA	94108	1619	38	06075	37.79469747	-122.4079497	San Francisco County
288193	Fee-for-Service	1619269883	1619269883	1	1	WEAVER, TIMOTHY A JR MD	7/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125727	05	Anesthesiology	0	In state provider	None	1100 W STEWART DRIVE	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
288197	Fee-for-Service	1659353969	1659353969	1	1	WHITCOMB, CHARLES K MD	12/16/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	29966	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2580 SR MARY COLUMBRA DR	None	RED BLUFF	CA	96080	0000	52	06103	40.14842672	-122.2180085	Tehama County
288219	Fee-for-Service	1518376409	1518376409	1	1	WEST VALLEY HOME HEALTH CARE	12/27/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	17915 VENTURA BLVD	SUITE 200	ENCINO	CA	91316	4810	19	06037	34.16385429	-118.522817	Los Angeles County
288234	Fee-for-Service	1326278995	1326278995	1	1	WONG, ALEX K MD	6/7/2010	208200000X	NA	General Surgery	026	PHYSICIANS	110517	24	Plastic Surgery	0	In state provider	None	1510 SAN PABLO ST	HCC 415	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
288251	Fee-for-Service	1710452198	1710452198	1	1	WILLIAMS, AMY LCSW	2/12/2024	390200000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
288276	Fee-for-Service	1730127002	1730127002	1	1	WENTZIEN, ERIN M MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75273	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	# 1E	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
288280	Fee-for-Service	1699988824	1699988824	1	1	WONG, CHRISTINE W NP	12/7/2011	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
288294	Fee-for-Service	1629353933	1629353933	1	1	WU, TIFFANY Y MD	3/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118732	02	General Surgery	0	In state provider	None	1140 W LA VETA AVE	STE 850	ORANGE	CA	92868	4218	30	06059	33.7802984	-117.8651669	Orange County
288333	Fee-for-Service	1336282094	1336282094	1	1	WOOLF, GRAHAM MARTIN MD	7/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	59652	08	Family Practice	0	In state provider	None	8635 W 3RD ST	STE 970W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
288345	Fee-for-Service	1851417000	1851417000	1	1	WASHINGTON, LUCILLE P OD	4/20/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	110 N LA BREA AVE	None	INGLEWOOD	CA	90301	1708	19	06037	33.96345848	-118.3533454	Los Angeles County
288410	Fee-for-Service	1386628212	1386628212	1	1	WONG, KENT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78664	41	Internal Medicine	0	In state provider	None	1401 SPANOS CT	STE 230	MODESTO	CA	95355	2816	50	06099	37.66975543	-120.9724048	Stanislaus County
288431	Fee-for-Service	1033350756	1033350756	1	3	WIN, PETER HO MD INC	9/28/2015	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	234 S 1ST AVE	SUITE 101	ARCADIA	CA	91006	3607	19	06037	34.13695131	-118.0282575	Los Angeles County
288443	Fee-for-Service	1356735575	1356735575	1	1	WEBB, TINA L LCSW	2/7/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1945 PALO VERDE AVE	203	LONG BEACH	CA	90815	3445	19	06037	33.791634	-118.1080175	Los Angeles County
288450	Fee-for-Service	1336282094	1336282094	1	1	WOOLF, GRAHAM MARTIN MD	7/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	59652	41	Internal Medicine	0	In state provider	None	8635 W 3RD ST	STE 970W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
288471	Fee-for-Service	1811315914	1811315914	1	1	WARD, CASEY J MD	8/31/2023	208600000X	NA	General Surgery	026	PHYSICIANS	138881	None	None	0	In state provider	None	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	38	06075	37.78594176	-122.421322	San Francisco County
288507	Fee-for-Service	1154819126	1154819126	1	1	WESTERN INSTITUTE OF CRITICA	9/1/2022	207LC0200X	NA	Other	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	L CARE MEDICINE, INC	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
288508	Fee-for-Service	1093706350	1093706350	1	1	WATSON, AMY H NP	12/4/2008	207RN0300X	NA	Nephrology	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	568 E HERNDON AVE	SUITE 201	FRESNO	CA	92720	2989	10	06019	36.83752653	-119.7776433	Fresno County
288517	Fee-for-Service	1306072970	1306072970	1	1	WANG, MARIE E MD	7/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113291	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
288599	Fee-for-Service	1518974518	1518974518	1	1	WALGREEN CO	10/15/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13231 VICTORY BLVD	None	VAN NUYS	CA	91401	2025	19	06037	34.18670546	-118.42164	Los Angeles County
288610	Fee-for-Service	1114506664	1114506664	1	1	WONG, BRANDON D DO	10/8/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21458	08	Family Practice	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
288627	Fee-for-Service	1093934101	1093934101	1	1	WEST LA SUPPORT SERVICES INC	11/14/1996	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1443 S GENESEE AVE	None	LOS ANGELES	CA	90019	3702	19	06037	34.04959165	-118.3639134	Los Angeles County
288658	Fee-for-Service	1326363995	1326363995	1	1	WALGREEN CO	10/14/2010	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	155 NORTHGATE ONE	None	SAN RAFAEL	CA	94903	3417	21	06041	38.0077165	-122.5460228	Marin County
288686	Fee-for-Service	1992122238	1992122238	1	1	WATFORD, DANIEL J MD	5/27/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	153704	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
288689	Fee-for-Service	1497844559	1497844559	1	1	WILSON, THOMAS I MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33997	08	Family Practice	0	In state provider	None	800 DELBON AVE	None	TURLOCK	CA	95382	2005	50	06099	37.51047152	-120.839499	Stanislaus County
288741	Fee-for-Service	1972685931	1972685931	1	1	WALKER, JEFFREY M MD	6/30/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	76706	40	Pediatrics	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
288742	Fee-for-Service	1740674696	1740674696	1	1	WANG, DEBBIE Y DO	9/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15318	01	General Practice	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	5480	19	06037	34.2206967	-118.5342638	Los Angeles County
288794	Fee-for-Service	1992122238	1992122238	1	1	WATFORD, DANIEL J MD	5/27/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	153704	45	Nephrology (Renal-Kidney)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
288805	Fee-for-Service	1598008187	1598008187	1	1	WALD-DICKLER, NOAH D MD	7/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132882	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
288849	Fee-for-Service	1982919064	1982919064	1	1	WEST COAST HOSPITALISTS PC	3/22/2011	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
288883	Fee-for-Service	1235297524	1235297524	1	1	WOO, JEANIE MD	8/22/1986	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	58357	41	Internal Medicine	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
288926	Fee-for-Service	1629521646	1629521646	1	1	WALKER, THOMAS P NP	3/14/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16745 W BERNARDO DR	STE 240	SAN DIEGO	CA	92127	1907	37	06073	33.01539521	-117.0824934	San Diego County
288998	Fee-for-Service	1427134915	1427134915	1	1	WALKER, MICHAEL T PHD	6/15/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	877 N DOUGLAS ST	None	EL SEGUNDO	CA	90245	2801	19	06037	33.92830583	-118.3831669	Los Angeles County
289122	Fee-for-Service	1376656967	1376656967	1	1	WONG, KAI Y MD	8/17/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53447	08	Family Practice	0	In state provider	None	711 W COLLEGE ST	STE 208	LOS ANGELES	CA	90012	1093	19	06037	34.06541412	-118.2414102	Los Angeles County
289221	Fee-for-Service	1750623633	1750623633	1	1	WAL-MART STORES, INC	5/15/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5420 LA PALMA AVE	None	LA PALMA	CA	90623	1705	30	06059	33.84624501	-118.0387461	Orange County
289224	Fee-for-Service	1790543163	1790543163	1	1	WOOJIN JOO MD PC	5/31/2024	193400000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	903 CRENSHAW BLVD	SUITE 101	LOS ANGELES	CA	90019	1965	19	06037	34.05617593	-118.3221956	Los Angeles County
289267	Fee-for-Service	1811046295	1811046295	1	1	WHITE, ROBERT C OD	1/13/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6860 AVENIDA ENCINAS	None	CARLSBAD	CA	92009	3201	37	06073	33.10754269	-117.3146974	San Diego County
289270	Fee-for-Service	1689022063	1689022063	1	1	WANG, ANNIE MD	9/5/2023	208600000X	NA	General Surgery	026	PHYSICIANS	186728	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
289305	Fee-for-Service	1861666224	1861666224	1	1	WILSON, SHRUTI P MD	8/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119432	41	Internal Medicine	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
289309	Fee-for-Service	1184745283	1184745283	1	1	WILLIS, SHARMAN S LMFT	1/8/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 CLAREMONT AVE	STE 213	STOCKTON	CA	95207	5700	39	06077	37.99861886	-121.3102123	San Joaquin County
289322	Fee-for-Service	1265479901	1265479901	1	1	WETHERBEE, ROBERT A JR MD	1/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	84872	66	Emergency Medicine (Urgent Care)	0	In state provider	None	75 NIELSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7937089	Santa Cruz County
289351	Fee-for-Service	1235249392	1235249392	1	1	WILLIAM ANDOLSEK	7/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 N MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
289398	Fee-for-Service	1861666224	1861666224	1	1	WILSON, SHRUTI P MD	8/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119432	03	Allergy	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
289483	Fee-for-Service	1548203607	1548203607	1	1	WHITTIER HEARING CENTER INC	10/14/2016	193200000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	13121 PHILADELPHIA ST	None	WHITTIER	CA	90601	4302	19	06037	33.97912551	-118.0353645	Los Angeles County
289521	Fee-for-Service	1710061783	1710061783	1	1	WITT, DAVE J MD	10/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46814	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1580 VALENCIA ST	None	SAN FRANCISCO	CA	94110	4423	38	06075	37.74746923	-122.4202583	San Francisco County
289564	Fee-for-Service	1548203607	1548203607	1	1	WHITTIER HEARING CENTER INC	10/14/2016	193200000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	13121 PHILADELPHIA ST	None	WHITTIER	CA	90601	4302	19	06037	33.97912551	-118.0353645	Los Angeles County
289611	Fee-for-Service	1336574896	1336574896	1	1	WILLIAMS, SHARON A LMFT	12/5/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7025 N CHESTNUT AVE	102	FRESNO	CA	93720	0351	10	06019	36.83802638	-119.7362506	Fresno County
289627	Fee-for-Service	1770974198	1770974198	1	1	WATERLANDER, KRISTINE NP	3/12/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
289714	Fee-for-Service	1699138511	1699138511	1	1	WU, VANESSA MD	4/17/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152955	08	Family Practice	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
289732	Fee-for-Service	1124197660	1124197660	1	1	WADHAR, HARSHAD B MD	6/3/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	156937	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DRIVE	None	VALLEJO	CA	94589	2594	48	06095	38.13070051	-122.237307	Solano County
289765	Fee-for-Service	1841641412	1841641412	1	1	WU, STEVEN MD	10/23/2020	207R00000X	NA	Other	026	PHYSICIANS	152011	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
289784	Fee-for-Service	1033154984	1033154984	1	1	WOSK, BERNARD MD	7/1/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	49350	40	Pediatrics	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
289790	Fee-for-Service	1265010029	1265010029	1	1	WILSON, KALIN L MD	4/25/2024	207R00000X	NA	Other	026	PHYSICIANS	191825	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
289802	Fee-for-Service	1558672030	1558672030	1	1	WEST, JENNIFER L	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
289848	Fee-for-Service	1184277691	1184277691	1	1	WITHERSPOON, NYKEA DOULA	4/10/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
289863	Fee-for-Service	1669418604	1669418604	1	1	WANG, MARGARET M DO	7/1/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	5664	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
289878	Fee-for-Service	1265013106	1265013106	1	1	WU, RITA MD	8/20/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
289885	Fee-for-Service	1417617663	1417617663	1	1	WECARE INC	10/15/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6356 VAN NUYS BLVD	STE 231	VAN NUYS	CA	91404	2743	19	06037	34.185861	-118.4487045	Los Angeles County
289905	Fee-for-Service	1992846414	1992846414	1	1	WEISSENBERG, RONALD DO	11/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	SURGERY SPECIALISTS AT	1713 S KOFA AVE	STE G	PARKER	AZ	85344	6400	00	None	34.14225319	-114.2871917	La Paz County
289917	Fee-for-Service	1730315300	1730315300	1	1	WINESTONE, LENA E MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	113788	78	Neoplastic Diseases/Oncology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
289924	Fee-for-Service	1063049823	1063049823	1	1	WILLIAMS, JUSTIN MD	3/18/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	186342	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
289944	Fee-for-Service	1811187560	1811187560	1	1	WANG, SONNY S MD	5/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81551	02	General Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
289963	Fee-for-Service	1750623666	1750623666	1	1	WILLIAMSON, MICHELLE LMFT	12/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5674 STONERIDGE DRIVE	SUITE 217	PLEASANTON	CA	94588	8532	01	06001	37.69154862	-121.8891352	Alameda County
289983	Fee-for-Service	1730315300	1730315300	1	1	WINESTONE, LENA E MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	113788	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
289991	Fee-for-Service	1558413971	1558413971	1	1	WANG,THOMAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	15225 SHADY GROVE RD	STE 201	ROCKVILLE	MD	20850	3278	00	None	39.10706489	-77.18961474	Montgomery County
290026	Fee-for-Service	1093778672	1093778672	1	1	WU,HUEY-YUAN	4/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45797	41	Internal Medicine	0	In state provider	None	55 S RAYMOND AVE	STE 200	ALHAMBRA	CA	91801	7103	19	06037	34.08999734	-118.145085	Los Angeles County
290034	Fee-for-Service	1730191065	1730191065	1	1	WATERS, PAUL A MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	23567	01	General Practice	0	In state provider	None	782 E HARDING WAY	None	STOCKTON	CA	95204	6101	39	06077	37.96910043	-121.284224	San Joaquin County
290048	Fee-for-Service	1730315300	1730315300	1	1	WINESTONE, LENA E MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	113788	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
290087	Fee-for-Service	1437134665	1437134665	1	1	WOLLMAN, ROBERT C MD	4/6/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78624	78	Neoplastic Diseases/Oncology	0	In state provider	None	3531 FASHION WAY	None	TORRANCE	CA	90503	4807	19	06037	33.8352235	-118.348254	Los Angeles County
290089	Fee-for-Service	1871553834	1871553834	1	1	WU, DAFANG MD	2/8/2022	207U00000X	NA	Other	026	PHYSICIANS	77987	None	None	0	In state provider	None	3195 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5233	34	06067	38.568744	-121.4652825	Sacramento County
290144	Fee-for-Service	1437134665	1437134665	1	1	WOLLMAN, ROBERT C MD	4/6/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78624	30	Radiology	0	In state provider	None	3531 FASHION WAY	None	TORRANCE	CA	90503	4807	19	06037	33.8352235	-118.348254	Los Angeles County
290173	Fee-for-Service	1083805378	1083805378	1	1	WHITE, MATTHEW P MD	1/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71577	41	Internal Medicine	0	In state provider	None	2450 ASHBY AVE	RM 1002	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
290187	Fee-for-Service	1891271730	1891271730	1	1	WORTHINGTON, TAMARA LCSW	7/17/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
290191	Fee-for-Service	1235302241	1235302241	1	1	WU, WENDY H DPM	2/9/2010	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	500 N GARFIELD AVE	STE 210	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
290220	Fee-for-Service	1700316916	1700316916	1	1	WONG, ANDREW MD	6/28/2022	2085R0001X	NA	Other	026	PHYSICIANS	176087	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
290274	Fee-for-Service	1992773139	1992773139	1	1	WEBB, GORDON V. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9395 CROWN CREST BLVD	None	PARKER	CO	80138	8573	00	None	39.5497445	-104.7700003	Douglas County
290332	Fee-for-Service	1205918034	1205918034	1	1	WALKNER, JUDITH K	2/8/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	214 S MAIN ST	None	WEAVERVILLE	CA	96093	9001	53	06105	40.73592528	-122.9469669	Trinity County
290356	Fee-for-Service	1437156247	1437156247	1	1	WOOSTER COMM HOSP	4/1/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1761 BEALL AVE	None	WOOSTER	OH	44691	0000	00	None	40.820832	-81.93421101	Wayne County
290371	Fee-for-Service	1396972956	1396972956	1	1	WONG, SANDY W K MD	11/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145511	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
290412	Fee-for-Service	1629280045	1629280045	1	1	WOLFF-FISHER, NADEEN PHD	10/31/1994	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	18663 VENTURA BLVD	STE 301	TARZANA	CA	91356	4161	19	06037	34.17051848	-118.5402557	Los Angeles County
290418	Fee-for-Service	1396972956	1396972956	1	1	WONG, SANDY W K MD	11/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145511	68	Hematology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
290471	Fee-for-Service	1851549273	1851549273	1	1	WEST CHESTER MEDICAL CENTER	3/31/2010	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	7700 UNIVERSITY DR	None	WEST CHESTER	OH	45069	2505	00	None	39.35695506	-84.36772609	Butler County
290474	Fee-for-Service	1578013561	1578013561	1	1	WANG, XIAOYIN	12/19/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5720 STONERIDGE MALL RD	STE 390	PLEASANTON	CA	94588	2831	01	06001	37.69247085	-121.9301884	Alameda County
290501	Fee-for-Service	1346045077	1346045077	1	1	WIKERT, BRIANA PT	2/27/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	16008 KAMANA RD.,	SUITE 200	APPLE VALLEY	CA	92307	0000	36	06071	34.54191149	-117.2725046	San Bernardino County
290510	Fee-for-Service	1851549273	1851549273	1	1	WEST CHESTER MEDICAL CENTER	3/31/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	7700 UNIVERSITY DR	None	WEST CHESTER	OH	45069	2505	00	None	39.35695506	-84.36772609	Butler County
290558	Fee-for-Service	1033410501	1033410501	1	1	WEISSMAN, LEE M AU	5/20/2020	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	505 SAN MARIN DRIVE	A130	NOVATO	CA	94945	1309	21	06041	38.12144894	-122.5842153	Marin County
290565	Fee-for-Service	1881829430	1881829430	1	1	WREN, JEREMY J DO	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11506	25	Physical Medicine and Rehabilitation	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
290579	Fee-for-Service	1568674877	1568674877	1	1	WILLIAM PETERSON	9/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2316 E MEYER BLVD	None	KANSAS CITY	MO	64132	1136	00	None	39.00731984	-94.55747576	Jackson County
290595	Fee-for-Service	1992817670	1992817670	1	1	WASHINGTON, KIMBERLY A MD	2/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	112469	25	Physical Medicine and Rehabilitation	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
290623	Fee-for-Service	1073701967	1073701967	1	1	WU, PEGGY S MD	4/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119174	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
290685	Fee-for-Service	1558386078	1558386078	1	1	WANG, FANG-RONG MD	7/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	51669	08	Family Practice	0	In state provider	None	416 W LAS TUNAS DR	STE 204	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
290786	Fee-for-Service	1689701039	1689701039	1	1	WEINACHT, KATJA G MD	11/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145468	78	Neoplastic Diseases/Oncology	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
290817	Fee-for-Service	1689701039	1689701039	1	1	WEINACHT, KATJA G MD	11/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145468	68	Hematology	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
290845	Fee-for-Service	1689701039	1689701039	1	1	WEINACHT, KATJA G MD	11/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145468	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
290859	Fee-for-Service	1659433514	1659433514	1	1	WISER, TANYA T LCSW	6/18/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
290907	Fee-for-Service	1962633164	1962633164	1	1	WILSON, LAWRENCE E JR MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131300	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
290933	Fee-for-Service	1962633164	1962633164	1	1	WILSON, LAWRENCE E JR MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131300	02	General Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
290954	Fee-for-Service	1598801961	1598801961	1	1	WANG, NANCY E MD	9/21/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79905	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
290959	Fee-for-Service	1700205499	1700205499	1	1	WIGGINS, CARA F	8/26/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39350 CIVIC CENTER DR	None	FREMONT	CA	94538	2343	01	06001	37.55399458	-121.9756047	Alameda County
290979	Fee-for-Service	1043303696	1043303696	1	1	WASHINGTON, TABITHA A MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	94950	05	Anesthesiology	0	In state provider	None	3559 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	1763	49	06097	38.47813376	-122.7279674	Sonoma County
290986	Fee-for-Service	1184821183	1184821183	1	1	WAXMAN, MATTHEW A MD	3/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85367	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
291023	Fee-for-Service	1588997407	1588997407	1	1	WHITE, HEATHER H NP	7/30/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
291029	Fee-for-Service	1629309588	1629309588	1	1	WEEDIN, JOHN W MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121212	34	Urology and Urological Surgery	0	In state provider	None	1789 W YOSEMITE AVENUE	None	MANTECA	CA	95337	5160	39	06077	37.79964	-121.246425	San Joaquin County
291044	Fee-for-Service	1972967297	1972967297	1	1	WALKER, ALEX G MD	9/20/2022	2085R0204X	NA	Other	026	PHYSICIANS	181174	None	None	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
291074	Fee-for-Service	1942215041	1942215041	1	1	WALGREEN CO	4/24/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3331 W CENTURY BLVD	None	INGLEWOOD	CA	90303	1366	19	06037	33.94550091	-118.3301957	Los Angeles County
291158	Fee-for-Service	1043615578	1043615578	1	1	WAL-MART STORE INC	6/8/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6197 SUNRISE BLVD	None	CITRUS HEIGHTS	CA	95610	6834	34	06067	38.675709	-121.273254	Sacramento County
291182	Fee-for-Service	1831200278	1831200278	1	1	WONG, KATHLEEN A MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69612	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
291235	Fee-for-Service	1427089754	1427089754	1	1	WASHINGTON CLINIC/FRMNT	7/30/2002	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2500 MOWRY AVE	STE 212	FREMONT	CA	94538	1605	01	06001	37.555011	-121.9801005	Alameda County
291253	Fee-for-Service	1578012043	1578012043	1	1	WISHNEK, HANNAH	4/18/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
291267	Fee-for-Service	1700448925	1700448925	1	3	WILLIAM Y. TO, O.D., INC	10/13/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	E	377 SANTANA ROW	STE 1115	SAN JOSE	CA	95128	2058	43	06085	37.32042463	-121.9485378	Santa Clara County
291279	Fee-for-Service	1902906068	1902906068	1	1	WESTERN HEALTH CARE	11/18/1992	174400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A PROFESSIONAL MED CORP	4760 S FIGUEROA ST	None	LOS ANGELES	CA	90037	3159	19	06037	33.99970148	-118.2826935	Los Angeles County
291288	Fee-for-Service	1902906068	1902906068	1	1	WESTERN HEALTH CARE	11/18/1992	174400000X	NA	Other	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	A PROFESSIONAL MED CORP	4760 S FIGUEROA ST	None	LOS ANGELES	CA	90037	3159	19	06037	33.99970148	-118.2826935	Los Angeles County
291299	Fee-for-Service	1336273325	1336273325	1	1	WAL-MART STORES, INC	10/26/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1400 HILLTOP MALL RD	None	RICHMOND	CA	94806	1913	07	06013	37.97825351	-122.3283482	Contra Costa County
291322	Fee-for-Service	1710468590	1710468590	1	1	WILLIAMS FORDE, TRISH VANESS	9/19/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	A NP	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
291329	Fee-for-Service	1780995068	1780995068	1	1	WADA, JONATHAN M MD	8/24/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	121522	08	Family Practice	0	In state provider	None	300 CORPORATE POINTE	STE 465	CULVER CITY	CA	90230	8706	19	06037	33.98867148	-118.3837334	Los Angeles County
291367	Fee-for-Service	1902966062	1902966062	1	1	WOLFE, VALERIE A PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2120 PROFESSIONAL DRIVE	None	ROSEVILLE	CA	95661	3700	31	06061	38.74247397	-121.2508672	Placer County
291402	Fee-for-Service	1881995272	1881995272	2	1	WESTERN SIERRA EMERGENCY	8/22/2011	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PHYSICIANS MEDICAL GROUP	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	0070	36	06071	34.26577765	-117.1695461	San Bernardino County
291435	Fee-for-Service	1174295349	1174295349	1	1	WELCOME HEALTH MEDICAL GROUP	6/8/2022	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	8135 PAINTER AVE	105	WHITTIER	CA	90602	3158	19	06037	33.965829	-118.032738	Los Angeles County
291568	Non-Physician Medical Practitioner	None	1407565641	0	0	WRIGHT, KAITLIN A PA-C	12/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 4TH ST	None	MARYSVILLE	CA	95901	5656	00	06000	39.13872267	-121.5944372	Yuba County
291572	Non-Physician Medical Practitioner	None	1952077315	0	0	WILLIAMS, CLAIRE NP	10/13/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
291574	Non-Physician Medical Practitioner	None	1245515972	0	0	WONG, JENNY YING	12/5/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
291612	Non-Physician Medical Practitioner	None	1912194689	0	0	WOODWARD, JENNIFER LYNN	8/25/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	322 POSADA LN STE A	None	TEMPLETON	CA	93465	4003	00	06000	35.55315677	-120.7214989	San Luis Obispo County
291619	Non-Physician Medical Practitioner	None	1922835172	0	0	WEBER, KATHRYN L NP	10/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 E HIGHLAND AVE	# 551	SAN BERNARDINO	CA	92404	3861	00	06000	34.1358627	-117.2757778	San Bernardino County
291659	Non-Physician Medical Practitioner	None	1437731742	0	0	WANDS, NOELLE T PA-C	11/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	00	06000	35.356203	-119.0612695	Kern County
291667	Non-Physician Medical Practitioner	None	1740848670	0	0	WIER, KOA R NP	10/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 N. TUSTIN AVE	UNIT # 216	SANTA ANA	CA	92705	3528	00	06000	33.754167	-117.834191	Orange County
291710	Non-Physician Medical Practitioner	None	1578932653	0	0	WYCHE, PETRA	1/24/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	06000	32.683167	-114.633459	Yuma County
291714	Non-Physician Medical Practitioner	None	1588343230	0	0	WONG, OLIVIAN NP	10/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	328 S. FIRST ST	F	ALHAMBRA	CA	91801	3790	00	06000	34.09104553	-118.1252904	Los Angeles County
291746	Non-Physician Medical Practitioner	None	1326537853	0	0	WITCZAK, VICTORIA PA	1/6/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
291754	Non-Physician Medical Practitioner	None	1376741934	0	0	WAX, PLUMMER L JR	9/23/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2749 VALLEYCREEK CIRCE	None	CHULA VISTA	CA	91914	4221	00	06000	32.6639899	-116.9532351	San Diego County
291776	Non-Physician Medical Practitioner	None	1659318780	0	0	WEST, ANNETTE E	7/4/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	00	06000	37.37715796	-122.0651926	Santa Clara County
291830	Non-Physician Medical Practitioner	None	1962942078	0	0	WADSWORTH, THELMA R PA-C	2/10/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2510 AIRPARK DR	STE 106	REDDING	CA	96001	2449	00	06000	40.57119566	-122.4016582	Shasta County
291834	Non-Physician Medical Practitioner	None	1659104008	0	0	WEDDINGTON, MEGAN NP	3/10/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
291931	Non-Physician Medical Practitioner	None	1538334065	0	0	WEST COUNTY HEALTH CENTERS, INC.	5/27/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6800 PALM AVE	SUITE C2	SEBASTOPOL	CA	95472	4269	00	06000	38.39602719	-122.8185446	Sonoma County
291955	Non-Physician Medical Practitioner	None	1801487095	0	0	WITEK, ERICA B PA-C	5/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2490 HOSPITAL DRIVE	SUITE 111	MOUNTAIN VIEW	CA	94040	4124	00	06000	37.369827	-122.0818185	Santa Clara County
291959	Non-Physician Medical Practitioner	None	1306378641	0	0	WADDELL, AMANDA D NP	12/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2810 FRANKLIN ST	APT 10	SAN FRANCISCO	CA	94123	3131	00	06000	37.80043112	-122.426015	San Francisco County
291961	Non-Physician Medical Practitioner	None	1033458161	0	0	WINFIELD, EMMA	4/22/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6001 NORRIS CANYON RD	None	SAN RAMON	CA	94583	5400	00	06000	37.7755858	-121.958923	Contra Costa County
291964	Non-Physician Medical Practitioner	None	1740810613	0	0	WON, JENIFFER	1/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3670 DEGNAN BLVD	None	LOS ANGELES	CA	90018	4015	00	06000	34.02110503	-118.329693	Los Angeles County
291973	Non-Physician Medical Practitioner	None	1295980977	0	0	WELCH, CHERYL M NP	12/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	727 H AVE	None	CORONADO	CA	92118	2133	00	06000	32.6920224	-117.1832151	San Diego County
291977	Non-Physician Medical Practitioner	None	1811268725	0	0	WATANABE, REIKO	4/16/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 UCLA MEDICAL PLZ	STE 550	LOS ANGELES	CA	90095	8344	00	06000	34.065126	-118.446237	Los Angeles County
291980	Non-Physician Medical Practitioner	None	1821271685	0	0	WEBB, SHANNON L PA-C	1/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6605 NANCY RIDGE DR	None	SAN DIEGO	CA	92121	2253	00	06000	32.88682438	-117.1796133	San Diego County
291984	Non-Physician Medical Practitioner	None	1942915137	0	0	WALLER, NATALIE NP	5/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2331 A MONTPELIER DR	STE 20	SAN JOSE	CA	95116	1688	00	06000	37.3649965	-121.8479359	Santa Clara County
291999	Non-Physician Medical Practitioner	None	1598549578	0	0	WALKER, KIM NP	1/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3634 ELIZABETH ST	None	RIVERSIDE	CA	92506	2506	00	06000	33.95782448	-117.3904065	Riverside County
292006	Non-Physician Medical Practitioner	None	1922434935	0	0	WONG, ADLEY	7/14/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	868 PARK DR	APT 3	MOUNTAIN VIEW	CA	94040	2539	00	06000	37.38585465	-122.0859069	Santa Clara County
292021	Non-Physician Medical Practitioner	None	1447337118	0	0	WANG, GEORGE J PA	10/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	00	06000	38.12188356	-121.285872	San Joaquin County
292039	Non-Physician Medical Practitioner	None	1568561553	0	0	WARD, APRIL L	5/25/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	685 TWELVE BRIDGES DR	#B	LINCOLN	CA	95648	8689	00	06000	38.85108687	-121.2886018	Placer County
292058	Non-Physician Medical Practitioner	None	1306281217	0	0	WALGAMUTH, MELISSA R	11/19/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13411 SHASTA MEADOW	None	REDDING	CA	96003	7798	00	06000	40.67951385	-122.3110354	Shasta County
292082	Non-Physician Medical Practitioner	None	1356973432	0	0	WALLER, BRENT S NP	2/25/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3400 W BALL ROAD	STE 207	ANAHEIM	CA	92804	3102	00	06000	33.81724472	-118.0083216	Orange County
292102	Non-Physician Medical Practitioner	None	1306072046	0	0	WILLIAMSON, JAMES D JR	4/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1407 AUGUSTA POINTE DR	None	RIPON	CA	95366	9383	00	06000	37.72790149	-121.139325	San Joaquin County
292110	Non-Physician Medical Practitioner	None	1386177129	0	0	WADZANI, DENIS NP	4/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2220 W MANCHESTER BLVD	None	INGLEWOOD	CA	90305	2514	00	06000	33.9598587	-118.318258	Los Angeles County
292126	Non-Physician Medical Practitioner	None	1659904365	0	0	WATSON, REGAN R CNM	7/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2020 SUTTER PL	None	DAVIS	CA	95616	6201	00	06000	38.56287659	-121.7715536	Yolo County
292163	Non-Physician Medical Practitioner	None	1548418635	0	0	WARD, MICHAEL PETER	7/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1180 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4868	00	06000	33.839505	-116.5455735	Riverside County
292183	Non-Physician Medical Practitioner	None	1093406456	0	0	WOODS, HELENE NP	11/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4849 VAN NUYS BLVD	211	SHERMAN OAKS	CA	91403	2110	00	06000	34.159113	-118.4487465	Los Angeles County
292228	Non-Physician Medical Practitioner	None	1366952244	0	0	WILSON, DARAH L	1/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	76 N SIERRA BONITA AVE	APT 3	PASADENA	CA	91106	2140	00	06000	34.14725899	-118.1170255	Los Angeles County
292245	Non-Physician Medical Practitioner	None	1154474716	0	0	WOLVERTON, BRIGITTE K	12/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5620 VISTA DEL MAR	None	YORBA LINDA	CA	92887	3266	00	06000	33.87714762	-117.783108	Orange County
292308	Non-Physician Medical Practitioner	None	1568542652	0	0	WALKER, MARGO JUSTINE	12/19/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	235 W 6TH ST	None	RENO	NV	89503	4548	00	06000	39.53165987	-119.8181899	Washoe County
292358	Non-Physician Medical Practitioner	None	1760972491	0	0	WESSELMAN, JILLIAN A NP	7/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	00	06000	37.25111017	-121.9465891	Santa Clara County
292424	Non-Physician Medical Practitioner	None	1780132142	0	0	WILLIAMS, KIMBERLY G NP	9/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1230 CLAYTON ST	APT 4	SAN FRANCISCO	CA	94114	1800	00	06000	37.76125747	-122.4464522	San Francisco County
292456	Non-Physician Medical Practitioner	None	1285276022	0	0	WANGENSTEEN, OLIVIA S PA-C	2/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
292467	Non-Physician Medical Practitioner	None	1295236222	0	0	WILDER, SARAH M	8/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	961 W SOLANO ST	None	UPLAND	CA	92507	1591	00	06000	34.13697257	-117.6647017	San Bernardino County
292470	Non-Physician Medical Practitioner	None	1205340973	0	0	WRIGHT, NICOLE PA	2/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26800 CROWN VALLEY PKWY	STE 305, 315, 325, 330	MISSION VIEJO	CA	92691	8033	00	06000	33.56286021	-117.6673449	Orange County
292527	Non-Physician Medical Practitioner	None	1083668149	0	0	WOOSNAM, NICOLE	12/13/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	06000	36.163269	-115.1654465	Clark County
292562	Non-Physician Medical Practitioner	None	1073914347	0	0	WOLKEN, KRYSTA L NP	3/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21842 LYONS BALD MTN RD	None	SONORA	CA	95370	8768	00	06000	38.01813073	-120.3311178	Tuolumne County
292591	Non-Physician Medical Practitioner	None	1790097269	0	0	WONG, STEPHANIE ANNE	7/19/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	FIRST AVENUE AT 16TH STR	None	NEW YORK	NY	10003	0000	00	06000	40.732668	-73.98162	New York County
292603	Non-Physician Medical Practitioner	None	1306243860	0	0	WHISMAN, DANICA H NP	1/31/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	626 EAST ORANGE GROVE	STE 102	BURBANK	CA	91501	2881	00	06000	34.18694763	-118.3040714	Los Angeles County
292627	Non-Physician Medical Practitioner	None	1619327467	0	0	WITCIK, KAYLA M PA-C	11/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
292631	Non-Physician Medical Practitioner	None	1285908947	0	0	WARD, CLAIRE A	6/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20 FOREST GLEN STREET	None	MOUNTAIN VIEW	CA	94043	2915	00	06000	37.4057516	-122.0896255	Santa Clara County
292646	Non-Physician Medical Practitioner	None	1003288481	0	0	WALTER, NICHOLAS M	12/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25814 SUNRISE WAY	None	LOMA LINDA	CA	92354	3846	00	06000	34.04618745	-117.2410605	San Bernardino County
292648	Non-Physician Medical Practitioner	None	1700449311	0	0	WALCHONSKI, JESSICA PA	9/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24241 HAWTHORNE BLVD	SUITE 201	TORRANCE	CA	90505	6504	00	06000	33.802578	-118.351229	Los Angeles County
292697	Non-Physician Medical Practitioner	None	1770662611	0	0	WOOD, PATRICIA LUCILLE	5/3/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1650 RESPONSE RD	WOMEN'S HEALTH	SACRAMENTO	CA	95815	4807	00	06000	38.596581	-121.4303535	Sacramento County
292699	Non-Physician Medical Practitioner	None	1164501177	0	0	WILLEMAIN, LYNNETTE A	5/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2350 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3305	00	06000	37.78305866	-122.4421313	San Francisco County
292700	Non-Physician Medical Practitioner	None	1093366957	0	0	WRIGHT, MEGAN N NP	10/31/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	627 W AVENUE Q	STE D	PALMDALE	CA	93551	3891	00	06000	34.58715647	-118.1417372	Los Angeles County
292713	Non-Physician Medical Practitioner	None	1851339212	0	0	WHALEN, MEGAN T NP	10/21/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	30942 VIA ERRECARTE	None	SAN JUAN CAPISTRA	CA	92675	2907	00	06000	33.513471	-117.6343405	Orange County
292731	Non-Physician Medical Practitioner	None	1154831063	0	0	WELLS, STACEY M PA-C	8/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
292739	Non-Physician Medical Practitioner	None	1518217330	0	0	WAGNER, CHASE C NP	1/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	459 AMPARO DR	None	ESCONDIDO	CA	92025	6657	00	06000	33.09840632	-117.0607499	San Diego County
292752	Non-Physician Medical Practitioner	None	1578540258	0	0	WOODARD, NATALIE A	9/24/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	332 N LAUDERDALE ST	MS 106	MEMPHIS	TN	38105	2729	00	06000	35.153532	-90.0428805	Shelby County
292803	Non-Physician Medical Practitioner	None	1013224658	0	0	WEAVER, SARAH	6/24/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	13123 E 16TH AVE	None	AURORA	CO	80045	7106	00	06000	39.742164	-104.8350375	Adams County
292895	Non-Physician Medical Practitioner	None	1598934812	0	0	WOLF, TRAVIS L	6/9/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	535 RAMONA ST	None	MODESTO	CA	95350	6016	00	06000	37.65229619	-120.9819231	Stanislaus County
292910	Non-Physician Medical Practitioner	None	1235455064	0	0	WELTY, BARBARA J NP	2/4/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	42335 WASHINGTON ST	STE F	PALM DESERT	CA	92211	8031	00	06000	33.741459	-116.303949	Riverside County
292918	Non-Physician Medical Practitioner	None	1972968188	0	0	WANGSADIPURA, PATRICIA	6/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7001 ACACIA AVE	None	FONTANA	CA	92336	3461	00	06000	34.12670266	-117.4338186	San Bernardino County
292950	Non-Physician Medical Practitioner	None	1184679805	0	0	WARREN, JANELLE MARIE	4/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11234 ANDERSON ST	ROOM 6700H	LOMA LINDA	CA	92354	2804	00	06000	34.049547	-117.264078	San Bernardino County
292955	Non-Physician Medical Practitioner	None	1003857277	0	0	WILSON, MARIE ELIZABETH	8/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 N ROSE AVE	None	OXNARD	CA	93030	3722	00	06000	34.21700406	-119.1582582	Ventura County
293033	Non-Physician Medical Practitioner	None	1477907533	0	0	WAN, ANNA N NP	5/20/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10671 CARRY WAY	None	CUPERTINO	CA	95014	2056	00	06000	37.3327205	-122.0272427	Santa Clara County
293113	Non-Physician Medical Practitioner	None	1780237875	0	0	WONG, DAVID Z PA-C	5/4/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	530 E WASHINGTON BLVD	None	LOS ANGELES	CA	90015	3723	00	06000	34.02866849	-118.2597481	Los Angeles County
293121	Non-Physician Medical Practitioner	None	1356996110	0	0	WHALEN, SARAH D PA-C	1/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1495 RIVER PARK DR	200	SACRAMENTO	CA	95815	4500	00	06000	38.599524	-121.437738	Sacramento County
293127	Non-Physician Medical Practitioner	None	1477518843	0	0	WHITE, MARIA FE M NP	3/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4080 VIA MARISOL STREET	APT 140	LOS ANGELES	CA	90042	5158	00	06000	34.09380584	-118.1853722	Los Angeles County
293141	Non-Physician Medical Practitioner	None	1003298324	0	0	WORLEY, GORDON H NP	10/19/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6109 THORNWOOD DRIVE	None	LOOMIS	CA	95650	9545	00	06000	38.82320033	-121.1887442	Placer County
293193	Non-Physician Medical Practitioner	None	1689768160	0	0	WOODWARD, PAIGE M NP	9/12/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2369 RODIN PLACE	None	DAVIS	CA	95618	7608	00	06000	38.56677297	-121.7221476	Yolo County
293211	Non-Physician Medical Practitioner	None	1598024697	0	0	WOODWARD, BARBARA L NP	7/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1833 W SHEA DR	None	FRESNO	CA	93720	4059	00	06000	36.87124449	-119.7500355	Fresno County
293232	Non-Physician Medical Practitioner	None	1548829773	0	0	WRIGHT, SARA L PA	5/11/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
293334	Non-Physician Medical Practitioner	None	1477196079	0	0	WONG, ADRIANNE PA-C	5/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4201 TORRANCE BLVD	SUITE 520	TORRANCE	CA	90503	4009	00	06000	33.8375955	-118.358748	Los Angeles County
293346	Non-Physician Medical Practitioner	None	1083165682	0	0	WAREHAM, MERIBETH NP	4/3/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2357 E EMILIE AVE	None	FRESNO	CA	93730	4756	00	06000	36.88659304	-119.7408763	Fresno County
293401	Non-Physician Medical Practitioner	None	1093947616	0	0	WEN, YI-PING NP	9/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	317 LAUREL AVE	None	ARCADIA	CA	91006	2518	00	06000	34.15021536	-118.0222351	Los Angeles County
293408	Non-Physician Medical Practitioner	None	1235603226	0	0	WONG, HONGDARA NP	7/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2101 STONE BLVD	STE 190	WEST SACRAMENTO	CA	95691	4055	00	06000	38.56318049	-121.5379228	Yolo County
293454	Non-Physician Medical Practitioner	None	1497377048	0	0	WONG, BRANDON M PA-C	8/4/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	00	06000	34.95203385	-120.4131707	Santa Barbara County
293567	Non-Physician Medical Practitioner	None	1699184358	0	0	WALLACE, CHASE E PA-C	7/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	415 LILY ST	APT B	SAN FRANCISCO	CA	94102	5509	00	06000	37.77381936	-122.4280558	San Francisco County
293569	Non-Physician Medical Practitioner	None	1962582866	0	0	WADE, KATHERINE ANN	8/24/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
293613	Non-Physician Medical Practitioner	None	1396414629	0	0	WU, VERONICA V PA-C	9/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	00	06000	37.37715796	-122.0651926	Santa Clara County
293629	Non-Physician Medical Practitioner	None	1346881927	0	0	WRONA, JULIA M PA	10/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	06000	36.132948	-115.136874	Clark County
293641	Non-Physician Medical Practitioner	None	1265860035	0	0	WEST, ERIN A NP	7/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1420 N ALTA VISTA BLVD	APT 422	LOS ANGELES	CA	90046	4394	00	06000	34.09654581	-118.3470697	Los Angeles County
293680	Non-Physician Medical Practitioner	None	1508850710	0	0	WERGLES, SUSAN E NP	3/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	48 BRISA FRESCA	None	RANCHO SANTA MARG	CA	92688	3325	00	06000	33.65102438	-117.6180635	Orange County
293682	Non-Physician Medical Practitioner	None	1033544341	0	0	WIBLE, DANAE M	10/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	00	06000	35.27804785	-120.649711	San Luis Obispo County
293725	Non-Physician Medical Practitioner	None	1780465625	0	0	WARD-LEV, ELIANA R PA-C	6/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
293751	Non-Physician Medical Practitioner	None	1639821655	0	0	WILLIAMS, KATELYN L NP	3/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2335 E KASHIAN LANE	SUITE 260	FRESNO	CA	93701	2234	00	06000	36.74333844	-119.7831874	Fresno County
293796	Non-Physician Medical Practitioner	None	1174036545	0	0	WONG, CHESTON J PA-C	4/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2250 HAYES ST	STE 302	SAN FRANCISCO	CA	94117	1078	00	06000	37.77302042	-122.45342	San Francisco County
293814	Non-Physician Medical Practitioner	None	1376159863	0	0	WEAVER, ALYSSA M PA	8/5/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
293847	Non-Physician Medical Practitioner	None	1477646610	0	0	WICKS, YVONNE J	4/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2789 GLENLOCKE GRV CT NW	None	ATLANTA	GA	30318	0675	00	06000	33.7972364	-84.48161455	Fulton County
293849	Non-Physician Medical Practitioner	None	1942314950	0	0	WAYMAN, LINDA A	7/19/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 DOYLE PARK DR	SUITE 100	SANTA ROSA	CA	95405	4558	00	06000	38.44332	-122.6985255	Sonoma County
293859	Non-Physician Medical Practitioner	None	1902842263	0	0	WORTHAM, CANDACE H	5/12/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	303 SMITH STREET	CLARK-HOLDER CLINIC, P.A	LAGRANGE	GA	30240	0000	00	06000	33.04332482	-85.03423653	Troup County
293867	Non-Physician Medical Practitioner	None	1114309911	0	0	WIEGAND, JOANNA L	6/26/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	110 GIRARD AVENUE	None	HATBORO	PA	19040	1622	00	06000	40.19206216	-75.12495783	Montgomery County
293925	Non-Physician Medical Practitioner	None	1306277686	0	0	WEHRMAN, PATRIA C NP	3/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8201 CAMINO COLEGIO	APT 134	ROHNERT PARK	CA	94928	8145	00	06000	38.32650179	-122.6851387	Sonoma County
293943	Non-Physician Medical Practitioner	None	1649588682	0	0	WYLIE, JONATHAN S NP	2/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1463 N WISHON AVENUE	None	FRESNO	CA	93728	1828	00	06000	36.762696	-119.801096	Fresno County
293946	Non-Physician Medical Practitioner	None	1013934934	0	0	WIESNER, BARBARA N NP	10/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1533 BARNETT CIRCLE	None	CARMICHAEL	CA	95608	5807	00	06000	38.593431	-121.352247	Sacramento County
293954	Non-Physician Medical Practitioner	None	1992173652	0	0	WILLIAMS, KIMECO M NP	5/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	06000	29.70724683	-95.4026169	Harris County
293956	Non-Physician Medical Practitioner	None	1356626741	0	0	WOODRUFF, JOLANA R PA-C	2/14/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	00	06000	34.28200485	-118.4030797	Los Angeles County
293983	Non-Physician Medical Practitioner	None	1427397983	0	0	WAREY, SUNITI	3/20/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	281 FISALIA COURT	None	FREMONT	CA	94539	3028	00	06000	37.56209457	-121.9511387	Alameda County
294047	Non-Physician Medical Practitioner	None	1780824912	0	0	WILSON, KOURTNEY LYNN	3/18/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2702 LOW CT	None	FAIRFIELD	CA	94534	9771	00	06000	38.23678474	-122.0847463	Solano County
294077	Non-Physician Medical Practitioner	None	1942799440	0	0	WATSON, JODI K CNM	9/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	00	06000	34.27771547	-119.2540344	Ventura County
294095	Non-Physician Medical Practitioner	None	1235584772	0	0	WINN, PAMELA J NP	9/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	9795 RAMHORN CANYON ST	None	LAS VEGAS	NV	89183	6304	00	06000	36.01161607	-115.1330994	Clark County
294116	Non-Physician Medical Practitioner	None	1194877613	0	0	WILSON, BRIDGET M NP	12/1/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6398 LAGUNA MIRAGE LN	None	ELK GROVE	CA	95758	5461	00	06000	38.424825	-121.4273295	Sacramento County
294136	Non-Physician Medical Practitioner	None	1518585447	0	0	WONG, ALEXANDER F PA-C	2/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	00	06000	35.3687456	-119.1106561	Kern County
294142	Non-Physician Medical Practitioner	None	1598164766	0	0	WAGENMAN, BRIANNE M	3/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7244 CAMINO DEGRAZIA	UNIT 285	SAN DIEGO	CA	92111	7849	00	06000	32.77272319	-117.1665025	San Diego County
294214	Non-Physician Medical Practitioner	None	1720383615	0	0	WALTZ, LAUREN PA	2/10/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
294230	Non-Physician Medical Practitioner	None	1770081655	0	0	WEIR, DANIEL NP	11/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7677 CENTER AVE	SUITE 214	HUNTINGTON BEACH	CA	92647	3074	00	06000	33.736257	-117.995535	Orange County
294251	Non-Physician Medical Practitioner	None	1568079317	0	0	WARR, JOSHUA D PA-C	1/22/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	600 N HIGHLAND SPRINGS A	None	BANNING	CA	92220	3046	00	06000	33.9316595	-116.9468639	Riverside County
294252	Non-Physician Medical Practitioner	None	1275950917	0	0	WHITESELL, KATHERINE M NP	3/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	50 RIO VISTA AVENUE	None	OAKLAND	CA	94611	5321	00	06000	37.82369814	-122.2539982	Alameda County
294281	Non-Physician Medical Practitioner	None	1629087002	0	0	WARD, MARIANN M	1/12/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE RM A80	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
294291	Non-Physician Medical Practitioner	None	1801363700	0	0	WOLOSCHYN, GREGORY B	2/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	211 HOPE ST	UNIT 74	MOUNTAIN VIEW	CA	94041	1306	00	06000	37.39311493	-122.0780205	Santa Clara County
294319	Non-Physician Medical Practitioner	None	1205614419	0	0	WEKALL, SAMANTHA L PA	9/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	111 W 17TH ST	None	SANTA ANA	CA	92706	2718	00	06000	33.76013946	-117.86832	Orange County
294400	Non-Physician Medical Practitioner	None	1144721358	0	0	WHEATON, THESAURA J NP	4/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4368 ELENA PLACE	None	QUARTZ HILL	CA	93536	3438	00	06000	34.64961357	-118.2085673	Los Angeles County
294420	Non-Physician Medical Practitioner	None	1316357007	0	0	WU, OLIVIA A	3/17/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	609 SOUTH GRAND AVENUE	SUITE 907	LOS ANGELES	CA	90017	3847	00	06000	34.04857259	-118.2554833	Los Angeles County
294437	Non-Physician Medical Practitioner	None	1477295046	0	0	WONG, CATHERINE PA-C	3/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	711 W COLLEGE ST	SUITE M88	LOS ANGELES	CA	90012	1163	00	06000	34.06541412	-118.2414102	Los Angeles County
294483	Non-Physician Medical Practitioner	None	1619296548	0	0	WALL, DAVID M	7/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	351 TREICHEL LN	None	CORRALITOS	CA	95076	0744	00	06000	36.95885465	-121.7913981	Santa Cruz County
294491	Non-Physician Medical Practitioner	None	1427716612	0	0	WOO-SAM, LYNETTE NP	1/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16955 VANOWEN	None	VAN NUYS	CA	91406	4542	00	06000	34.19389751	-118.503342	Los Angeles County
294502	Non-Physician Medical Practitioner	None	1164806329	0	0	WEBER, MARK R PA	2/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25455 BARTON RD	101B 102B 104B 106B 108B	LOMA LINDA	CA	92354	3128	00	06000	34.04805253	-117.249534	San Bernardino County
294505	Non-Physician Medical Practitioner	None	1497096713	0	0	WILLIAMS, KACEE S NP	12/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1670 MCALLISTER ST	APT 2	SAN FRANCISCO	CA	94115	4450	00	06000	37.77767061	-122.4394854	San Francisco County
294506	Non-Physician Medical Practitioner	None	1366516205	0	0	WONG, IRENE SHUK	4/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 WILLOW RD,	331C	MENLO PARK	CA	94025	0000	00	06000	37.466676	-122.160384	San Mateo County
294547	Non-Physician Medical Practitioner	None	1043688542	0	0	WHALEY, SEANEEN C NP	1/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3214 SCOTT WAY	None	NAPA	CA	94558	3422	00	06000	38.3191331	-122.3032015	Napa County
294556	Non-Physician Medical Practitioner	None	1558967489	0	0	WATSON, CARMEN H NP	12/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
294572	Non-Physician Medical Practitioner	None	1245545581	0	0	WALKINS, BETHANY M NP	8/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	00	06000	32.798889	-117.150826	San Diego County
294598	Non-Physician Medical Practitioner	None	1891392643	0	0	WILLIAMS, MATTHEW T PA	11/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	115 MALL DRIVE	None	HANFORD	CA	93230	5786	00	06000	36.32396253	-119.6688834	Kings County
294629	Non-Physician Medical Practitioner	None	1962184291	0	0	WILLIAMS, KRYSTA	12/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	421 NUT TREE RD	None	VACAVILLE	CA	95687	3508	00	06000	38.36441975	-121.9525909	Solano County
294659	Non-Physician Medical Practitioner	None	1982121885	0	0	WARREN, JENNIFER E NP	9/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1144 SONOMA AVE	STE 119	SANTA ROSA	CA	95405	4812	00	06000	38.441097	-122.6989755	Sonoma County
294670	Non-Physician Medical Practitioner	None	1124238548	0	0	WENCK, PATIENCE	8/22/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1154 EMERALD BAY RD	None	SOUTH LAKE TAHOE	CA	96150	6288	00	06000	38.90859803	-120.0018502	El Dorado County
294673	Non-Physician Medical Practitioner	None	1336790963	0	0	WILLIAMS, LORILEA P NP	9/25/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	00	06000	35.3687456	-119.1106561	Kern County
294720	Non-Physician Medical Practitioner	None	1831476779	0	0	WILLIAMS, KASINEE PA	11/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	00	06000	34.06477215	-117.9845382	Los Angeles County
294730	Non-Physician Medical Practitioner	None	1164207593	0	0	WILLIAMS, ERICA PA-C	10/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3833 WORSHAM AVENUE	SUITE 300	LONG BEACH	CA	90808	1745	00	06000	33.828552	-118.1462755	Los Angeles County
294760	Non-Physician Medical Practitioner	None	1730836040	0	0	WEATHERSPOON, INDIE NP	9/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 S VINCENT AVE	SUITE 205	WEST COVINA	CA	91790	6712	00	06000	34.0662144	-117.9274205	Los Angeles County
294763	Non-Physician Medical Practitioner	None	1619477817	0	0	WUYSANG, KRISTIAN NP	6/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7576 STERLING AVE	STE C&D	SAN BERNARDINO	CA	92410	4202	00	06000	34.116201	-117.243686	San Bernardino County
294770	Non-Physician Medical Practitioner	None	1811292253	0	0	WEBB, JAMES JUNGO	5/2/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7391 W CHARLESTON BLVD	SUITE 140	LAS VEGAS	NV	89117	1577	00	06000	36.15908224	-115.2528371	Clark County
294800	Non-Physician Medical Practitioner	None	1407082878	0	0	WESTPHALN, KRISTI K NP	9/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	847 STEVENS AVE	APT B	SOLANA BEACH	CA	92075	2536	00	06000	32.98403003	-117.2593316	San Diego County
294816	Non-Physician Medical Practitioner	None	1932201977	0	0	WONG, MICHELLE L	10/2/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	173 ARDITH DR	None	ORNIDA	CA	94563	4232	00	06000	37.84677243	-122.1475765	Contra Costa County
294832	Non-Physician Medical Practitioner	None	1669780722	0	0	WEAVER, ANGELA R F	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	32886 RUTH HILL ROAD	None	SQUAW VALLEY	CA	93675	0584	00	06000	36.727002	-119.215152	Fresno County
294845	Non-Physician Medical Practitioner	None	1750484929	0	0	WICE, MELANIE S	1/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5 BON AIR RD	SUITE 217	LARKSPUR	CA	94939	1143	00	06000	37.9438204	-122.5395357	Marin County
294859	Non-Physician Medical Practitioner	None	1003307463	0	0	WHITNEY, ALEXANDER PA	6/2/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4125 BANGS AVE	None	MODESTO	CA	95356	8713	00	06000	37.70451024	-121.0709696	Stanislaus County
294860	Non-Physician Medical Practitioner	None	1386850246	0	0	WAITE, MOLLY	8/14/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1595 SOQUEL DR	SUITE 400	SANTA CRUZ	CA	95065	1719	00	06000	36.98879599	-121.9826354	Santa Cruz County
294874	Non-Physician Medical Practitioner	None	1932672615	0	0	WILLIAMSON, LEVI B PA	8/14/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1180 N INDIAN CANYON DR	W201	PALM SPRINGS	CA	92262	4876	00	06000	33.839505	-116.5455735	Riverside County
294892	Non-Physician Medical Practitioner	None	1639161052	0	0	WYER, KATHY LENAY	12/4/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	4160 W ARABIAN LANE	None	YUMA	AZ	85365	8021	00	06000	32.668416	-114.668721	Yuma County
294916	Non-Physician Medical Practitioner	None	1003801820	0	0	WILLERUP, ELIZABETH BARBARA	8/13/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1643 EUREKA RD	None	ROSEVILLE	CA	95661	3027	00	06000	38.74688342	-121.2469903	Placer County
294969	Non-Physician Medical Practitioner	None	1578189262	0	0	WASSOM, LAORENCE NP	8/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4950 BARRANCA PARKWAY	SUITE 104	IRVINE	CA	92604	4630	00	06000	33.67620851	-117.7948348	Orange County
294970	Non-Physician Medical Practitioner	None	1073262549	0	0	WIRTZ FIERRO, GABRIEL R PA-C	2/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4201 TORRANCE BLVD	SUITE 520	TORRANCE	CA	90503	4009	00	06000	33.8375955	-118.358748	Los Angeles County
294976	Non-Physician Medical Practitioner	None	1275198608	0	0	WONG, REBECCA X PA-C	2/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2773 HARRIS ST	STE A & D	EUREKA	CA	95503	4866	00	06000	40.78052829	-124.1363953	Humboldt County
294982	Non-Physician Medical Practitioner	None	1245326305	0	0	WEBER, KATHRYN J	5/17/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4676 SMOKE RIVER CT	None	SAN JOSE	CA	95136	2750	00	06000	37.26428456	-121.8626315	Santa Clara County
294988	Non-Physician Medical Practitioner	None	1245428929	0	0	WIDMAN, MARY ANN	7/2/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1713 S KOFA AVE	SUITE A	PARKER	AZ	85344	6477	00	06000	34.14225319	-114.2871917	La Paz County
295024	Non-Physician Medical Practitioner	None	1205874765	0	0	WARSTLER, APRIL L	3/27/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15211 VANOWEN ST	SUITE 105	VAN NUYS	CA	91405	3606	00	06000	34.19395411	-118.4642527	Los Angeles County
295033	Non-Physician Medical Practitioner	None	1205083524	0	0	WOO, LILLIAN	6/3/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 NORTH ROSSMORE AVE	APT 306	LOS ANGELES	CA	90004	2436	00	06000	34.079238	-118.3272415	Los Angeles County
295040	Non-Physician Medical Practitioner	None	1336874635	0	0	WONG, MIA NP	3/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	00	06000	34.05362775	-118.2661889	Los Angeles County
295155	Non-Physician Medical Practitioner	None	1477982577	0	0	WEISS, ROBERT G	2/22/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	82 EINSTEIN RIDGE WAY	None	LAS VEGAS	NV	89193	5020	00	06000	35.98292512	-115.1696147	Clark County
295166	Non-Physician Medical Practitioner	None	1154550986	0	0	WU, YVONNE YANCHIU YU	10/21/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17220 NEWHOPE ST	None	FOUNTAIN VALLEY	CA	92708	4272	00	06000	33.713244	-117.923877	Orange County
295177	Non-Physician Medical Practitioner	None	1982386074	0	0	WRINKLE, HELEN R PA	8/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6848 MAGNOLIA AVE	STE 220	RIVERSIDE	CA	92506	2858	00	06000	33.94954856	-117.3989256	Riverside County
295191	Non-Physician Medical Practitioner	None	1568951606	0	0	WANLESS, ANDREA R PA-C	3/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	255 TERRACINA BLVD	STE 205C	REDLANDS	CA	92373	4870	00	06000	34.03788441	-117.2055761	San Bernardino County
295218	Non-Physician Medical Practitioner	None	1801052410	0	0	WOLFORD, CONNIE S	10/2/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	211 QUARRY RD	SUITE 206	PALO ALTO	CA	94304	1416	00	06000	37.44198478	-122.1694088	Santa Clara County
295220	Non-Physician Medical Practitioner	None	1376748095	0	0	WILKERSON, CARLIE JEANETTE	1/11/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	990 SONOMA AVE STE 20	None	SANTA ROSA	CA	95404	4813	00	06000	38.440305	-122.701653	Sonoma County
295283	Non-Physician Medical Practitioner	None	1013407170	0	0	WELCH, CARLY B NP	3/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
295287	Non-Physician Medical Practitioner	None	1609850023	0	0	WIENS, KIMBERLY DAWN	5/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	TRAUMA PROGRAM ROOM 4212	SACRAMENTO	CA	95817	0000	00	06000	38.555181	-121.4566785	Sacramento County
295334	Non-Physician Medical Practitioner	None	1750166591	0	0	WILLIAMSON, TROY PA	2/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3113	00	06000	33.80318353	-118.0666665	Orange County
295372	Non-Physician Medical Practitioner	None	1780226001	0	0	WEEBER, CHRISTIAN M PA-C	4/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	00	06000	38.443806	-122.701374	Sonoma County
295402	Non-Physician Medical Practitioner	None	1467270421	0	0	WISZ, STEVIE L PA-C	1/28/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 WASHINGTON ST	STE 512	SAN DIEGO	CA	92103	2231	00	06000	32.74986289	-117.1599343	San Diego County
295428	Non-Physician Medical Practitioner	None	1346765823	0	0	WOLFKIN, DEVON L NP	11/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3980 SOMERSET AVE	None	CASTRO VALLEY	CA	94546	3445	00	06000	37.70186953	-122.0747422	Alameda County
295435	Non-Physician Medical Practitioner	None	1487489571	0	0	WHEELER, NICOLE	10/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
295485	Non-Physician Medical Practitioner	None	1174853543	0	0	WEIL, DANNIELLE B NP	2/8/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	SUMC - PEDS PHYSICIAN BI	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
295487	Non-Physician Medical Practitioner	None	1275659401	0	0	WILSON, JAMES A	12/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4819 CORBINA WAY	None	OXNARD	CA	93035	2810	00	06000	34.18624213	-119.2370436	Ventura County
295496	Non-Physician Medical Practitioner	None	1548516339	0	0	WILSON, RACHEAL PA-C	4/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1117 E DEVONSHIRE AVENUE	None	HEMET	CA	92543	3083	00	06000	33.75116909	-116.9601666	Riverside County
295574	Non-Physician Medical Practitioner	None	1497812648	0	0	WALTER, CHRISTINA M PA-C	9/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	901 CAMPUS DR.	None	DALY CITY	CA	94015	4900	00	06000	37.66535778	-122.4763793	San Mateo County
295588	Non-Physician Medical Practitioner	None	1760716765	0	0	WEIGEL, JANELLE MARY	5/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4150 CLEMENT ST	None	SAN FRANCISCO	CA	94121	1545	00	06000	37.78109398	-122.5051321	San Francisco County
295641	Non-Physician Medical Practitioner	None	1801120977	0	0	WILLCOTT, AARON M PA-C	1/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
295674	Non-Physician Medical Practitioner	None	1598879884	0	0	WILLIS, MICHELLE L	3/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3327 PROSPECT AVE	None	EUREKA	CA	95503	5037	00	06000	40.77803935	-124.1788834	Humboldt County
295679	Non-Physician Medical Practitioner	None	1023682986	0	0	WILLIS, AUSTIN J PA	9/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
295726	Non-Physician Medical Practitioner	None	1205398138	0	0	WASHBURN, CYNTHIA PA-C	7/13/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
295730	Non-Physician Medical Practitioner	None	1922643386	0	0	WALSH, LEAH NP	6/23/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	00	06000	38.91229842	-119.9978133	El Dorado County
295771	Non-Physician Medical Practitioner	None	1700951126	0	0	WINDOM, ANDREA MARTIN	8/27/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
295834	Non-Physician Medical Practitioner	None	1770896508	0	0	WONGRAVEEKUL, SUCHEERA	12/10/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3625 MARTIN LUTHER KING	SUITE 4	LYNWOOD	CA	90262	3509	00	06000	33.93044131	-118.2021564	Los Angeles County
295835	Non-Physician Medical Practitioner	None	1386703098	0	0	WARTA, RAWLIN L	3/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5656 EAST OVERLOOK DR	None	RANCHO CUCAMONGA	CA	91739	2386	00	06000	34.151094	-117.524049	San Bernardino County
295869	Non-Physician Medical Practitioner	None	1124660923	0	0	WANG, BETTY PA-C	5/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
295894	Non-Physician Medical Practitioner	None	1104809474	0	0	WESTON, ABIGAIL N NP	5/23/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8104 SIENNA LOOP	None	ROSEVILLE	CA	95678	6054	00	06000	38.7950495	-121.2868329	Placer County
295901	Non-Physician Medical Practitioner	None	1982161337	0	0	WARD, CRYSTAL J CNP	12/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19270 SONOMA HIGHWAY 12	None	SONOMA	CA	95476	5414	00	06000	38.29871411	-122.4751509	Sonoma County
295915	Non-Physician Medical Practitioner	None	1629845193	0	0	WOOD, JENNA NP	8/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
295924	Non-Physician Medical Practitioner	None	1962185405	0	0	WAGGONER, KATIE	2/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
295960	Non-Physician Medical Practitioner	None	1598908907	0	0	WILSON, CHRISTINA	5/13/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR # H3600	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
295976	Non-Physician Medical Practitioner	None	1194261115	0	0	WALIA, SABRINA K NP	3/15/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1404 RESERVOIR DRIVE	None	SAN BERNARDINO	CA	92407	5006	00	06000	34.17578102	-117.3172015	San Bernardino County
295992	Non-Physician Medical Practitioner	None	1740729805	0	0	WACHIRA, ESTHER NP	1/16/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7677 CENTER AVE	SUITE 214	HUNTINGTON BEACH	CA	92647	3074	00	06000	33.736257	-117.995535	Orange County
296011	Non-Physician Medical Practitioner	None	1396091203	0	0	WINTERS, KELLY NP	1/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	00	06000	35.39052148	-119.0070765	Kern County
296013	Non-Physician Medical Practitioner	None	1396992939	0	0	WILLIAMS, CHRISTOPHER R PA	5/7/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6028 MOONSTONE AVENUE	None	ALTA LOMA	CA	91701	2722	00	06000	34.14514768	-117.6140306	San Bernardino County
296025	Non-Physician Medical Practitioner	None	1144697053	0	0	WILLIAMS, RAVYN W	3/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4820 BEEMAN AVE	None	VALLEY VILLAGE	CA	91607	3403	00	06000	34.15869042	-118.4064332	Los Angeles County
296080	Non-Physician Medical Practitioner	None	1750045316	0	0	WIN, WAI P PA-C	12/13/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33560 ALVARADO NILES	None	UNION CITY	CA	94587	3111	00	06000	37.59123987	-122.0355648	Alameda County
296082	Non-Physician Medical Practitioner	None	1902318199	0	0	WETZEL, DANIELLE R	3/7/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2547 HAMPTON AVE	None	REDWOOD CITY	CA	94061	2539	00	06000	37.45867394	-122.2350646	San Mateo County
296109	Non-Physician Medical Practitioner	None	1124598818	0	0	WESTWOOD, JULIE A NP	12/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	9755 SILVER SKY PKWY	APT 1303	RENO	NV	89506	2229	00	06000	39.63693479	-119.8732764	Washoe County
296145	Non-Physician Medical Practitioner	None	1578816633	0	0	WRIGHT, JENNIFER N PA	2/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1374 E ALLUVIAL AVE	None	FRESNO	CA	93720	2608	00	06000	36.84475352	-119.758806	Fresno County
296184	Non-Physician Medical Practitioner	None	1992210660	0	0	WANG, ALICE PA	1/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5763 GREEN PINE COURT	None	RANCHO CUCAMONGA	CA	91739	2236	00	06000	34.14918203	-117.497623	San Bernardino County
296209	Non-Physician Medical Practitioner	None	1134522865	0	0	WOLCOTT, CAROL PA-C	8/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1135 S SUNSET AVE	STE 200	WEST COVINA	CA	91790	3937	00	06000	34.06215064	-117.9453997	Los Angeles County
296238	Non-Physician Medical Practitioner	None	1952935819	0	0	WOLF, CHELSEA NP	11/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4849 VAN NUYS BLVD	211	SHERMAN OAKS	CA	91403	2110	00	06000	34.159113	-118.4487465	Los Angeles County
296247	Non-Physician Medical Practitioner	None	1902253974	0	0	WACHUTKA, GINA L PA-C	9/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 CALDECOTT LN	UNIT 302	OAKLAND	CA	94618	2417	00	06000	37.85817838	-122.2214033	Alameda County
296258	Non-Physician Medical Practitioner	None	1376779066	0	0	WILLIAMS, KERRY M NP	9/14/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	222 N SINGINGWOOD ST	APT 10	ORANGE	CA	92869	3176	00	06000	33.78907038	-117.79079	Orange County
296262	Non-Physician Medical Practitioner	None	1306683321	0	0	WISHNER, HAYLEY PA-C	12/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	160 E ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	00	06000	34.07556833	-117.7507835	Los Angeles County
296267	Non-Physician Medical Practitioner	None	1437609534	0	0	WILHELM, MELISSA D NP	12/19/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8701 DELGANY AVENUE	#101	PLAYA DEL REY	CA	90293	8151	00	06000	33.95600313	-118.4397666	Los Angeles County
296270	Non-Physician Medical Practitioner	None	1417966466	0	0	WASHBURN, JON R.	12/1/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	525 WEST ACACIA STREET	None	STOCKTON	CA	95203	2405	00	06000	37.9611947	-121.3009489	San Joaquin County
296282	Non-Physician Medical Practitioner	None	1265700694	0	0	WANG, ANN M NP	11/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13902 YORBA ST	UNIT 3-C	TUSTIN	CA	92780	1854	00	06000	33.761079	-117.8270535	Orange County
296310	Non-Physician Medical Practitioner	None	1023788759	0	0	WON, PHYLLIS S PA	6/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	00	06000	38.00450116	-122.5540001	Marin County
296311	Non-Physician Medical Practitioner	None	1376912212	0	0	WAGNER, KRISTIN L	10/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	271 KENNEBEC AVE	# 4	LONG BEACH	CA	90803	5773	00	06000	33.76762083	-118.1638994	Los Angeles County
296321	Non-Physician Medical Practitioner	None	1871351544	0	0	WILLIAMS, SARAH NP	5/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8701 CUYAMACA ST	None	SANTEE	CA	92071	4253	00	06000	32.83439779	-116.98366	San Diego County
296326	Non-Physician Medical Practitioner	None	1336999408	0	0	WALLACE, STEPHANIE NP	6/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	00	06000	39.74352822	-121.8495394	Butte County
296377	Non-Physician Medical Practitioner	None	1831627181	0	0	WALDRUP, LA'RHONDA M NP	3/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
296409	Non-Physician Medical Practitioner	None	1831368109	0	0	WONG, PATRICK J	5/12/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3232 CALHOUN ST	None	ALAMEDA	CA	94501	5507	00	06000	37.75201557	-122.2364262	Alameda County
296423	Non-Physician Medical Practitioner	None	1639504962	0	0	WAHLGREN, REBECCA E NP	3/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1665 SCENIC AVE	None	BERKELEY	CA	94709	1334	00	06000	37.87808887	-122.2627701	Alameda County
296454	Non-Physician Medical Practitioner	None	1770098774	0	0	WU, VICTOR J PA	11/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
296468	Non-Physician Medical Practitioner	None	1811267909	0	0	WENGER, ANGEL L	11/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1121 SAFFEX ROSE AVE	None	HENDERSON	NV	89052	8720	00	06000	35.99155335	-115.1394025	Clark County
296470	Non-Physician Medical Practitioner	None	1396198982	0	0	WELLSPACE HEALTH	9/20/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2425 ALHAMBRA BLVD	None	SACRAMENTO	CA	95817	1109	00	06000	38.55627	-121.471875	Sacramento County
296471	Non-Physician Medical Practitioner	None	1699041418	0	0	WEIR, JANET NP	9/27/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8454 WHITE OAK AVE	None	NORTHRIDGE	CA	91325	3938	00	06000	34.22419669	-118.5198224	Los Angeles County
296572	Non-Physician Medical Practitioner	None	1487999140	0	0	WHITE, JESSICA M NP	9/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1231 LAS PALMAS	APT 103	LOS ANGELES	CA	90038	1267	00	06000	34.09363252	-118.3363331	Los Angeles County
296596	Non-Physician Medical Practitioner	None	1083983852	0	0	WOOD, BRENT M	3/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	202 MADRONA ROAD	None	FELTON	CA	95018	9652	00	06000	37.03424234	-122.0753765	Santa Cruz County
296613	Non-Physician Medical Practitioner	None	1912419276	0	0	WILSON, ALIX M	1/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2207 BRIDGEPORT WAY	None	MARTINEZ	CA	94553	6711	00	06000	37.99602758	-122.0869323	Contra Costa County
296616	Non-Physician Medical Practitioner	None	1699071365	0	0	WIENER, SHARON	2/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	ROOM M1493, BOX 0132	SAN FRANCISCO	CA	94143	0132	00	06000	37.7634502	-122.4579779	San Francisco County
296641	Non-Physician Medical Practitioner	None	1851893192	0	0	WOOD, ERICKA R NP	8/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7960 RAFAEL RIVERA WAY	APT 1358	LAS VEGAS	NV	89113	5358	00	06000	36.06685034	-115.263219	Clark County
296657	Non-Physician Medical Practitioner	None	1548632920	0	0	WAY, ALLYSON K	2/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1933 CRAIG AVE	None	ALTADENA	CA	91001	3514	00	06000	34.17937587	-118.1050556	Los Angeles County
296684	Non-Physician Medical Practitioner	None	1194308031	0	0	WILKINS, LISA M NP	7/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	729 N MEDICAL CENTER DRI	223	CLOVIS	CA	93611	6879	00	06000	36.84152435	-119.6624818	Fresno County
296714	Non-Physician Medical Practitioner	None	1346925195	0	0	WANG, MIAO NP	9/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
296722	Non-Physician Medical Practitioner	None	1427873223	0	0	WILSON, MELISSA G NP	12/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
296747	Non-Physician Medical Practitioner	None	1710624424	0	0	WHITE GARCIA, MONICA D NP	11/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	700 W 19TH ST	None	COSTA MESA	CA	92627	3517	00	06000	33.64342564	-117.9280911	Orange County
296817	Non-Physician Medical Practitioner	None	1225576770	0	0	WEXLER, SARAH A	4/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17660 CAMINO DE YATASTO	None	PACIFIC PALISADES	CA	90272	2014	00	06000	34.07884877	-118.5716973	Los Angeles County
296824	Non-Physician Medical Practitioner	None	1780221796	0	0	WATUNG, MICHAEL C NP	2/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	742 W HIGHLAND AVE	None	SAN BERNARDINO	CA	92405	3839	00	06000	34.13604853	-117.29952	San Bernardino County
296858	Non-Physician Medical Practitioner	None	1447993530	0	0	WILSON, BRADLEY	12/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
296867	Non-Physician Medical Practitioner	None	1407242456	0	0	WANG, ZHIJIAN	5/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1160 E PERRIN AVE	105	FRESNO	CA	93720	4263	00	06000	36.87361895	-119.7621057	Fresno County
296900	Non-Physician Medical Practitioner	None	1336587534	0	0	WAY, ALIA E PA	9/13/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	00	06000	33.03623896	-117.2837308	San Diego County
296932	Non-Physician Medical Practitioner	None	1619643368	0	0	WYNER, JESSICA L NP	1/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12660 RIVERSIDE DRIVE	SUITE 225	NORTH HOLLYWOOD	CA	91201	3000	00	06000	34.1575795	-118.409499	Los Angeles County
296981	Non-Physician Medical Practitioner	None	1902571037	0	0	WILLIAMS, KIRSTEN E MSW LCSW	12/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
297058	Non-Physician Medical Practitioner	None	1467513861	0	0	WOODHEAD, SHELLEY JEAN	9/30/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6600 BRUCEVILLE RD	MOB 3, MEDICINE J	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
297125	Non-Physician Medical Practitioner	None	1356813299	0	0	WITHROW, JENNA PA-C	3/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	511 BATH ST	None	SANTA BARBARA	CA	93101	3403	00	06000	34.41386476	-119.6993335	Santa Barbara County
297172	Non-Physician Medical Practitioner	None	1801123914	0	0	WEGRZYN, TAMMY R NP	9/30/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6674 LEANNE ST	None	MIRA LOMA	CA	91752	3478	00	06000	33.96704329	-117.5500528	Riverside County
297180	Non-Physician Medical Practitioner	None	1326073263	0	0	WILSON, ANNA M NP	11/5/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1150 S MEADOW LN	APT 29	COLTON	CA	92324	6472	00	06000	34.0507959	-117.2992514	San Bernardino County
297286	Non-Physician Medical Practitioner	None	1194837278	0	0	WYSONG, MARC PA-C	7/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	00	06000	39.506454	-121.5412785	Butte County
297334	Non-Physician Medical Practitioner	None	1295296622	0	0	WEIDEMAN, AUSTIN PA	7/14/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	00	06000	34.2064445	-118.8824085	Ventura County
297411	Non-Physician Medical Practitioner	None	1447433826	0	0	WATSON, KAROLINA A NP	12/27/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH ROAD MC 5500	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
297423	Non-Physician Medical Practitioner	None	1134829211	0	0	WEINER, HALEY E PA-C	8/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	75 NIELSON ST	None	WATSONVILLE	CA	95076	2468	00	06000	36.9282117	-121.7937089	Santa Cruz County
297428	Non-Physician Medical Practitioner	None	1083104582	0	0	WELK, CASEY J	8/5/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 W SUNSET BLVD	SUITE 812	WEST HOLLYWOOD	CA	90069	3709	00	06000	34.09054375	-118.392295	Los Angeles County
297433	Non-Physician Medical Practitioner	None	1003519885	0	0	WILLIAMS, TIWANNA	9/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
297434	Non-Physician Medical Practitioner	None	1811167752	0	0	WATSON, KAROLINA A NP	12/27/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1000 WELCH RD	STE 300	PALO ALTO	CA	94304	1811	00	06000	37.43572075	-122.1785985	Santa Clara County
297452	Non-Physician Medical Practitioner	None	1295918001	0	0	WILHELM, MICHAEL D	1/25/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	782 SHASTA OAKS CT	None	ROSEVILLE	CA	95678	1275	00	06000	38.76043083	-121.2832638	Placer County
297476	Non-Physician Medical Practitioner	None	1013951417	0	0	WILLIAMS, TANISHA G	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15740 AVIENDA DE CIRCO	None	MORENO VALLEY	CA	92555	4230	00	06000	33.8917849	-117.201239	Riverside County
297483	Non-Physician Medical Practitioner	None	1427568351	0	0	WIDYASTAMI, LAURENSIA H NP	5/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2121 PINE ST	None	SAN FRANCISCO	CA	94115	2829	00	06000	37.78824776	-122.4311213	San Francisco County
297537	Non-Physician Medical Practitioner	None	1295272201	0	0	WILLIAMS, SARI NP	11/28/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
297554	Non-Physician Medical Practitioner	None	1720328487	0	0	WEISS, KAREN L NP	1/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	00	06000	38.00771973	-122.1331484	Contra Costa County
297572	Non-Physician Medical Practitioner	None	1245619295	0	0	WITT, NORA M D NP	3/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9 BELLEZZA	None	IRVINE	CA	92620	1815	00	06000	33.72147983	-117.7663855	Orange County
297581	Non-Physician Medical Practitioner	None	1295190890	0	0	WEST, KATE E NP	7/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5314 BLACKFOX COURT	None	WEED	CA	96094	5314	00	06000	41.55130069	-122.3848176	Siskiyou County
297586	Non-Physician Medical Practitioner	None	1346740578	0	0	WALLACE, MERIT NP	9/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	00	06000	39.33573744	-120.180872	Nevada County
297587	Non-Physician Medical Practitioner	None	1184311391	0	0	WILT, BRANDY N NP	6/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1145 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3528	00	06000	33.89242734	-118.2947128	Los Angeles County
297640	Non-Physician Medical Practitioner	None	1639547755	0	0	WEINER, ALYSSA R	10/8/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	131 S SUMMERTREE ROAD	None	ANAHEIM HILLS	CA	92807	4022	00	06000	33.85252516	-117.7770952	Orange County
297647	Non-Physician Medical Practitioner	None	1548685175	0	0	WICKE, WENDY A PA	1/27/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	426 S SHEPHERD ST	None	SONORA	CA	95370	5124	00	06000	37.97965653	-120.3798484	Tuolumne County
297651	Non-Physician Medical Practitioner	None	1093537540	0	0	WILSON, SIERRAH B	11/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6926 BROCKTON AVE	SUITE 6 & 11	RIVERSIDE	CA	92506	3800	00	06000	33.947919	-117.3967225	Riverside County
297674	Non-Physician Medical Practitioner	None	1225103161	0	0	WOO, SANDI T	12/31/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	32 CAMELIA PLACE	None	OAKLAND	CA	94602	2506	00	06000	37.80806948	-122.2013245	Alameda County
297679	Non-Physician Medical Practitioner	None	1235742420	0	0	WAHIDI, NANCY A PA	11/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	517 N MAIN ST	STE 100	SANTA ANA	CA	92701	4619	00	06000	33.74951945	-117.8675809	Orange County
297733	Non-Physician Medical Practitioner	None	1063847150	0	0	WANTZ, RACHEL A NP	10/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4860 Y ST	None	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
297771	Non-Physician Medical Practitioner	None	1003090697	0	0	WILLIAMS, JORDAN RYAN	1/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	00	06000	34.95203385	-120.4131707	Santa Barbara County
297787	Non-Physician Medical Practitioner	None	1588101844	0	0	WHITE, BRITTEN NP	6/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 CORPORATE POINTE	STE 465	CULVER CITY	CA	90230	8706	00	06000	33.98867148	-118.3837334	Los Angeles County
297798	Non-Physician Medical Practitioner	None	1699254052	0	0	WHITE, RACHEL L NP	3/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
297850	Non-Physician Medical Practitioner	None	1184757791	0	0	WARNOCK, ROBERT S NP	3/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2461 CHELSEA PLACE	UNIT 1	SANTA MONICA	CA	90404	2066	00	06000	34.03325103	-118.4760352	Los Angeles County
297889	Non-Physician Medical Practitioner	None	1972850360	0	0	WALKER, ELISABETH NP	1/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5821 JAMESON CT	None	CARMICHAEL	CA	95608	0820	00	06000	38.651409	-121.3290945	Sacramento County
297893	Non-Physician Medical Practitioner	None	1447332036	0	0	WELLSPACE HEALTH	2/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8233 E STOCKTON BLVD STE	None	SACRAMENTO	CA	95828	8203	00	06000	38.459628	-121.4095815	Sacramento County
297934	Non-Physician Medical Practitioner	None	1649344136	0	0	WILLEY, GERARD J	5/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5459 E SAGINAW	None	FRESNO	CA	93727	7536	00	06000	36.78875967	-119.7064236	Fresno County
297941	Non-Physician Medical Practitioner	None	1821278540	0	0	WALKER, ANABELLE L	12/19/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10121 CENTER DR	None	VILLA PARK	CA	92861	2740	00	06000	33.81559155	-117.8133846	Orange County
297947	Non-Physician Medical Practitioner	None	1629514153	0	0	WELLER, MICAH J	8/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2084 STARFALL LN	None	CHINO HILLS	CA	91709	2369	00	06000	33.96377375	-117.7591941	San Bernardino County
297971	Non-Physician Medical Practitioner	None	1295850790	0	0	WATKINS, JOHN S	3/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10564 CAMINITO FLORES	None	SAN DIEGO	CA	92126	2804	00	06000	32.9106567	-117.1339025	San Diego County
298030	Non-Physician Medical Practitioner	None	1417079112	0	0	WILLIAMS, JAMES T	6/12/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	721 ARLINGTON CIRCLE	None	NOVATO	CA	94947	4906	00	06000	38.07735105	-122.5636113	Marin County
298046	Non-Physician Medical Practitioner	None	1093735243	0	0	WEBSTER, KRISTEN M	3/5/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	821 COLBY COURT	None	WOODLAND	CA	95695	6812	00	06000	38.66477172	-121.7991073	Yolo County
298071	Non-Physician Medical Practitioner	None	1750537437	0	0	WEST COUNTY MEDICAL CORP-NON PROFIT	10/20/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2272 PACIFIC AVE	UNIT A	LONG BEACH	CA	90806	4312	00	06000	33.798582	-118.193644	Los Angeles County
298084	Non-Physician Medical Practitioner	None	1487956934	0	0	WOLF, STACY A NP	8/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 PINE STREET	APT 56	SAN FRANCISCO	CA	94108	3123	00	06000	37.79125022	-122.407562	San Francisco County
298158	Non-Physician Medical Practitioner	None	1497822241	0	0	WEBB, WILLIAM A	3/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9763 PEACH TREE LANE	None	ALTA LOMA	CA	91737	2205	00	06000	34.15289052	-117.591894	San Bernardino County
298203	Non-Physician Medical Practitioner	None	1174799464	0	0	WOODS, DEBORAH A	10/24/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9431 BULLION WAY	None	ORANGEVALE	CA	95662	5424	00	06000	38.666259	-121.200759	Sacramento County
298218	Non-Physician Medical Practitioner	None	1477516409	0	0	WHITING, TERRI M	3/5/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17497 KUMEYAI TRAIL	None	ALPINE	CA	91901	1202	00	06000	32.86282883	-116.7726891	San Diego County
298275	Non-Physician Medical Practitioner	None	1356896617	0	0	WETSEL, SOMMER L	9/6/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4482 VILLAGE DR	APT A	CHINO HILLS	CA	91709	3755	00	06000	33.97979775	-117.7077658	San Bernardino County
298286	Non-Physician Medical Practitioner	None	1801575147	0	0	WALL, KATHERINE PA-C	9/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	00	06000	32.79692047	-117.1567137	San Diego County
298369	Non-Physician Medical Practitioner	None	1659667681	0	0	WHITE, KRISTEN D PA	1/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	00	06000	34.072245	-117.4319685	San Bernardino County
298379	Non-Physician Medical Practitioner	None	1598031130	0	0	WOLF, ERIN C	11/8/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1247 E FOXHILL DRIVE	#134	FRESNO	CA	93720	5005	00	06000	36.86773436	-119.7612146	Fresno County
298386	Non-Physician Medical Practitioner	None	1083865026	0	0	WALSH, HEATHER J PA-C	2/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3969 4TH AVE	STE 208	SAN DIEGO	CA	92103	3165	00	06000	32.74948151	-117.1615826	San Diego County
298391	Non-Physician Medical Practitioner	None	1699317958	0	0	WELCH, BRIA PA	9/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
298395	Non-Physician Medical Practitioner	None	1801316765	0	0	WILLIAMSON, ANN NP	8/28/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 MEDICAL PLAZA	STE 214	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
298417	Non-Physician Medical Practitioner	None	1750474243	0	0	WERGIN, CATHERINE D A	2/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1900 ARGAIL WAY	None	SACRAMENTO	CA	95822	1902	00	06000	38.534589	-121.4958915	Sacramento County
298459	Non-Physician Medical Practitioner	None	1841067857	0	0	WESTMAN, STELIANA M NP	3/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14901 RINALDI STREET	SUITE 200-201	MISSION HILLS	CA	91345	1254	00	06000	34.27903452	-118.457433	Los Angeles County
298481	Non-Physician Medical Practitioner	None	1629494919	0	0	WARHAFT, CHRISTINE D NP	9/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21201 HILLSDALE LN	None	HUNTINGTON BEACH	CA	92313	3411	00	06000	33.65497118	-117.9660092	Orange County
298492	Non-Physician Medical Practitioner	None	1396095675	0	0	WONG, KRISTEN M	10/24/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1417 VIA CAMILLE	None	MONTEBELLO	CA	90640	3122	00	06000	34.02137594	-118.1126862	Los Angeles County
298510	Non-Physician Medical Practitioner	None	1669725271	0	0	WOOD, ERIN E PA-C	10/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2075 SAN JOAQUIN HILLS R	None	NEWPORT BEACH	CA	92660	6505	00	06000	33.61676129	-117.869325	Orange County
298522	Non-Physician Medical Practitioner	None	1699287698	0	0	WEST, ELIZABETH NP	4/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
298523	Non-Physician Medical Practitioner	None	1427058932	0	0	WALLACE, EVELINE S NP	2/11/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2773 HARRIS ST	STE A & D	EUREKA	CA	95503	4866	00	06000	40.78052829	-124.1363953	Humboldt County
298529	Non-Physician Medical Practitioner	None	1225063969	0	0	WILKES, ANNE C NP	8/9/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1219 W SCOTT AVE	None	FRESNO	CA	93711	3121	00	06000	36.81106328	-119.8134554	Fresno County
298577	Non-Physician Medical Practitioner	None	1437404654	0	0	WELLSPACE HEALTH	10/24/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10423 OLD PLACERVILLE RD	None	SACRAMENTO	CA	95827	2540	00	06000	38.570382	-121.3075395	Sacramento County
298579	Non-Physician Medical Practitioner	None	1447927751	0	0	WAGNER, TRICIA NP	12/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1305 STRATFORD AVE	None	DIXON	CA	95620	2024	00	06000	38.45801155	-121.839444	Solano County
298587	Non-Physician Medical Practitioner	None	1134224223	0	0	WESTBERG, LARA LYNN	12/7/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1119 PACIFIC AVE	SUITE 200	SANTA CRUZ	CA	95060	7503	00	06000	36.9722444	-122.0256836	Santa Cruz County
298592	Non-Physician Medical Practitioner	None	1568223451	0	0	WORTLEY, CHRISTINE R NP	12/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
298596	Non-Physician Medical Practitioner	None	1710320437	0	0	WETMORE, DUSTIN K PA-C	8/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3130 DEL MONTE BLVD	None	MARINA	CA	93933	3047	00	06000	36.68590557	-121.8010492	Monterey County
298614	Non-Physician Medical Practitioner	None	1568075190	0	0	WEBSTER, CAREY C NP	11/22/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	584 N. SUNRISE AVE	100	ROSEVILLE	CA	95661	2862	00	06000	38.75842021	-121.2528302	Placer County
298640	Non-Physician Medical Practitioner	None	1760631592	0	0	WILSON, THERESA L NP	10/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	231 VIA SOCORRO	None	SAN CLEMENTE	CA	92672	8009	00	06000	33.44337448	-117.6357737	Orange County
298653	Non-Physician Medical Practitioner	None	1235412545	0	0	WILSON, DIANE M	2/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1659 JUNIPER AVE	None	SAN BRUNO	CA	94066	2919	00	06000	37.62432367	-122.4241628	San Mateo County
298654	Non-Physician Medical Practitioner	None	1538595509	0	0	WELZIG, ALEXANDER M PA	5/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	800 S MAIN STREET	None	CORONA	CA	92882	3420	00	06000	33.872958	-117.568359	Riverside County
298718	Non-Physician Medical Practitioner	None	1306245410	0	0	WILLIAMS, CHRISTOPHER R	10/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1730 LUTON DRIVE	None	ROSEVILLE	CA	95747	6482	00	06000	38.7524183	-121.3432281	Placer County
298750	Non-Physician Medical Practitioner	None	1033760772	0	0	WOOD, KERRY E NP	10/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18111 BROOKHURST ST	STE 5100	FOUNTAIN VALLEY	CA	92708	6728	00	06000	33.70027259	-117.9544055	Orange County
298849	Non-Physician Medical Practitioner	None	1144784158	0	0	WILLIS, DALYNNE NP	3/28/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	00	06000	38.571084	-121.471074	Sacramento County
298850	Non-Physician Medical Practitioner	None	1174120836	0	0	WATTS, ALEXANDRA L CNM	5/13/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1665 ESPLANADE	None	CHICO	CA	95926	3312	00	06000	39.74388808	-121.8503372	Butte County
298862	Non-Physician Medical Practitioner	None	1982165999	0	0	WAGNITZ, CHRISTOPHER PA-C	9/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
298922	Non-Physician Medical Practitioner	None	1093706350	0	0	WATSON, AMY HELEN	12/5/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	568 E HERNDON AVE	SUITE 201	FRESNO	CA	93720	2989	00	06000	36.83752653	-119.7776433	Fresno County
298930	Non-Physician Medical Practitioner	None	1972563880	0	0	WANG, MICHAEL YU	7/18/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 S CHEVY CHASE DR	105	GLENDALE	CA	91205	4431	00	06000	34.136757	-118.2396195	Los Angeles County
298978	Non-Physician Medical Practitioner	None	1396988390	0	0	WANG, TING LIN	6/9/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17631 MAIDSTONE AVE	None	ARTESIA	CA	90701	3821	00	06000	33.87057193	-118.0858763	Los Angeles County
299008	Non-Physician Medical Practitioner	None	1609499391	0	0	WATSON, SHANNON J PA-C	6/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 4TH ST	None	MARYSVILLE	CA	95901	5656	00	06000	39.13872267	-121.5944372	Yuba County
299048	Non-Physician Medical Practitioner	None	1992142277	0	0	WEST SIDE HEALTH CARE DISTRI	5/2/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 E NORTH ST	None	TAFT	CA	93268	3606	00	06000	35.13962803	-119.4517471	Kern County
299063	Non-Physician Medical Practitioner	None	1871227462	0	0	WILHELM, KATHERINE L NP	1/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
299096	Non-Physician Medical Practitioner	None	1841799053	0	0	WRIGHT, TOYREE S NP	10/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
299157	Non-Physician Medical Practitioner	None	1770748956	0	0	WILTSIE, MEREDITH N NP	12/8/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	629 FRANCISCO ST	None	HALF MOON BAY	CA	94019	4807	00	06000	37.5051351	-122.4672109	San Mateo County
299165	Non-Physician Medical Practitioner	None	1831602416	0	0	WARNER, JESSICA C	5/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5675 TELEGRAPH AVE	APT C	OAKLAND	CA	94609	6134	00	06000	37.84261037	-122.2615978	Alameda County
299195	Non-Physician Medical Practitioner	None	1902053945	0	0	WESTERN SIERRA MEDICAL CLINIC	6/30/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	209 NEVADA STREET	None	DOWNIEVILLE	CA	95936	0000	00	06000	39.55907195	-120.8295366	Sierra County
299240	Non-Physician Medical Practitioner	None	1629674858	0	0	WRIGHT, DEREK PA-C	5/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3434 MIDWAY DRIVE	SUITE 2001	SAN DIEGO	CA	92110	4924	00	06000	32.75065153	-117.2126147	San Diego County
299242	Non-Physician Medical Practitioner	None	1831726694	0	0	WILLIAMS, CYNTHIA J NP	11/16/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3700 H ST,	None	SACRAMENTO	CA	95816	4611	00	06000	38.572137	-121.4562375	Sacramento County
299252	Non-Physician Medical Practitioner	None	1609912690	0	0	WOO, STEPHEN CHRISTOPHER	1/16/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	438 EAST LAS TUNAS DR.	None	SAN GABRIEL	CA	91776	0000	00	06000	34.1033113	-118.0946668	Los Angeles County
299322	Non-Physician Medical Practitioner	None	1174891568	0	0	WONG, STACY NICOLE	3/8/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	RM M779	SAN FRANCISCO	CA	94143	0112	00	06000	37.7634502	-122.4579779	San Francisco County
299333	Non-Physician Medical Practitioner	None	1215981170	0	0	WALLACE, JESSICA E NP	3/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 16TH ST	110	SANTA MONICA	CA	90404	1235	00	06000	34.02726451	-118.4857138	Los Angeles County
299363	Non-Physician Medical Practitioner	None	1134687544	0	0	WOODFOLK, LONDON M PA-C	4/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	00	06000	32.781483	-117.007182	San Diego County
299389	Non-Physician Medical Practitioner	None	1659329951	0	0	WILSON, DEAN PA	6/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7300 MEDICAL CENTER DRIV	None	WEST HILLS	CA	91307	1902	00	06000	34.20289797	-118.6294006	Los Angeles County
299394	Non-Physician Medical Practitioner	None	1285911214	0	0	WOODS, TEJON NP	12/3/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1227 SOUTH FIRST AVENUE	None	ARCADIA	CA	91006	4130	00	06000	34.12600644	-118.0280781	Los Angeles County
299415	Non-Physician Medical Practitioner	None	1932179777	0	0	WITTENBURG, THERESA A	9/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	440 LINFIELD DR	None	MENLO PARK	CA	94025	3739	00	06000	37.45078435	-122.1721571	San Mateo County
299511	Non-Physician Medical Practitioner	None	1124528062	0	0	WANZEK, BRITTANY PA	5/6/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	00	06000	34.072245	-117.4319685	San Bernardino County
299572	Non-Physician Medical Practitioner	None	1164570057	0	0	WALPUS, HARTMUTH E	3/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5003 GARRETT AVE	None	RANCHO CUCAMONGA	CA	91739	2198	00	06000	34.162911	-117.496374	San Bernardino County
299578	Non-Physician Medical Practitioner	None	1629542923	0	0	WALSH, JASON NP	9/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3100 TELEGRAPH AVE	STE 2102	OAKLAND	CA	94609	3210	00	06000	37.82037533	-122.2667839	Alameda County
299599	Non-Physician Medical Practitioner	None	1417258294	0	0	WALLCE, JOETTA DESWARTE	12/21/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2653 ELM AVE	SUITE 200	LONG BEACH	CA	90806	1652	00	06000	33.805512	-118.188348	Los Angeles County
299657	Non-Physician Medical Practitioner	None	1770926594	0	0	WHEADON, LISA M NP	11/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	314 COPA DE ORO DRIVE	None	BREA	CA	92823	7017	00	06000	33.92927034	-117.8089654	Orange County
299676	Non-Physician Medical Practitioner	None	1861590804	0	0	WITHERSPOON, LESETTE D	1/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 W 220TH ST	UNIT 43	CARSON	CA	90745	2865	00	06000	33.82807177	-118.2832209	Los Angeles County
299707	Non-Physician Medical Practitioner	None	1689902603	0	0	WATSON NELSON, KIMBER KATHLEEN	5/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17777 CENTER COURT DR N	SUITE 400	CERRITOS	CA	90703	8567	00	06000	33.8693357	-118.0609689	Los Angeles County
299719	Non-Physician Medical Practitioner	None	1245945369	0	0	WOODWARD, ERIN NP	5/4/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	00	06000	34.0956033	-118.2916918	Los Angeles County
299730	Non-Physician Medical Practitioner	None	1629097191	0	0	WESTERBERG, SHARON A	7/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9968 CAMROSE CIR	None	FOUNTAIN VALLEY	CA	92708	2027	00	06000	33.72531552	-117.9552356	Orange County
299753	Non-Physician Medical Practitioner	None	1265972301	0	0	WU, JESSICA CNP	10/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14051 RAMONA PKWY	None	BALDWIN PARK	CA	91706	4114	00	06000	34.08521541	-117.9674931	Los Angeles County
299800	Non-Physician Medical Practitioner	None	1346941317	0	0	WALTER, BREANNE K PA	5/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
299809	Non-Physician Medical Practitioner	None	1750048583	0	0	WALTER, LAUREN R PA	6/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24422 AVENIDA DE LA CARL	130	LAGUNA HILLS	CA	92653	3636	00	06000	33.56726005	-117.705397	Orange County
299811	Non-Physician Medical Practitioner	None	1649844655	0	0	WONG, STEPHANIE S PA	1/25/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4601 DALE ROAD	None	MODESTO	CA	95356	9718	00	06000	37.706508	-121.052457	Stanislaus County
299816	Non-Physician Medical Practitioner	None	1659819845	0	0	WEEKS, COLLEEN P	3/21/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11415 DEERFIELD DR	10961	TRUCKEE	CA	96162	2119	00	06000	39.32054782	-120.2091147	Nevada County
299844	Non-Physician Medical Practitioner	None	1770259434	0	0	WILKENS, BOBBI PA	9/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1131 W 6TH ST	250	ONTARIO	CA	91762	1108	00	06000	34.084404	-117.6717015	San Bernardino County
299859	Non-Physician Medical Practitioner	None	1821723727	0	0	WURTH, SAMANTHA R NP	2/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3000 Q STREET	4TH FLOOR	SACRAMENTO	CA	95816	7058	00	06000	38.564991	-121.4696565	Sacramento County
299944	Non-Physician Medical Practitioner	None	1861653800	0	0	WILLENBORG, REBECCA A NP	2/11/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9374 CHERRY AVE	None	ORANGEVALE	CA	95662	2210	00	06000	38.710188	-121.2028155	Sacramento County
299972	Non-Physician Medical Practitioner	None	1265660385	0	0	WOLFE, MAUREEN A CNM	6/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
299983	Non-Physician Medical Practitioner	None	1922726306	0	0	WAH, SZE MAN NP	9/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	525 NORTH GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	00	06000	34.06794352	-118.1229278	Los Angeles County
300040	Non-Physician Medical Practitioner	None	1528577343	0	0	WORTH, MEGAN R PA-C	9/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	00	06000	35.27804785	-120.649711	San Luis Obispo County
300067	Non-Physician Medical Practitioner	None	1437538485	0	0	WEAVER, JESSICA G NP	11/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5515 RIVER AVE	APT 308	NEWPORT BEACH	CA	92663	2229	00	06000	33.6243872	-117.9449817	Orange County
300094	Non-Physician Medical Practitioner	None	1245012293	0	0	WENGER, ANGELA	9/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
300129	Non-Physician Medical Practitioner	None	1184365496	0	0	WILKINSON, JOSEPH K NP	11/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4631 TELLER AVE	100	NEWPORT BEACH	CA	92660	8105	00	06000	33.66641504	-117.857408	Orange County
300148	Non-Physician Medical Practitioner	None	1457694200	0	0	WOOD, SYDNEY L	4/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	517 SARGENT CT	None	BENICIA	CA	94510	1377	00	06000	38.07778038	-122.1815684	Solano County
300226	Non-Physician Medical Practitioner	None	1366584658	0	0	WOO, JOSEPH WILLIAM	5/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	845 JACKSON ST	None	SAN FRANCISCO	CA	94133	4851	00	06000	37.79571919	-122.4089166	San Francisco County
300228	Non-Physician Medical Practitioner	None	1275981086	0	0	WHITEHEAD, LINDSEY M	9/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1102 IDAHO AVE	#C	SANTA MONICA	CA	90403	3011	00	06000	34.02870263	-118.4961885	Los Angeles County
300232	Non-Physician Medical Practitioner	None	1528217346	0	0	WRIGHT, ZHANDRA	3/14/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
300264	Non-Physician Medical Practitioner	None	1508164856	0	0	WIDENER, MARY E	9/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3160 S PITCH FORK DRIVE	None	JACKSON	WY	83001	9235	00	06000	43.43446042	-110.786863	Teton County
300297	Non-Physician Medical Practitioner	None	1093917429	0	0	WEYMANN, LAURIE A NP	5/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
300323	Non-Physician Medical Practitioner	None	1316146939	0	0	WILKINSON, GREG M	8/8/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2288 AUBURN BLVD	SUITE 106	SACRAMENTO	CA	95821	1618	00	06000	38.625345	-121.4114985	Sacramento County
300394	Non-Physician Medical Practitioner	None	1871730747	0	0	WEIR, AMANDA JEAN	7/13/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1353 SHELL BEACH RD	None	PISMO BEACH	CA	93449	1954	00	06000	35.15754287	-120.6718967	San Luis Obispo County
300395	Non-Physician Medical Practitioner	None	1023395142	0	0	WILLIS, HAIDY D NP	5/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	00	06000	38.570976	-121.416651	Sacramento County
300397	Non-Physician Medical Practitioner	None	1255853131	0	0	WONG, ANGELA Y NP	8/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
300405	Non-Physician Medical Practitioner	None	1386049716	0	0	WANG, MAGGIE H NP	11/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18938 BRITTANY PLACE	None	ROWLAND	CA	91748	8603	00	06000	33.9677797	-117.8875418	Los Angeles County
300424	Non-Physician Medical Practitioner	None	1255894945	0	0	WINTERS, LORIN E NP	5/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
300519	Non-Physician Medical Practitioner	None	1851910863	0	0	WANG, FIONA K PA	8/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
300529	Non-Physician Medical Practitioner	None	1184616260	0	0	WOOLLEY, KIMBERLY A NP	1/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2160 JEFFERSON STREET	260	NAPA	CA	94559	1253	00	06000	38.30647594	-122.2951788	Napa County
300544	Non-Physician Medical Practitioner	None	1144686056	0	0	WEST, JESSICA L NP	12/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	00	06000	37.70554251	-121.873005	Alameda County
300551	Non-Physician Medical Practitioner	None	1851587919	0	0	WILSON, JULIANA S	11/12/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14035 S DITTMAR DR	None	WHITTIER	CA	90605	2445	00	06000	33.95175434	-118.0273875	Los Angeles County
300556	Non-Physician Medical Practitioner	None	1538442512	0	0	WALKER, NANCY J NP	12/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7856 REGENCY PARK STREET	None	LAS VEGAS	NV	89149	3772	00	06000	36.304506	-115.311944	Clark County
300569	Non-Physician Medical Practitioner	None	1679229389	0	0	WONG, KEVIN M PA	3/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
300578	Non-Physician Medical Practitioner	None	1780787036	0	0	WEDEL, DANA LYN	9/8/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3031 TELEGRAPH AVE	None	OAKLAND	CA	94609	3205	00	06000	37.81967788	-122.2670259	Alameda County
300618	Non-Physician Medical Practitioner	None	1558987743	0	0	WU, NATHALY NP	4/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	00	06000	34.065126	-118.446237	Los Angeles County
300626	Non-Physician Medical Practitioner	None	1477223576	0	0	WARD, KATHERINE	9/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8881 FLETCHER PKWY	200	LA MESA	CA	91942	3134	00	06000	32.78442148	-117.0073814	San Diego County
300627	Non-Physician Medical Practitioner	None	1083003156	0	0	WONG, JARED A	5/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23024 GARZOTA DR	None	VALENCIA	CA	91354	2229	00	06000	34.43741221	-118.538827	Los Angeles County
300628	Non-Physician Medical Practitioner	None	1366778326	0	0	WAYNE, ELIZABETH MALLORY	10/19/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	SUITE A701	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
300636	Non-Physician Medical Practitioner	None	1902201643	0	0	WINKLES, BRANDON PA-C	9/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4871 WHITE LN	None	BAKERSFIELD	CA	93309	6375	00	06000	35.31793896	-119.0561249	Kern County
300655	Non-Physician Medical Practitioner	None	1912535451	0	0	WONG, YIU SING EUGENE PA-C	11/9/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2288 MARKET ST	None	SAN FRANCISCO	CA	94114	1506	00	06000	37.76471878	-122.4326019	San Francisco County
300685	Non-Physician Medical Practitioner	None	1700329687	0	0	WALKER, KATHRYN D NP	2/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3883 AIRWAY DRIVE	STE 120,165,201,202,203	SANTA ROSA	CA	95403	1678	00	06000	38.483226	-122.739705	Sonoma County
300740	Non-Physician Medical Practitioner	None	1962250241	0	0	WANG, VALERIA PA	11/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2020 SUTTER PL	None	DAVIS	CA	95616	6201	00	06000	38.56287659	-121.7715536	Yolo County
300802	Non-Physician Medical Practitioner	None	1760758676	0	0	WILSON, MEGAN E NP	11/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4861 MAMMOTH AVENUE	None	SHERMAN OAKS	CA	91423	1317	00	06000	34.159329	-118.432519	Los Angeles County
300812	Non-Physician Medical Practitioner	None	1437772423	0	0	WEBSTER, KYLE T PA-C	3/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	00	06000	36.327888	-119.294919	Tulare County
300879	Non-Physician Medical Practitioner	None	1871199950	0	0	WAIDHOFER, ALEXIS PA-C	6/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1533 E 4TH ST	STE A	SANTA ANA	CA	92701	5115	00	06000	33.74814149	-117.848421	Orange County
300937	Non-Physician Medical Practitioner	None	1073122412	0	0	WILLS, CHRISTOPHER PA-C	10/6/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	00	06000	35.3687456	-119.1106561	Kern County
300941	Non-Physician Medical Practitioner	None	1134540941	0	0	WILLIS, JENNIFER	2/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	45 MALEENA MESA	STE 1811	HENDERSON	NV	89074	8148	00	06000	36.03219058	-115.0397089	Clark County
300948	Non-Physician Medical Practitioner	None	1497283212	0	0	WILLIAMS, HILLARY M NP	11/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	00	06000	38.66314048	-121.794696	Yolo County
301012	Non-Physician Medical Practitioner	None	1174128201	0	0	WESTHAFER, LIA R PA-C	8/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	416 AVIATION BLVD	SUITE B	SANTA ROSA	CA	95403	1032	00	06000	38.51406287	-122.7847603	Sonoma County
301028	Non-Physician Medical Practitioner	None	1629596911	0	0	WEIDNER, JESSICA T NP	9/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1951 PACIFIC AVENUE	None	LONG BEACH	CA	90806	5321	00	06000	33.792642	-118.1937995	Los Angeles County
301037	Non-Physician Medical Practitioner	None	1215451356	0	0	WACHTMANN, AMBER RN	2/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	370 E VIRGINIA AVE	SUITE 100	PHOENIX	AZ	85004	1214	00	06000	33.476985	-112.0663215	Maricopa County
301038	Non-Physician Medical Practitioner	None	1619634839	0	0	WONG, MEGAN V PA-C	3/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	825 DELBON AVE	None	TURLOCK	CA	95382	2016	00	06000	37.51052943	-120.8386573	Stanislaus County
301048	Non-Physician Medical Practitioner	None	1881844397	0	0	WOLFF-BAKER, DEBORAH	11/13/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3536 MENDOCINO AVE	STE 300	SANTA ROSA	CA	95403	3634	00	06000	38.473326	-122.725935	Sonoma County
301119	Non-Physician Medical Practitioner	None	1386633816	0	0	WINTER, JULIE L NP	2/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1755 COURT STREET	None	REDDING	CA	96001	1721	00	06000	40.58041248	-122.3945221	Shasta County
301121	Non-Physician Medical Practitioner	None	1518527589	0	0	WELTON, MONET D NP	4/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8670 WILSHIRE BLVD	STE 200	BEVERLY HILLS	CA	90211	2930	00	06000	34.06629779	-118.3807407	Los Angeles County
301130	Non-Physician Medical Practitioner	None	1477898989	0	0	WASHINGTON, TANEA D NP	5/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2523 YEARLING ST	None	LAKEWOOD	CA	90712	2829	00	06000	33.84950153	-118.1616075	Los Angeles County
301140	Non-Physician Medical Practitioner	None	1164072567	0	0	WALTER, APRIL J	4/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	00	06000	38.26109552	-122.0470245	Solano County
301158	Non-Physician Medical Practitioner	None	1902272750	0	0	WINKEL, BRADLEY T	11/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	245 TAMPICO GLEN	None	ESCONDIDO	CA	92025	5896	00	06000	33.08804347	-117.0662001	San Diego County
301165	Non-Physician Medical Practitioner	None	1871963835	0	0	WU, RACHEL NP	10/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10332 SOUTH STELLING RD	None	CUPPERTINO	CA	95014	4227	00	06000	37.31792199	-122.0414314	Santa Clara County
301183	Non-Physician Medical Practitioner	None	1487703161	0	0	WU, GRACE S NP	11/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	255 LOS LAURELE STREET	None	SOUTH PASADENA	CA	91030	4118	00	06000	34.10681185	-118.1706354	Los Angeles County
301193	Non-Physician Medical Practitioner	None	1144535980	0	0	WANG, SHANA	7/5/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 W FERN AVE	None	REDLANDS	CA	92373	5916	00	06000	34.05016907	-117.1793443	San Bernardino County
301317	Non-Physician Medical Practitioner	None	1487817268	0	0	WEAVER, COLLEEN	4/22/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5444 LAUREL HILLS DR	None	SACRAMENTO	CA	95841	3106	00	06000	38.661678	-121.337622	Sacramento County
301319	Non-Physician Medical Practitioner	None	1346716941	0	0	WOODS, SARAH M NP	12/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3814 AUBURN BLVD	SUITE 72	SACRAMENTO	CA	95821	2123	00	06000	38.639034	-121.375305	Sacramento County
301341	Non-Physician Medical Practitioner	None	1366225906	0	0	WAGDY, AUDREY PA-C	3/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	631 S BROOKHURST ST	SUITE # 101	ANAHEIM	CA	92804	3510	00	06000	33.823647	-117.9589675	Orange County
301361	Non-Physician Medical Practitioner	None	1013337666	0	0	WILLIAMS, JODI-ANN S PA	10/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1250 16TH STREET	2100	SANTA MONICA	CA	90404	1249	00	06000	34.02749142	-118.486063	Los Angeles County
301377	Non-Physician Medical Practitioner	None	1326594144	0	0	WALLACH, DEBORAH NP	1/23/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5106 BERAN ST	None	TORRANCE	CA	90503	6804	00	06000	33.82758483	-118.3675894	Los Angeles County
301420	Non-Physician Medical Practitioner	None	1124219134	0	0	WEST, JOAN M	1/11/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2490 HOSPITAL DR STE 303	None	MOUNTAIN VIEW	CA	94040	4124	00	06000	37.369827	-122.0818185	Santa Clara County
301477	Non-Physician Medical Practitioner	None	1932408960	0	0	WILLIAMSON, CHARLAINE I NP	1/30/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11422 ANZIO COURT	None	ALTA LOMA	CA	91701	8500	00	06000	34.13192825	-117.5556502	San Bernardino County
301486	Non-Physician Medical Practitioner	None	1497074454	0	0	WEINTRAUB, ANDREW J PA	12/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	06000	33.38982	-111.8760885	Maricopa County
301512	Non-Physician Medical Practitioner	None	1518060508	0	0	WELCOME, STACY C PA-C	1/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2540 EAST ST	None	CONCORD	CA	94520	1906	00	06000	37.98292379	-122.0341876	Contra Costa County
301520	Non-Physician Medical Practitioner	None	1689067084	0	0	WAND, KIMBERLY	4/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2100 POWELL ST	STE 900	EMERYVILLE	CA	94608	1844	00	06000	37.83953006	-122.2990736	Alameda County
301531	Non-Physician Medical Practitioner	None	1003129925	0	0	WONG, CLAUDIA L NP	8/6/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1839 BELOIT AVENUE	APT 1	LOS ANGELES	CA	90025	7093	00	06000	34.04350012	-118.4444609	Los Angeles County
301553	Non-Physician Medical Practitioner	None	1124654082	0	0	WANG, SEAN PA	10/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	00	06000	34.13489987	-118.0424069	Los Angeles County
301564	Non-Physician Medical Practitioner	None	1962063016	0	0	WILLIAMS, JORDAN K PA-C	4/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	00	06000	34.95203385	-120.4131707	Santa Barbara County
301579	Non-Physician Medical Practitioner	None	1629581764	0	0	WILLIAMS, MACKENZIE L NP	3/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5671 BALBOA AVE	None	SAN DIEGO	CA	92111	2705	00	06000	32.82010691	-117.1788026	San Diego County
301610	Non-Physician Medical Practitioner	None	1598213886	0	0	WILLENBORG, MALLORY K PA	10/27/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20702 EL TORA ROAD	APT 272	LAKE FOREST	CA	92630	6124	00	06000	33.66089712	-117.6446413	Orange County
301640	Non-Physician Medical Practitioner	None	1477537736	0	0	WILLIAMS, STEPHEN C PA	8/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
301652	Non-Physician Medical Practitioner	None	1740941434	0	0	WELKER, MICHELE L NP	5/31/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1180 NORTH INDIAN CANYON	SUITE W300	PALM SPRINGS	CA	92262	4809	00	06000	33.839505	-116.5455735	Riverside County
301662	Non-Physician Medical Practitioner	None	1841958220	0	0	WOODCOCK, ASHLEY L NP	2/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25405 HANCOCK AVE	SUITE 206	MURRIETA	CA	92562	5982	00	06000	33.5580833	-117.1850127	Riverside County
301767	Non-Physician Medical Practitioner	None	1770349235	0	0	WALKER, ERIC	1/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	06000	32.683167	-114.633459	Yuma County
301790	Non-Physician Medical Practitioner	None	1053894717	0	0	WASIK, ELIZABETH NP	2/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	888 LAKESIDE VILLAGE COM	None	CHICO	CA	95926	2281	00	06000	39.750084	-121.7934327	Butte County
301809	Non-Physician Medical Practitioner	None	1851732960	0	0	WIGFALL, CHRISTIAN J	5/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1112 SANTA CLARA	None	ALAMEDA	CA	94501	0000	00	06000	37.77292828	-122.2651886	Alameda County
301826	Non-Physician Medical Practitioner	None	1396418497	0	0	WILWAND, MCKELLE PA-C	3/23/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	00	06000	39.506454	-121.5412785	Butte County
301837	Non-Physician Medical Practitioner	None	1104367846	0	0	WONG, HEATHER PA	2/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12761 SCHABARUM AVE	None	BALDWIN PARK	CA	91706	6807	00	06000	34.08060971	-117.9958001	Los Angeles County
301872	Non-Physician Medical Practitioner	None	1588908305	0	0	WELLNESS CENTER AT JEFFERSON HIGH SCHOOL	9/30/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3410 S. HOOPER AVE.	None	LOS ANGELES	CA	90011	2161	00	06000	34.01250965	-118.2521249	Los Angeles County
301874	Non-Physician Medical Practitioner	None	1134698731	0	0	WEBB, JESSICA NP	11/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1417 AMHERST AVE	3	LOS ANGELES	CA	90025	0350	00	06000	34.0407846	-118.4652967	Los Angeles County
301875	Non-Physician Medical Practitioner	None	1932571643	0	0	WUJCIK, KARI A NP	1/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1 MAPLE ST	#2104	REDWOOD CITY	CA	94063	1965	00	06000	37.48101119	-122.2267053	San Mateo County
301885	Non-Physician Medical Practitioner	None	1205925799	0	0	WEKALL, ALICE L	7/12/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2413 CORONADO DRIVE	None	FULLERTON	CA	92835	2509	00	06000	33.89893114	-117.9306711	Orange County
301897	Non-Physician Medical Practitioner	None	1225871577	0	0	WEI, XINHE NP	11/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	805 LA VETA	STE 101	ORANGE	CA	98268	3901	00	06000	33.78064152	-117.8606475	Orange County
301982	Non-Physician Medical Practitioner	None	1487267670	0	0	WHITEAKER, ARIKA PA-C	8/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28780 SINGLE OAK DRIVE	SUITE 160	TEMECULA	CA	92590	5528	00	06000	33.49890392	-117.1612965	Riverside County
301988	Non-Physician Medical Practitioner	None	1104469055	0	0	WIEDEMANN, AVA PA	1/24/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7677 CENTER AVE	SUITE 214	HUNTINGTON BEACH	CA	92647	3074	00	06000	33.736257	-117.995535	Orange County
301992	Non-Physician Medical Practitioner	None	1679262067	0	0	WAYNE, ANNIE E PA-C	9/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	00	06000	34.062852	-117.9446658	Los Angeles County
301995	Non-Physician Medical Practitioner	None	1982161584	0	0	WALAND, SONALI NP	4/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2100 WEBSTER ST	516	SAN FRANCISCO	CA	94115	2373	00	06000	37.7904826	-122.4324477	San Francisco County
301996	Non-Physician Medical Practitioner	None	1336706530	0	0	WILLIAMS, DAVID PA	11/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	00	06000	34.03717616	-117.2046115	San Bernardino County
302042	Non-Physician Medical Practitioner	None	1740854892	0	0	WYMA, REBECCA L NP	6/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4501 X ST	None	SACRAMENTO	CA	95817	2229	00	06000	38.553822	-121.452822	Sacramento County
302056	Non-Physician Medical Practitioner	None	1417448838	0	0	WILDEY, RICHELLE C PA	5/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	185 E 7TH AVE	STE A	CHICO	CA	95926	3356	00	06000	39.74473059	-121.8488381	Butte County
302091	Non-Physician Medical Practitioner	None	1588718902	0	0	WOODEN, VICTORIA LLANES	2/17/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4459 PHILBROOK SQ	None	SAN DIEGO	CA	92130	8674	00	06000	32.92977915	-117.2246409	San Diego County
302100	Non-Physician Medical Practitioner	None	1518104942	0	0	WALLACE, STEPHANIE C PA	7/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	00	06000	33.03623896	-117.2837308	San Diego County
302105	Non-Physician Medical Practitioner	None	1538704515	0	0	WHANG, SUSAN	2/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	00	06000	34.0653985	-118.3769177	Los Angeles County
302183	Non-Physician Medical Practitioner	None	1104692656	0	0	WILBORN, BRIANA Y CNM	2/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
302192	Non-Physician Medical Practitioner	None	1982675708	0	0	WITT, CHRISTOPHER PA	5/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
302211	Non-Physician Medical Practitioner	None	1396319463	0	0	WANG, CHRIS PA	12/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	00	06000	37.36217918	-121.8472051	Santa Clara County
302215	Non-Physician Medical Practitioner	None	1114457959	0	0	WONG, MATTHEW PA-C	4/23/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	911 SUNSET DR	None	HOLLISTER	CA	95023	5695	00	06000	36.83504962	-121.3858245	San Benito County
302254	Non-Physician Medical Practitioner	None	1295326056	0	0	WHITE, BRIANNA NP	4/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6555 COYLE	SUITE 220	CARMICHAEL	CA	95608	0303	00	06000	38.66859	-121.3118055	Sacramento County
302268	Non-Physician Medical Practitioner	None	1235645888	0	0	WANG, RACHEL C PA	10/11/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CITY DR S	# B10	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
302318	Non-Physician Medical Practitioner	None	1790454130	0	0	WALLIS, KELLY A NP	12/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
302415	Non-Physician Medical Practitioner	None	1730341900	0	0	WELSH, HELEN VICTORIA	8/18/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DRIVE	A160 MC 5313 STANFORD HO	STANFORD	CA	94305	5313	00	06000	37.43304542	-122.1759654	Santa Clara County
302436	Non-Physician Medical Practitioner	None	1174001804	0	0	WOLLENBERG, CASEY K NP	12/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
302451	Non-Physician Medical Practitioner	None	1922057124	0	0	WOOD, WILLIAM A	12/17/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	00	06000	37.85646136	-122.2573894	Alameda County
302500	Non-Physician Medical Practitioner	None	1619575198	0	0	WEI, WENTING	8/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	822 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4714	00	06000	34.05216368	-118.1372429	Los Angeles County
302531	Non-Physician Medical Practitioner	None	1396957379	0	0	WALSH, HEIDI C	2/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1611 23RD ST	None	MANHATTAN BEACH	CA	90278	4046	00	06000	33.89393221	-118.3846397	Los Angeles County
302536	Non-Physician Medical Practitioner	None	1457912784	0	0	WALKER, SUKHJIT K PA	1/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2425 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2215	00	06000	38.553012	-121.45545	Sacramento County
302557	Non-Physician Medical Practitioner	None	1295518355	0	0	WHITEHEAD, ANAIA NP	11/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	00	06000	33.9760587	-117.3800672	Riverside County
302583	Non-Physician Medical Practitioner	None	1467842054	0	0	WANG, IREENA J S NP	7/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6451 CRANDALL DR	None	HUNTINGTON BEACH	CA	92647	4205	00	06000	33.72042666	-118.0158492	Orange County
302628	Non-Physician Medical Practitioner	None	1467105437	0	0	WONG, ANNIE PA-C	8/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
302685	Non-Physician Medical Practitioner	None	1679199004	0	0	WASCHEVSKI, ZACHARY F PA	1/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	277 COHASSET ROAD	None	CHICO	CA	95926	2242	00	06000	39.75152348	-121.8511763	Butte County
302720	Non-Physician Medical Practitioner	None	1417025636	0	0	WICKWARE, TRACY L	12/15/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3930 4TH AVE	SUITE 200	SAN DIEGO	CA	92103	3119	00	06000	32.74892723	-117.1616459	San Diego County
302743	Non-Physician Medical Practitioner	None	1285035311	0	0	WOOD, KATELYN PA	5/5/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
302746	Non-Physician Medical Practitioner	None	1336876754	0	0	WILLIAMS, SUGI U	9/30/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	333 MERCY AVENUE	None	MERCED	CA	95340	8319	00	06000	37.33875148	-120.467457	Merced County
302764	Non-Physician Medical Practitioner	None	1932537016	0	0	WILLIAMS, ASHLEY M	2/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5135 BRANDING IRON PL	None	RANCHO CUCAMONGA	CA	91739	2273	00	06000	34.16062768	-117.5052274	San Bernardino County
302790	Non-Physician Medical Practitioner	None	1225163850	0	0	WECKL, JOYCE ELAINE	11/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3585 MAPLE ST	SUITE # 205	VENTURA	CA	93003	3504	00	06000	34.26916737	-119.2456769	Ventura County
302792	Non-Physician Medical Practitioner	None	1245008580	0	0	WALKER, NATALIE NP	2/28/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18345 VENTURA BLVD.	STE 510	TARZANA	CA	91356	4245	00	06000	34.16738049	-118.5325057	Los Angeles County
302797	Non-Physician Medical Practitioner	None	1568659712	0	0	WARE, DUSTIN D	7/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29729 LONGHORN DR	None	CANYON LAKE	CA	92587	7641	00	06000	33.68844048	-117.2748628	Riverside County
302827	Non-Physician Medical Practitioner	None	1558870931	0	0	WEBB, WENDY L NP	10/17/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10787 WILLOWBROOK WAY	None	CUPERTINO	CA	95014	4540	00	06000	37.31144118	-122.0213075	Santa Clara County
302868	Non-Physician Medical Practitioner	None	1407907751	0	0	WISER, JEANNE M PA	7/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
302930	Non-Physician Medical Practitioner	None	1952703894	0	0	WOLF, DAVID M	1/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	132 PLACER MINE RD	None	FOLSOM	CA	95603	5113	00	06000	38.683611	-121.1964435	Sacramento County
302941	Non-Physician Medical Practitioner	None	1881932846	0	0	WENDELL, SHIRLEY VICTORIA	9/20/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0112	00	06000	34.06169385	-118.2044698	Los Angeles County
302989	Non-Physician Medical Practitioner	None	1760467948	0	0	WAGNER, PAULA	11/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4860 Y ST	SUITE 2200	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
303003	Non-Physician Medical Practitioner	None	1205285079	0	0	WU, JANE PA-C	4/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1818 N ORANGE GROVE AVE	STE 101	POMONA	CA	91767	3028	00	06000	34.07694934	-117.7489598	Los Angeles County
303017	Non-Physician Medical Practitioner	None	1851322002	0	0	WINDERWEEDLE, JEREMY L	9/1/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17340 MESQUITE RD	None	APPLE VALLEY	CA	92307	6958	00	06000	34.56498491	-117.1627734	San Bernardino County
303036	Non-Physician Medical Practitioner	None	1396868964	0	0	WILLIAM, WARIAM KAUR	7/21/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 N RIVERSIDE AVE	None	RIALTO	CA	92376	5924	00	06000	34.10384154	-117.370545	San Bernardino County
303062	Non-Physician Medical Practitioner	None	1477608511	0	0	WEISE, JENNIFER HAYMAN	4/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10050 N WOLFE RD	SW1-190	CUPERTINO	CA	95014	2519	00	06000	37.323639	-122.014123	Santa Clara County
303070	Non-Physician Medical Practitioner	None	1679961783	0	0	WENZ, LORI A NP	9/4/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
303073	Non-Physician Medical Practitioner	None	1609261965	0	0	WOUDSTRA, JOCELYN H NP	7/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
303113	Non-Physician Medical Practitioner	None	1518083716	0	0	WOO, ANITA L	3/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9200 PETIT AVE	None	NORTH HILLS	CA	91343	3530	00	06000	34.237773	-118.497932	Los Angeles County
303119	Non-Physician Medical Practitioner	None	1437563624	0	0	WILLIAMS, LAUREN A	2/13/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	00	06000	38.26876442	-122.6598332	Sonoma County
303130	Non-Physician Medical Practitioner	None	1801307335	0	0	WEBER, JOSEPH M PA-C	1/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 GOVERNORS LN	SUITE A	CHICO	CA	95926	6300	00	06000	39.75567003	-121.8588553	Butte County
303152	Non-Physician Medical Practitioner	None	1306170519	0	0	WEIGEL, NICOLE L	9/29/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	SUMC - PEDS PHYSICIAN BI	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
303165	Non-Physician Medical Practitioner	None	1174656789	0	0	WONG, CATHERINE W NP	3/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16688 GOLDEN BLUFF LOOP	None	RIVERSIDE	CA	92503	0244	00	06000	33.87497814	-117.4772567	Riverside County
303169	Non-Physician Medical Practitioner	None	1881996445	0	0	WILLIAMSON, LIONEL NP	12/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3529 WALNUT AVE	None	CARMICHAEL	CA	95608	3049	00	06000	38.629179	-121.3466355	Sacramento County
303176	Non-Physician Medical Practitioner	None	1427529874	0	0	WOODWARD, ROBYN J NP	11/23/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
303184	Non-Physician Medical Practitioner	None	1972847747	0	0	WILSON, LAUREN E NP	2/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	650 HOWE AVE	STE 100	SACRAMENTO	CA	95825	4732	00	06000	38.577294	-121.4146395	Sacramento County
303193	Non-Physician Medical Practitioner	None	1043967383	0	0	WILAND, WINONA PA	10/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9834 GENESEE AVENUE	SUITE 111	LA JOLLA	CA	92037	1214	00	06000	32.884074	-117.225855	San Diego County
303197	Non-Physician Medical Practitioner	None	1821516287	0	0	WASIK, JAIME E NP	10/3/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3873 GLENHAVEN WAY	None	KINGMAN	AZ	86409	4909	00	06000	35.23536	-114.0239115	Mohave County
303207	Non-Physician Medical Practitioner	None	1215488770	0	0	WILLE, CECILIA L NP	2/10/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1390 49TH AVE	None	CAPITOLA	CA	95010	3858	00	06000	36.97116686	-121.9564641	Santa Cruz County
303233	Non-Physician Medical Practitioner	None	1497001879	0	0	WALLS, EMILY M NP	2/29/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 ARCADE DR	None	VENTURA	CA	93003	3099	00	06000	34.26982949	-119.266234	Ventura County
303325	Non-Physician Medical Practitioner	None	1447769377	0	0	WESTBROOK, CATHERINE J PA-C	10/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2710 DOLBEER ST	None	EUREKA	CA	95501	4736	00	06000	40.78449066	-124.1414748	Humboldt County
303330	Non-Physician Medical Practitioner	None	1699115212	0	0	WINTERS, XAVIER F NP	6/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
303345	Non-Physician Medical Practitioner	None	1831412659	0	0	WALSH, KIMBERLEE K PA-C	1/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1667 DOMINICAN WAY	STE 234	SANTA CRUZ	CA	95065	1529	00	06000	36.99032635	-121.9811719	Santa Cruz County
303385	Non-Physician Medical Practitioner	None	1841200789	0	0	WAYNE, KEVIN A	1/7/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	603 LAKE ST	None	HUNTINGTON BEACH	CA	92648	4703	00	06000	33.66271428	-117.9978141	Orange County
303430	Non-Physician Medical Practitioner	None	1790111490	0	0	WINSTON, LAUREAN J PA	12/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
303444	Non-Physician Medical Practitioner	None	1841571908	0	0	WILLIAMSON, LISA A	9/29/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14350 WHITTIER BLVD	None	WHITTIER	CA	90605	2138	00	06000	33.95501294	-118.0185665	Los Angeles County
303453	Non-Physician Medical Practitioner	None	1134374705	0	0	WISEMAN, CORI L NP	4/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3531 HONOLULU AVENUE	None	GLENDALE	CA	91214	3221	00	06000	34.22522388	-118.2562902	Los Angeles County
303505	Non-Physician Medical Practitioner	None	1700828621	0	0	WESTBROOK-MAY, NANCY	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 N TUSTIN AVE	EMERGENCY DEPARTMENT	SANTA ANA	CA	92705	3502	00	06000	33.75363187	-117.8341886	Orange County
303508	Non-Physician Medical Practitioner	None	1518139336	0	0	WAITHAKA, MARGARET W NP	6/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	00	06000	33.6526055	-117.910746	Orange County
303526	Non-Physician Medical Practitioner	None	1477196897	0	0	WATERS, NATALIE PA-C	12/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41880 KALMIA ST	SUITE 100	MURRIETA	CA	92562	8835	00	06000	33.55740114	-117.2157733	Riverside County
303539	Non-Physician Medical Practitioner	None	1134812548	0	0	WIBISONO, BIANCA N PA-C	9/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1071 BLOSSOM HILL RD	None	SAN JOSE	CA	95123	1103	00	06000	37.2509447	-121.8743507	Santa Clara County
303595	Non-Physician Medical Practitioner	None	1609151851	0	0	WHITNEY, DHILLON T	8/26/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7740 RANCHO SANTA FE RD	None	CARLSBAD	CA	92009	8685	00	06000	33.08100093	-117.2372485	San Diego County
303617	Non-Physician Medical Practitioner	None	1952957474	0	0	WILLIAMS, SHAUNI V NP	10/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1755 COURT STREET	None	REDDING	CA	96001	1721	00	06000	40.58041248	-122.3945221	Shasta County
303618	Non-Physician Medical Practitioner	None	1760853220	0	0	WALKER, ALLEN J	1/10/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	22214 N 32ND AVENUE	None	PHOENIX	AZ	85027	1624	00	06000	33.687801	-112.128768	Maricopa County
303631	Non-Physician Medical Practitioner	None	1780227926	0	0	WASHBURN, KRISTINA E PA	8/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	00	06000	33.78785649	-117.8276715	Orange County
303695	Non-Physician Medical Practitioner	None	1093943268	0	0	WISCO, CHERILYN R	3/18/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST STE 43	None	LOS ANGELES	CA	90033	5330	00	06000	34.06269295	-118.2030006	Los Angeles County
303779	Non-Physician Medical Practitioner	None	1790714947	0	0	WARD, JESSICA A NP	11/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	259 AUBURN AVENUE	None	SIERRA MADRE	CA	91024	1149	00	06000	34.16623924	-118.0550314	Los Angeles County
303790	Non-Physician Medical Practitioner	None	1245208818	0	0	WARD, JENNIFER PA-C	2/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	600 NUT TREE ROAD	260	VACAVILLE	CA	95687	4686	00	06000	38.36133624	-121.9496789	Solano County
303800	Non-Physician Medical Practitioner	None	1912216581	0	0	WIJESINGHE, SAMPATH	8/9/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1393 ACADEMY AVE	None	SANGER	CA	93657	0000	00	06000	36.69592515	-119.554222	Fresno County
303807	Non-Physician Medical Practitioner	None	1073228862	0	0	WILLIAMS, ALLISON T PA	5/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41880 KALMIA ST	SUITE 100	MURRIETA	CA	92562	8835	00	06000	33.55740114	-117.2157733	Riverside County
303816	Non-Physician Medical Practitioner	None	1700074200	0	0	WEST, LYNN	4/11/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	00	06000	37.48948529	-122.2232468	San Mateo County
303848	Non-Physician Medical Practitioner	None	1720423304	0	0	WHEELWRIGHT, CHRISTINA M NP	9/2/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13934 BORA BORA WAY	APT E 221	MARINA DEL REY	CA	90292	6887	00	06000	33.97150899	-118.4532112	Los Angeles County
303867	Non-Physician Medical Practitioner	None	1649360678	0	0	WESTBROOK, CRAIG S	3/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23741 MORNING GLORY DR	None	MURRIETA	CA	92562	6051	00	06000	33.583096	-117.2217735	Riverside County
303887	Non-Physician Medical Practitioner	None	1790184075	0	0	WONG, MELISSA K NP	2/13/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	00	06000	38.26876442	-122.6598332	Sonoma County
303911	Non-Physician Medical Practitioner	None	1740684893	0	0	WU, CYBEL PA-C	7/31/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5900 W. OLYMPIC BOULEVAR	None	LOS ANGELES	CA	90036	4671	00	06000	34.05760692	-118.3604361	Los Angeles County
303982	Non-Physician Medical Practitioner	None	1629498118	0	0	WOMENS COMMUNITY CLINIC	8/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1833 FILLMORE ST	None	SAN FRANCISCO	CA	94115	3180	00	06000	37.78652252	-122.4333821	San Francisco County
304008	Non-Physician Medical Practitioner	None	1023470317	0	0	WHITNEY, MALINDA D NP	9/8/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
304032	Non-Physician Medical Practitioner	None	1437453297	0	0	WESTERFIELD, STEPHANIE A NP	12/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	00	06000	34.39696803	-118.5525278	Los Angeles County
304059	Non-Physician Medical Practitioner	None	1518575992	0	0	WILLIAMS, SHELLEY M NP	8/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18785 BROOKHURST STREET	STE 101	FOUNTAIN VALLEY	CA	92708	7300	00	06000	33.68987636	-117.9542321	Orange County
304068	Non-Physician Medical Practitioner	None	1629011093	0	0	WOO, MONICA MEI-YUK	11/1/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
304089	Non-Physician Medical Practitioner	None	1154838621	0	0	WALL, MICHEL PA	2/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
304128	Non-Physician Medical Practitioner	None	1730374992	0	0	WHITMER PINGREE, JAIME A PA	8/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	00	06000	33.62609529	-117.7293191	Orange County
304129	Non-Physician Medical Practitioner	None	1902184823	0	0	WHEELER, REBEKAH GATES	2/13/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1580 VALENCIA ST	SUITE 508	SAN FRANCISCO	CA	94110	4423	00	06000	37.74746923	-122.4202583	San Francisco County
304139	Non-Physician Medical Practitioner	None	1205891314	0	0	WONG, SHELLEY L NP	10/9/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 HOSPITAL DR	STE 200	VALLEJO	CA	94589	2580	00	06000	38.13100118	-122.2403008	Solano County
304156	Non-Physician Medical Practitioner	None	1821053984	0	0	WADHAM, ANNE C PA-C	4/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3200 WALFORD AVE	None	EUREKA	CA	95503	4828	00	06000	40.77887445	-124.1378239	Humboldt County
304185	Non-Physician Medical Practitioner	None	1760971972	0	0	WICKRAMANAYAKE, PRIYANTHA L PA-C	10/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
304188	Non-Physician Medical Practitioner	None	1184180184	0	0	WILLIAMS, LAYNA A CNM	3/15/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 16TH STREET	SUITE 125, 204, 307	SANTA MONICA	CA	90404	1240	00	06000	34.02726451	-118.4857138	Los Angeles County
304195	Non-Physician Medical Practitioner	None	1588791669	0	0	WINTER, WILLIAM J III	3/20/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2788 HERROD AVE	None	ATWATER	CA	95301	9422	00	06000	37.32834224	-120.5923272	Merced County
304202	Non-Physician Medical Practitioner	None	1467092072	0	0	WOOD, EMILY A PA-C	12/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N MCDOWELL BLVD	None	PETALUMA	CA	95954	2339	00	06000	38.25477	-122.63175	Sonoma County
304211	Non-Physician Medical Practitioner	None	1568562502	0	0	WEN, MINDY S NP	8/31/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
304231	Non-Physician Medical Practitioner	None	1588187546	0	0	WONG, MATTHEW NP	3/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
304264	Non-Physician Medical Practitioner	None	1467889451	0	0	WETMORE, ANGELA M PA-C	3/23/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6580 HEMBREE LANE	SUITE 270	WINDSOR	CA	95492	6885	00	06000	38.52650514	-122.7897518	Sonoma County
304267	Non-Physician Medical Practitioner	None	1669409652	0	0	WALTSAK, MARTIN JOSEPH	5/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1627 E ANAHEIM ST	None	LONG BEACH	CA	90813	3809	00	06000	33.78263549	-118.171296	Los Angeles County
304295	Non-Physician Medical Practitioner	None	1285358507	0	0	WALKER, TODD C PA-C	2/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	555 EAST HARDY STREET	None	INGLEWOOD	CA	90301	4011	00	06000	33.94909549	-118.3481595	Los Angeles County
304297	Non-Physician Medical Practitioner	None	1609020494	0	0	WHITE, JOSHUA ALAN	6/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	955 S BAILEY AVE	None	SOUTH HAVEN	MI	49090	9701	00	06000	42.39115944	-86.26411769	Van Buren County
304312	Non-Physician Medical Practitioner	None	1932235371	0	0	WOODFORK, MARY V	12/6/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12021 WILMINGTON AVE	None	LOS ANGELES	CA	90059	3019	00	06000	33.922863	-118.2431655	Los Angeles County
304375	Non-Physician Medical Practitioner	None	1255647053	0	0	WALTERS, KELSI R	1/7/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	542 ARCHER ST	None	SALINAS	CA	93901	1602	00	06000	36.67596203	-121.6692089	Monterey County
304393	Non-Physician Medical Practitioner	None	1891278917	0	0	WALKER, ASHLEY J	4/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	58471 29 PALMS HWY	STE 201	YUCCA VALLEY	CA	92284	5818	00	06000	34.13270029	-116.3881647	San Bernardino County
304407	Non-Physician Medical Practitioner	None	1730106675	0	0	WARD, LIDA S NP	6/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4520 BUSINESS CENTER DR	200	FAIRFIELD	CA	94534	6888	00	06000	38.22519621	-122.1327459	Solano County
304470	Non-Physician Medical Practitioner	None	1336453455	0	0	WILSON, NICOLE ANN	7/27/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1001 BLYTHE BLVD	SUITE 200D	CHARLOTTE	NC	28203	5866	00	06000	35.205003	-80.838036	Mecklenburg County
304486	Non-Physician Medical Practitioner	None	1215350848	0	0	WELLSPACE HEALTH	10/8/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5959 GREENBACK LN STE 50	None	CITRUS HEIGHTS	CA	95621	4700	00	06000	38.681397	-121.322682	Sacramento County
304511	Non-Physician Medical Practitioner	None	1598934481	0	0	WASSERBERG, ANDREW N PA	9/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1000 GREENLEY RD	None	SONORA	CA	95370	4685	00	06000	37.97749352	-120.3700335	Tuolumne County
304541	Non-Physician Medical Practitioner	None	1124212741	0	0	WRIGHT, TOBY L PA-C	6/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	00	06000	36.06953472	-119.0273379	Tulare County
304601	Non-Physician Medical Practitioner	None	1760072557	0	0	WATSON, KEVIN J NP	8/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	00	06000	35.38333823	-119.0188872	Kern County
304629	Non-Physician Medical Practitioner	None	1306482344	0	0	WILLIS, LESTER J NP	2/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	536 CAMINO MERCADO	STE.306	ARROYO GRANDE	CA	93420	1418	00	06000	35.12986992	-120.6006027	San Luis Obispo County
304691	Non-Physician Medical Practitioner	None	1447797444	0	0	WILLIAMS, LESHA L PA-C	7/18/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
304692	Non-Physician Medical Practitioner	None	1396426086	0	0	WALKER, SAMANTHA PA-C	9/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3800 GEER RD	200	TURLOCK	CA	95382	1146	00	06000	37.52713247	-120.8488664	Stanislaus County
304706	Non-Physician Medical Practitioner	None	1366168676	0	0	WONG, KATHRYN N PA	3/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3413 W PACIFIC AVE	100, 200	BURBANK	CA	91505	1555	00	06000	34.18839272	-118.3485967	Los Angeles County
304811	Non-Physician Medical Practitioner	None	1134399165	0	0	WISE &HEALTHY AGING	11/19/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1527 4TH ST	3RD FLOOR	SANTA MONICA	CA	90401	2358	00	06000	34.01449532	-118.4928768	Los Angeles County
304814	Non-Physician Medical Practitioner	None	1225153729	0	0	WOYSHNER, EMILY A	9/22/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 WILSHIRE BLVD	SUITE 1802	LOS ANGELES	CA	90017	1946	00	06000	34.05247091	-118.2636998	Los Angeles County
304829	Non-Physician Medical Practitioner	None	1790852960	0	0	WANG, JAN	4/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	276 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1197	00	06000	37.2402111	-121.8021684	Santa Clara County
304840	Non-Physician Medical Practitioner	None	1528241593	0	0	WILLIAMS, ISAIAH W	4/15/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14850 OKA RD	APT 5	LOS GATOS	CA	95032	1926	00	06000	37.25280759	-121.9607546	Santa Clara County
304857	Non-Physician Medical Practitioner	None	1437553039	0	0	WRIGHT, MELISSA J NP	12/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3400 BELL RD	None	AUBURN	CA	95603	9241	00	06000	38.94188162	-121.1099369	Placer County
304860	Non-Physician Medical Practitioner	None	1295073815	0	0	WRITER, NICOLE R PA	6/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	44-419 TOWN CENTER WAY	STE E	PALM DESERT	CA	92260	7100	00	06000	33.72583102	-116.398368	Riverside County
304862	Non-Physician Medical Practitioner	None	1861748774	0	0	WEST, KIM R NP	8/3/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	0001	00	06000	37.97026329	-121.2890849	San Joaquin County
304874	Non-Physician Medical Practitioner	None	1710433834	0	0	WINDSOR, MONICA NP	10/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2335 E KASHIAN LANE	SUITE 260	FRESNO	CA	93701	2234	00	06000	36.74333844	-119.7831874	Fresno County
304887	Non-Physician Medical Practitioner	None	1629290838	0	0	WYATT, SU ROBYN	5/13/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4141 STATE ST	SUITE A1	SANTA BARBARA	CA	93110	1814	00	06000	34.4404695	-119.7612045	Santa Barbara County
304889	Non-Physician Medical Practitioner	None	1437767431	0	0	WONG, JAMES T	3/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43839 15TH ST W	None	LANCASTER	CA	93534	4756	00	06000	34.678791	-118.156867	Los Angeles County
304947	Non-Physician Medical Practitioner	None	1508858747	0	0	WILLIAMS, FRANCES	3/22/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	432 S MILL ST	None	TEHACHAPI	CA	93561	2027	00	06000	35.12816152	-118.4531859	Kern County
304961	Non-Physician Medical Practitioner	None	1316168578	0	0	WUEST, ROXANN E	5/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	833 N GARDSEN AVE	None	COVINA	CA	91724	0000	00	06000	34.09472843	-117.8520112	Los Angeles County
305006	Non-Physician Medical Practitioner	None	1992153977	0	0	WONG, KENNETH PA	1/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
305020	Non-Physician Medical Practitioner	None	1477801587	0	0	WHALEN, JOELLE C	10/29/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1645 SEQUOIA DRIVE	None	PETALUMA	CA	94954	6691	00	06000	38.25941549	-122.6308943	Sonoma County
305030	Non-Physician Medical Practitioner	None	1922175769	0	0	WIDER, STEPHEN P	3/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4607 RUBIDOUX AVE	None	RIVERSIDE	CA	92506	1915	00	06000	33.96400132	-117.4016858	Riverside County
305033	Non-Physician Medical Practitioner	None	1770263824	0	0	WARDLE, BRITTANY NP	2/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31625 DE PORTOLA RD	SUITE 101	TEMECULA	CA	92592	2770	00	06000	33.48359715	-117.1048345	Riverside County
305042	Non-Physician Medical Practitioner	None	1831656289	0	0	WEAVER, BRIANNE PA	1/13/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	00	06000	33.9760587	-117.3800672	Riverside County
305050	Non-Physician Medical Practitioner	None	1639464845	0	0	WATKINS, KENIA N PA-C	11/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8500 FLORENCE AVENUE	101	DOWNEY	CA	90240	4062	00	06000	33.94970699	-118.1216339	Los Angeles County
305055	Non-Physician Medical Practitioner	None	1124598974	0	0	WANG, SHARON D NP	1/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2701 S BRISTOL ST	None	SANTA ANA	CA	92704	6201	00	06000	33.71114199	-117.8853958	Orange County
305063	Non-Physician Medical Practitioner	None	1316938616	0	0	WOOTTEN, TIMOTHY S	3/20/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3011 WAVES END WY	None	TURLOCK	CA	95382	0988	00	06000	37.52051011	-120.8575488	Stanislaus County
305068	Non-Physician Medical Practitioner	None	1831415462	0	0	WOODWARD, WHITNEY KATHLEEN	8/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2100 POWELL ST	SUITE 900	EMERYVILLE	CA	94608	1826	00	06000	37.83953006	-122.2990736	Alameda County
305114	Non-Physician Medical Practitioner	None	1124551494	0	0	WOLFE-ROUBATIS, EMILY C NP	11/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
305132	Non-Physician Medical Practitioner	None	1467029579	0	0	WU, BRYAN PA-C	12/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 S RAYMOND AVE	None	ALHAMBRA	CA	91801	3166	00	06000	34.09027878	-118.1450083	Los Angeles County
305138	Non-Physician Medical Practitioner	None	1205874740	0	0	WRIGHT, ANNE E	4/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4130 WINDING CREEK ROAD	None	SACRAMENTO	CA	95864	1682	00	06000	38.600604	-121.366863	Sacramento County
305145	Non-Physician Medical Practitioner	None	1467172338	0	0	WINTER, JENNIFER PA-C	1/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
305185	Non-Physician Medical Practitioner	None	1346089141	0	0	WANG, XIAOXIAO	10/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	00	06000	34.05362775	-118.2661889	Los Angeles County
305232	Non-Physician Medical Practitioner	None	1942365572	0	0	WURZBACH, ELKE L NP	12/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	208 SANTA ANA AVE	None	LONG BEACH	CA	90803	6162	00	06000	33.75937666	-118.1310419	Los Angeles County
305234	Non-Physician Medical Practitioner	None	1194434969	0	0	WENTZ, KELSEY K PA	3/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
305245	Non-Physician Medical Practitioner	None	1932591245	0	0	WIRTH, JESSICA M PA-C	2/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CASA BUENA DR	None	CORTE MADERA	CA	94925	1762	00	06000	37.92483214	-122.51669	Marin County
305246	Non-Physician Medical Practitioner	None	1275018186	0	0	WRIGHT, MONICA M	10/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8040 WESTCAMP RD	None	FAIR OAKS	CA	95628	5017	00	06000	38.655945	-121.2663015	Sacramento County
305255	Non-Physician Medical Practitioner	None	1518283506	0	0	WALKER, KARIN E NP	1/16/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	4220 SADDLEHORN PLACE	None	RENO	NV	89511	6734	00	06000	39.40176303	-119.7937533	Washoe County
305262	Non-Physician Medical Practitioner	None	1013642297	0	0	WILCOX, MELISSA NP	11/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
305305	Non-Physician Medical Practitioner	None	1720485329	0	0	WIESE, LAIRA M CNM	10/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1740 W GRAND AVE	None	PORTERVILLE	CA	93257	1318	00	06000	36.07692392	-119.056242	Tulare County
305355	Non-Physician Medical Practitioner	None	1730413758	0	0	WANCHUN, LU	3/26/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7218 VAN NUYS BLVD STE D	None	VAN NUYS	CA	91405	6804	00	06000	34.20173513	-118.4487045	Los Angeles County
305364	Non-Physician Medical Practitioner	None	1225365182	0	0	WONG, EUNICE B NP	7/2/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	633 ALISO VIEJO CT	None	ROSEVILLE	CA	95747	5054	00	06000	38.80484579	-121.3423168	Placer County
305386	Non-Physician Medical Practitioner	None	1710314257	0	0	WALSH, AMY C PA-C	8/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
305388	Non-Physician Medical Practitioner	None	1922105584	0	0	WONG, SALLY KIM	11/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DRIVE	None	VALLEJO	CA	94589	0000	00	06000	38.12828446	-122.24821	Solano County
305414	Non-Physician Medical Practitioner	None	1295805364	0	0	WOJCIECHOWSKI, RYAN PAUL	10/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	150 NORTH WASHINGTON BLV	None	OGDEN	UT	84404	0000	00	06000	41.2621098	-111.9695746	Weber County
305491	Non-Physician Medical Practitioner	None	1942527908	0	0	WRIGHT, JANEL L	9/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3469 LEGATO COURT	None	PHILLIPS RANCH	CA	91766	0977	00	06000	34.04287105	-117.7977015	Los Angeles County
305512	Non-Physician Medical Practitioner	None	1326814765	0	0	WOO, MEI YAN NP	2/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	555 E HARDY ST	IRA KAUFMAN PAVILION	INGLEWOOD	CA	90301	4106	00	06000	33.94909549	-118.3481595	Los Angeles County
305532	Non-Physician Medical Practitioner	None	1346813870	0	0	WADE, EVELYN P CNM	3/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	00	06000	35.39052148	-119.0070765	Kern County
305610	Non-Physician Medical Practitioner	None	1396227583	0	0	WISDOM, DAVID M PA	11/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 NORTH PEPPER AVENUE	None	COLTON	CA	92324	1819	00	06000	34.073505	-117.3505995	San Bernardino County
305629	Non-Physician Medical Practitioner	None	1932748951	0	0	WOYWOD, ERICA M PA-C	11/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7050 N RECREATION AVE	STE 101	FRESNO	CA	93720	8001	00	06000	36.83835219	-119.7404373	Fresno County
305632	Non-Physician Medical Practitioner	None	1770357022	0	0	WAY, SUSAN R NP	9/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
305655	Non-Physician Medical Practitioner	None	1477109668	0	0	WISDOM, LAUREN NP	3/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
305673	Non-Physician Medical Practitioner	None	1508307364	0	0	WATSON, CHRISTINE M	2/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4020 ARROYO SORRENTO	None	SAN DIEGO	CA	92130	2611	00	06000	32.93079408	-117.2280089	San Diego County
305676	Non-Physician Medical Practitioner	None	1679673347	0	0	WINCHELL, TAMMY A NP	3/9/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1709 LAKE STREET	None	HUNTINGTON BEACH	CA	92648	3110	00	06000	33.67253328	-117.9979772	Orange County
305679	Non-Physician Medical Practitioner	None	1366472649	0	0	WONG, DOMINIC TAN	11/14/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13652 CANTARA ST	BALBOA PLAZA BLDG	PANORAMA CITY	CA	91402	5423	00	06000	34.21980849	-118.4301135	Los Angeles County
305685	Non-Physician Medical Practitioner	None	1932549649	0	0	WU, OLIVIA X J	11/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2731 CONCETTA CT	None	SAN JOSE	CA	95127	1881	00	06000	37.36843361	-121.8400428	Santa Clara County
305692	Non-Physician Medical Practitioner	None	1144672528	0	0	WYNNE, STEPHANIE J NP	7/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	00	06000	37.39572142	-122.1051204	Santa Clara County
305724	Non-Physician Medical Practitioner	None	1477705564	0	0	WHEELER, BETH A	4/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	515 SCRIPPS DR	None	DAVIS	CA	95616	1029	00	06000	38.55797932	-121.7551298	Yolo County
305800	Non-Physician Medical Practitioner	None	1609951391	0	0	WITASCHEK, MELISSA STEBBINS	4/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27303 SLEEPY HOLLOW AVEN	None	HAYWARD	CA	94545	4203	00	06000	37.63208871	-122.0939191	Alameda County
305801	Non-Physician Medical Practitioner	None	1982122560	0	0	WHITEHEAD, THOMAS L JR NP	10/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2555 VALLE VERDE	None	IMPERIAL	CA	92251	8003	00	06000	32.837922	-115.5939975	Imperial County
305836	Non-Physician Medical Practitioner	None	1699840538	0	0	WOON, JUDY	6/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
305843	Non-Physician Medical Practitioner	None	1396968152	0	0	WANG, ALISA PA-C	5/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
305866	Non-Physician Medical Practitioner	None	1124318027	0	0	WILSON, KELLY L PA-C	10/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7471 N FRESNO ST	None	FRESNO	CA	93720	2457	00	06000	36.84632065	-119.783885	Fresno County
305874	Non-Physician Medical Practitioner	None	1467053371	0	0	WILSON, DAVID L NP	12/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
305877	Non-Physician Medical Practitioner	None	1215587266	0	0	WELSH, STANTON A PA	8/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2122 W KETTLEMAN LANE	None	LODI	CA	95242	4321	00	06000	38.11537452	-121.299291	San Joaquin County
305914	Non-Physician Medical Practitioner	None	1184809212	0	0	WHITE, SARAH R NP	3/13/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1051 EAST 33RD STREET	None	OAKLAND	CA	94610	4024	00	06000	37.80266481	-122.2356311	Alameda County
305951	Non-Physician Medical Practitioner	None	1932494499	0	0	WEIR, JACQUELINE R PA	11/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2075 SAN JOAQUIN HILLS R	None	NEWPORT BEACH	CA	92660	6505	00	06000	33.61676129	-117.869325	Orange County
305957	Non-Physician Medical Practitioner	None	1417526732	0	0	WILLIAM, VICTORIA PA	6/30/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8920 WILSHIRE BLVD	STE 520	BEVERLY HILLS	CA	90211	2007	00	06000	34.06703599	-118.3863456	Los Angeles County
305965	Non-Physician Medical Practitioner	None	1851870422	0	0	WONG, BRANDON M	11/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1409 PARK AVE	None	NOVATO	CA	94945	3126	00	06000	38.10784438	-122.5751213	Marin County
305971	Non-Physician Medical Practitioner	None	1942832043	0	0	WALLING, KRISTEN J PA-C	1/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2321 HARRISON AVE	STE S	EUREKA	CA	95501	3216	00	06000	40.786857	-124.1396125	Humboldt County
305994	Non-Physician Medical Practitioner	None	1720463649	0	0	WHITAKER, BRIAN P	12/4/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1911 28TH ST	None	SAN DIEGO	CA	92102	1102	00	06000	32.72592708	-117.1338648	San Diego County
306030	Non-Physician Medical Practitioner	None	1568961423	0	0	WALKER, LINDSAY B PA	7/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
306035	Non-Physician Medical Practitioner	None	1265091946	0	0	WENTLING, CHRISTOPHER PA	2/3/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1515 EAST OCEAN AVE.	None	LOMPOC	CA	93436	7092	00	06000	34.63941491	-120.4393023	Santa Barbara County
306085	Non-Physician Medical Practitioner	None	1437301488	0	0	WANG, SUSAN NP	8/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1595 SOQUEL DRIVE	STE 110	SANTA CRUZ	CA	95065	1717	00	06000	36.98879599	-121.9826354	Santa Cruz County
306088	Non-Physician Medical Practitioner	None	1083823322	0	0	WAHLIN, TAMARA A	5/2/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4644 TERRAZA MAR MARVELO	None	SAN DIEGO	CA	92130	4675	00	06000	32.91410099	-117.2165681	San Diego County
306092	Non-Physician Medical Practitioner	None	1265496509	0	0	WILDER, MARY ANN	9/7/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	06000	36.163269	-115.1654465	Clark County
306103	Non-Physician Medical Practitioner	None	1457013021	0	0	WOODS, KATHARINE A NP	12/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
306131	Non-Physician Medical Practitioner	None	1811302045	0	0	WELLSPACE HEALTH	10/22/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7601 HOSPITAL DR	SUITE 220	SACRAMENTO	CA	95823	5408	00	06000	38.464794	-121.415571	Sacramento County
306136	Non-Physician Medical Practitioner	None	1003439142	0	0	WEI, ANGELA PA-C	9/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	00	06000	37.39572142	-122.1051204	Santa Clara County
306183	Non-Physician Medical Practitioner	None	1619640125	0	0	WALLE, VARVARA PA	3/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	00	06000	37.7802547	-122.4642049	San Francisco County
306217	Non-Physician Medical Practitioner	None	1619610821	0	0	WILSON, AUBREY M NP	10/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
306238	Non-Physician Medical Practitioner	None	1861593808	0	0	WADHWANI, RITA TIKAM	2/18/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	00	06000	33.83760674	-118.3572569	Los Angeles County
306242	Non-Physician Medical Practitioner	None	1629349410	0	0	WIPFF, ERIN K NP	8/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	353 29TH STREET	None	SAN FRANCISCO	CA	94131	2304	00	06000	37.74359625	-122.4279319	San Francisco County
306269	Non-Physician Medical Practitioner	None	1174084644	0	0	WALIA, SAPANDIP K	4/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2800 L STREET	STE 300	SACRAMENTO	CA	95816	5616	00	06000	38.571237	-121.469958	Sacramento County
306277	Non-Physician Medical Practitioner	None	1831593136	0	0	WONG, SHELLY W NP	1/13/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5427 BROOK HOLLOW CT	None	STOCKTON	CA	95219	2440	00	06000	37.99184999	-121.3593393	San Joaquin County
306279	Non-Physician Medical Practitioner	None	1346432929	0	0	WARHOVER, AGNES PA-C	8/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	00	06000	38.6657551	-121.7922645	Yolo County
306295	Non-Physician Medical Practitioner	None	1184006520	0	0	WORDEN, KARINA PA-C	12/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	511 BATH ST	None	SANTA BARBARA	CA	93101	3403	00	06000	34.41386476	-119.6993335	Santa Barbara County
306300	Non-Physician Medical Practitioner	None	1457599003	0	0	WONG, SHARON	4/26/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	375 LAGUNA HONDA BLVD	A400	SAN FRANCISCO	CA	94116	1411	00	06000	37.74791027	-122.4587116	San Francisco County
306302	Non-Physician Medical Practitioner	None	1669046025	0	0	WEI, ANNE V PA-C	10/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	00	06000	37.592811	-122.382351	San Mateo County
306354	Non-Physician Medical Practitioner	None	1376089219	0	0	WAIRERI, ANDREW N NP	3/30/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3584 BELLAIRE AVE	None	CLOVIS	CA	93619	7211	00	06000	36.79198765	-119.6421277	Fresno County
306373	Non-Physician Medical Practitioner	None	1730614298	0	0	WINTERHALTER, BRIDGET PA-C	1/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8635 W 3RD ST	SUITE 1090 WEST	LOS ANGELES	CA	90048	6101	00	06000	34.07361928	-118.3803143	Los Angeles County
306397	Non-Physician Medical Practitioner	None	1538569710	0	0	WHITMIRE, KELLY R	6/17/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2889 TIFFANY LN	None	SIMI VALLEY	CA	93063	2137	00	06000	34.28840602	-118.7293065	Ventura County
306405	Non-Physician Medical Practitioner	None	1750539391	0	0	WILLIAMS, TARQUIN S PA-C	10/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17051 SIERRA LAKES PKWY	None	FONTANA	CA	92336	1274	00	06000	34.13797332	-117.4324372	San Bernardino County
306426	Non-Physician Medical Practitioner	None	1417729146	0	0	WINDEKNECHT, TAMMY NP	11/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	191 E ALESSANDRO BLVD	9A	RIVERSIDE	CA	92508	5095	00	06000	33.91628074	-117.3284633	Riverside County
306481	Non-Physician Medical Practitioner	None	1619532108	0	0	WIMMER, ELIZABETH A NP	1/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	00	06000	37.51438187	-122.2607682	San Mateo County
306487	Non-Physician Medical Practitioner	None	1801542071	0	0	WELLER, BRIANNA NP	7/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6155 CORNERSTONE CT E	220	SAN DIEGO	CA	92121	4736	00	06000	32.89582335	-117.1880966	San Diego County
306502	Non-Physician Medical Practitioner	None	1881112449	0	0	WIANECKI, TESS PA	11/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1320 LAS TABLAS ROAD	SUITE B	TEMPLETON	CA	93465	9711	00	06000	35.5544315	-120.7225935	San Luis Obispo County
306531	Non-Physician Medical Practitioner	None	1326257973	0	0	WIDMANN, COURTNEY F	2/11/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	297 BARKENTINE CT	None	APTOS	CA	95003	3751	00	06000	36.98032949	-121.9162256	Santa Cruz County
306672	Non-Physician Medical Practitioner	None	1093145898	0	0	WU, JIA NP	5/5/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 DEL VALLE PARKWAY	None	PLEASANTON	CA	94566	6433	00	06000	37.66787088	-121.8805541	Alameda County
306688	Non-Physician Medical Practitioner	None	1992991186	0	0	WHITEHEAD, HANNAH MILLER	5/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	20 RESEARCH PKWY	None	OLD SAYBROOK	CT	06475	4214	00	06000	41.30021378	-72.38482179	Lower Connecticut River Valley Planning Region
306689	Non-Physician Medical Practitioner	None	1871743393	0	0	WRIGHT, HEIKE PA	1/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2216 BUENAVENTURA BLVD	SUITE B	REDDING	CA	96001	3838	00	06000	40.55453352	-122.3904825	Shasta County
306712	Non-Physician Medical Practitioner	None	1437878444	0	0	WARD, SHANNON M NP	12/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5451 WALNUT AVE	None	CHINO	CA	91710	2609	00	06000	34.02626886	-117.6858645	San Bernardino County
306742	Non-Physician Medical Practitioner	None	1902355753	0	0	WATERS, SAMANTHA C PA	12/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1255 LIBERTY STREET	None	REDDING	CA	96001	0814	00	06000	40.58769807	-122.3879041	Shasta County
306936	Non-Physician Medical Practitioner	None	1427814938	0	0	WRIGHT, VANESSA NP	4/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6789 N BLACKSTONE AVE	None	FRESNO	CA	93710	3530	00	06000	36.83695148	-119.7904013	Fresno County
306939	Non-Physician Medical Practitioner	None	1174194641	0	0	WILE, KIMBERLY L PA	11/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	625 W CITRACADO PKWY	108	ESCONDIDO	CA	92025	6428	00	06000	33.09166731	-117.0784699	San Diego County
306994	Non-Physician Medical Practitioner	None	1659836823	0	0	WALTERS, ALVIN R NP	5/6/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	00	06000	39.22820863	-121.0465856	Nevada County
306998	Non-Physician Medical Practitioner	None	1821324583	0	0	WALKER, EKUA N NP	10/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	00	06000	37.39572142	-122.1051204	Santa Clara County
307001	Non-Physician Medical Practitioner	None	1669988812	0	0	WALZ, CALINA A	1/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	138 PRINCIPIA CT	None	CLAREMONT	CA	91711	4657	00	06000	34.09477547	-117.724266	Los Angeles County
307011	Non-Physician Medical Practitioner	None	1144917311	0	0	WASSERMAN, TEAGAN S PA	10/28/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	00	06000	33.89343304	-117.9279349	Orange County
307102	Non-Physician Medical Practitioner	None	1962618496	0	0	WON, SUETEFI N NP	6/5/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3201 S ST	APT 484	SACRAMENTO	CA	94816	7095	00	06000	38.562948	-121.467726	Sacramento County
307132	Non-Physician Medical Practitioner	None	1306287883	0	0	WAN, DOROTHY NP	8/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	00	06000	37.70554251	-121.873005	Alameda County
307144	Non-Physician Medical Practitioner	None	1275689192	0	0	WREN, MICHAEL J	8/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
307147	Non-Physician Medical Practitioner	None	1073847620	0	0	WON, JOANN PA-C	7/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 N EUCLID ST	None	ANAHEIM	CA	92801	4122	00	06000	33.8420837	-117.9415765	Orange County
307277	Non-Physician Medical Practitioner	None	1639587017	0	0	WEBER, CHRISTINE A	3/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	580 MINT LANE	None	VENTURA	CA	93001	2453	00	06000	34.28786755	-119.2771915	Ventura County
307288	Non-Physician Medical Practitioner	None	1629453386	0	0	WEMPLE, STEVEN P	12/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	569 CANYON ROAD	None	REDWOOD CITY	CA	94062	3019	00	06000	37.47328953	-122.2605922	San Mateo County
307305	Non-Physician Medical Practitioner	None	1811274780	0	0	WHITE, BARTLETT	12/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	00	06000	37.36269	-118.407312	Inyo County
307364	Non-Physician Medical Practitioner	None	1952124661	0	0	WAROLIN, ASUSENA NP	12/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 CHINA GRADE LOOP	None	BAKERSFIELD	CA	93308	1707	00	06000	35.4265209	-119.0190909	Kern County
307408	Non-Physician Medical Practitioner	None	1962117697	0	0	WANG, MICHELLE K NP	5/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	525 NORTH GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	00	06000	34.06794352	-118.1229278	Los Angeles County
307425	Non-Physician Medical Practitioner	None	1750466181	0	0	WELLS, DANIELLE PA	7/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14443 CULVER DR	14443-A	IRVINE	CA	92604	0343	00	06000	33.70541708	-117.7871432	Orange County
307464	Non-Physician Medical Practitioner	None	1639763931	0	0	WESSEL, TALINA F NP	12/4/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1510 HERNDON	210 AND 230	FRESNO	CA	93720	3303	00	06000	36.83756048	-119.7609525	Fresno County
307487	Non-Physician Medical Practitioner	None	1891319828	0	0	WILLIAMS, REANNA PA-C	12/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
307572	Non-Physician Medical Practitioner	None	1639846140	0	0	WILLIAMS, BRITANE D NP	9/24/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	802 W COLTON AVENUE	SUITE E	REDLANDS	CA	92374	2905	00	06000	34.06290649	-117.1918845	San Bernardino County
307677	Non-Physician Medical Practitioner	None	1982148011	0	0	WOOLEY, LAURA A	11/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24806 TULIP AVE	None	LOMA LINDA	CA	92354	3406	00	06000	34.0462383	-117.2627443	San Bernardino County
307705	Non-Physician Medical Practitioner	None	1063028959	0	0	WU, MAN LUNG NP	1/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	00	06000	38.66314048	-121.794696	Yolo County
307733	Non-Physician Medical Practitioner	None	1376630814	0	0	WYLIE, CONSTANCE R	1/1/1986	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21300 BALD RIDGE DR	None	PENN VALLEY	CA	95946	9402	00	06000	39.21932127	-121.2405425	Nevada County
307742	Non-Physician Medical Practitioner	None	1861833659	0	0	WHEELER, SAMANTHA K PA-C	1/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
307753	Non-Physician Medical Practitioner	None	1639362874	0	0	WEINAND, VICTORIA RACHEL	1/11/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	00	06000	37.8242017	-122.2578306	Alameda County
307770	Non-Physician Medical Practitioner	None	1942558721	0	0	WATSON, LORENA A	10/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5108 HILL ROAD EAST	None	LAKEPORT	CA	95453	0000	00	06000	39.10322744	-122.9095492	Lake County
307790	Non-Physician Medical Practitioner	None	1457759359	0	0	WARD, KIMBERLY R	8/11/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	597 ENCINA DR	None	EL DORADO HILLS	CA	95762	3515	00	06000	38.72962613	-121.0863314	El Dorado County
307819	Non-Physician Medical Practitioner	None	1407050545	0	0	WOLFSON, AMY	3/20/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	30 ANACAPA LANE	None	ALISO VIEJO	CA	92656	1630	00	06000	33.59757933	-117.7285143	Orange County
307857	Non-Physician Medical Practitioner	None	1861016362	0	0	WANG, CHRISTINA PA-C	7/13/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8930 S SEPULVEDA BLVD	STE 104	LOS ANGELES	CA	90045	3606	00	06000	33.955128	-118.3961915	Los Angeles County
307859	Non-Physician Medical Practitioner	None	1720682693	0	0	WHITESELL, HANNAH PA	7/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
307873	Non-Physician Medical Practitioner	None	1972971018	0	0	WALLER, KATIE L NP	2/25/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3320 ALRIDGE RD	None	VACAVILLE	CA	95688	9330	00	06000	38.40066947	-121.961799	Solano County
307874	Non-Physician Medical Practitioner	None	1245377977	0	0	W, RODRIGUEZ R	3/1/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25200 LA PAZ RD	None	LAGUNA HILLS	CA	92653	5110	00	06000	33.59650811	-117.6779452	Orange County
307875	Non-Physician Medical Practitioner	None	1598190365	0	0	WILEY, DANIELLE N PA-C	6/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	168 NORTH BRENT ST	STE 508	VENTURA	CA	93003	2817	00	06000	34.27448266	-119.2572489	Ventura County
307880	Non-Physician Medical Practitioner	None	1679721740	0	0	WARD, MICHELLE MARIE	7/30/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5800 GRANITE PKWY	STE 900	PLANO	TX	75024	6614	00	06000	33.08783343	-96.81981086	Collin County
307910	Non-Physician Medical Practitioner	None	1245777374	0	0	WOOD, JENNIFER	11/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	360 S LOLA LN	None	PAHRUMP	NV	89048	0884	00	06000	36.214524	-116.025615	Nye County
307924	Non-Physician Medical Practitioner	None	1184644825	0	0	WHITMORE, MARY L	12/12/1992	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21 SHASTA SPRINGS RD	None	WEAVERVILLE	CA	96093	2330	00	06000	40.73439771	-122.9249589	Trinity County
307935	Non-Physician Medical Practitioner	None	1497307763	0	0	WONG, AMANDA K PA	7/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1145 WHISKEYTOWN COURT	SUITE A	REDDING	CA	96001	0227	00	06000	40.58504488	-122.4126269	Shasta County
307943	Non-Physician Medical Practitioner	None	1255025029	0	0	WANG, LI MIAO PA	10/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5794	00	06000	34.47092468	-117.2977236	San Bernardino County
307956	Non-Physician Medical Practitioner	None	1215950159	0	0	WESTBROOK, KATHERINE A NP	5/9/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1479 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	2986	00	06000	37.91301169	-122.0438513	Contra Costa County
307965	Non-Physician Medical Practitioner	None	1326410127	0	0	WU, BEVERLY H	12/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3401 IRON POINT DR	APT 351	SAN JOSE	CA	95134	3427	00	06000	37.40485062	-121.9313645	Santa Clara County
307975	Non-Physician Medical Practitioner	None	1386240844	0	0	WILLIAMSON, DOUGLAS L NP	6/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1551 BISHOP ST	A 150	SAN LUIS OBISPO	CA	93401	4635	00	06000	35.27475609	-120.6454494	San Luis Obispo County
307987	Non-Physician Medical Practitioner	None	1871826776	0	0	WILLIS, VALERIE LYNN	11/17/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 W CALIFORNIA BLVD	None	PASADENA	CA	91109	7013	00	06000	34.133598	-118.1534895	Los Angeles County
308001	Non-Physician Medical Practitioner	None	1780921379	0	0	WHITE, FRANCES ANNE A NP	11/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	808 ALAMEDA	DE LAS PULGAS	BELMONT	CA	94002	1602	00	06000	37.51555078	-122.2959039	San Mateo County
308011	Non-Physician Medical Practitioner	None	1356199491	0	0	WHANG, SABRINA PA	8/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	00	06000	35.356203	-119.0612695	Kern County
308038	Non-Physician Medical Practitioner	None	1356821136	0	0	WATERSTRAUT, CARLY NP	9/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2700 GRANT ST	STE 200	CONCORD	CA	94520	2266	00	06000	37.98417931	-122.0361585	Contra Costa County
308098	Non-Physician Medical Practitioner	None	1922491521	0	0	WILLIAMS, STEPHANIE C	3/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	969 S. SANTA FE AVE	A	VISTA	CA	92083	6910	00	06000	33.1927833	-117.2316819	San Diego County
308118	Non-Physician Medical Practitioner	None	1184011710	0	0	WAHBE, DINA S NP	8/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
308173	Non-Physician Medical Practitioner	None	1407324742	0	0	WERSTLER, JENNIFER M PA-C	9/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	00	06000	36.98863619	-121.9830754	Santa Cruz County
308216	Non-Physician Medical Practitioner	None	1417549015	0	0	WOODWORTH, KRISTIN PA-C	7/19/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
308228	Non-Physician Medical Practitioner	None	1124257324	0	0	WELLSPACE HEALTH	9/2/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3415 MARTIN LUTHER KING	None	SACRAMENTO	CA	95817	3648	00	06000	38.54376	-121.4644095	Sacramento County
308277	Non-Physician Medical Practitioner	None	1609159615	0	0	WARE, REBECCA R	3/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9343 BISTRO PLACE	None	RANCHO CUCAMONGA	CA	91730	5721	00	06000	34.08393642	-117.5972759	San Bernardino County
308281	Non-Physician Medical Practitioner	None	1265423750	0	0	WRIGHT, HERBERT S PA	11/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	00	06000	33.82736911	-116.5109632	Riverside County
308285	Non-Physician Medical Practitioner	None	1912604307	0	0	WALKER, SUMMER L PA	5/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1095 IRVINE BLVD	None	TUSTIN	CA	92780	3526	00	06000	33.74821163	-117.8097851	Orange County
308289	Non-Physician Medical Practitioner	None	1225315963	0	0	WASSELL, ANNETTE D NP	10/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9436 NORTH SAYBROOK DR	264	FRESNO	CA	93720	9996	00	06000	36.87203891	-119.7692683	Fresno County
308363	Non-Physician Medical Practitioner	None	1619751930	0	0	WONG, NATALIE PA-C	9/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 N. TUSTIN AVE	UNIT # 216	SANTA ANA	CA	92705	3528	00	06000	33.754167	-117.834191	Orange County
308378	Non-Physician Medical Practitioner	None	1679215453	0	0	WALKER, TRICIA R NP	8/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
308391	Non-Physician Medical Practitioner	None	1093114365	0	0	WANG, DENNIS P S	11/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13826 MONET ST	None	MORENO VALLEY	CA	92555	2571	00	06000	33.91984599	-117.2008191	Riverside County
308393	Non-Physician Medical Practitioner	None	1851885933	0	0	WEISKIRCH, SARA Q PA-C	12/10/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7320 WOODLAKE AVE.	SUITE 340	WEST HILLS	CA	91307	7320	00	06000	34.20245266	-118.6321273	Los Angeles County
308403	Non-Physician Medical Practitioner	None	1518338169	0	0	WAHINEHOOKAE, REBECCA A NP	11/5/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8401 E HERMOSA DR	None	SAN GABRIEL	CA	91775	2340	00	06000	34.10626925	-118.0861046	Los Angeles County
308476	Non-Physician Medical Practitioner	None	1962563585	0	0	WALKER, GARY B	1/9/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2711 SHERWIN WY	None	LA VERNE	CA	91750	4665	00	06000	34.1021497	-117.7576157	Los Angeles County
308488	Non-Physician Medical Practitioner	None	1982932539	0	0	WAGNER, JEANINE C	3/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	45640 VIA PUEBLA	None	TEMECULA	CA	92592	5884	00	06000	33.46446708	-117.0834454	Riverside County
308508	Non-Physician Medical Practitioner	None	1396265245	0	0	WINTER, GEORGE D NP	9/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8300 SHERWOOD BLVD	None	LOS MOLINOS	CA	96055	9758	00	06000	40.03705068	-122.0964131	Tehama County
308565	Non-Physician Medical Practitioner	None	1275626384	0	0	WARDLAW, MARY E	3/26/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 SAN PABLO AVE	SUITE 300	ALBANY	CA	94706	1127	00	06000	37.89781848	-122.3014067	Alameda County
308567	Non-Physician Medical Practitioner	None	1467705525	0	0	WINSHIP, ALEXANDRA HANNA	11/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	4536 BONNEY RD	None	VIRGINIA BEACH	VA	23462	3818	00	06000	36.83392557	-76.13273018	Virginia Beach city
308586	Non-Physician Medical Practitioner	None	1245885458	0	0	WHITNEY, ADAM D PA	10/31/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23931375	-121.8014189	Santa Clara County
308619	Non-Physician Medical Practitioner	None	1649674276	0	0	WEAVER, GLYNIS E	9/30/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	6225 EVEREST CT	None	RENO	NV	89523	9731	00	06000	39.53608985	-119.8870218	Washoe County
308628	Non-Physician Medical Practitioner	None	1225638265	0	0	WRIGHT, NALINPORN NP	2/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10880 WILSHIRE BLVD	1101	LOS ANGELES	CA	90024	4112	00	06000	34.05897499	-118.4431123	Los Angeles County
308645	Non-Physician Medical Practitioner	None	1639152838	0	0	WRIGHT, AARON JOSEPH	1/9/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	UC DAVIS MEDICAL CENTER	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
308656	Non-Physician Medical Practitioner	None	1194418012	0	0	WILCOX, MICHELLE NP	4/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8590 RIO SAN DIEGO DR	SUITE 111	SAN DIEGO	CA	92108	5507	00	06000	32.77472926	-117.1448295	San Diego County
308729	Non-Physician Medical Practitioner	None	1114281839	0	0	WILLIAMS, CATHERINE E PA-C	3/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
308736	Non-Physician Medical Practitioner	None	1477079606	0	0	WAHABZAI, JAHID A	10/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 WEST CENTRAL AVE	APT 2910	TRACY	CA	95376	9205	00	06000	37.71508803	-121.4301704	San Joaquin County
308775	Non-Physician Medical Practitioner	None	1043966658	0	0	WILCHER, CLYETTE	8/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
308829	Non-Physician Medical Practitioner	None	1316991102	0	0	WOLFSON, BRENDA ANNE	8/20/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 UNIVERSITY AVE	None	SACRAMENTO	CA	95825	6523	00	06000	38.568402	-121.418019	Sacramento County
308852	Non-Physician Medical Practitioner	None	1306943451	0	0	WILLIAMSON, BARBARA ANN	1/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1030 NEVIN AVE	None	RICHMOND	CA	94801	3122	00	06000	37.93680005	-122.3591889	Contra Costa County
308867	Non-Physician Medical Practitioner	None	1659306470	0	0	WARD, MARY D T NP	8/16/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2516 KENNEDY PL	None	EL DORADO HILLS	CA	95762	7810	00	06000	38.70412825	-121.075125	El Dorado County
308928	Non-Physician Medical Practitioner	None	1396984118	0	0	WONG, JORDAN PA	5/11/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11840 MAGNOLIA	STE C	RIVERSIDE	CA	92503	7112	00	06000	33.89540021	-117.4902651	Riverside County
308970	Non-Physician Medical Practitioner	None	1154999787	0	0	WAUNG, STACY NP	1/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2704 E WILLOW ST	None	SIGNAL HILL	CA	90755	2217	00	06000	33.80432955	-118.1594295	Los Angeles County
309010	Non-Physician Medical Practitioner	None	1497850150	0	0	WADE GOOCH, PATRICIA S NP	11/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	00	06000	34.27771547	-119.2540344	Ventura County
309011	Non-Physician Medical Practitioner	None	1598701914	0	0	WILLIAMS, BRIAN G	8/22/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	869 NORTH CHERRY STREET	None	TULARE	CA	93274	2287	00	06000	36.220932	-119.337698	Tulare County
309047	Non-Physician Medical Practitioner	None	1821357492	0	0	WELLSPACE HEALTH	11/29/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8231 E STOCKTON BLVD	SUITE C	SACRAMENTO	CA	95828	8202	00	06000	38.459727	-121.410315	Sacramento County
309112	Non-Physician Medical Practitioner	None	1942366349	0	0	WILLER, ELIZABETH ELLEN	6/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	00	06000	37.89189148	-122.057999	Contra Costa County
309132	Non-Physician Medical Practitioner	None	1518563600	0	0	WISEMAN, NICHOLAS W PA-C	9/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
309149	Non-Physician Medical Practitioner	None	1528663929	0	0	WILLIAMS, ALISHA	8/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
309161	Non-Physician Medical Practitioner	None	1215368626	0	0	WONG, WAI KEI M NP	4/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
309178	Non-Physician Medical Practitioner	None	1285910935	0	0	WINGER, SARA E NP	3/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	312 SELBY RANCH RD	SUITE 3	SACRAMENTO	CA	95864	5804	00	06000	38.57071066	-121.3810118	Sacramento County
309195	Non-Physician Medical Practitioner	None	1992083877	0	0	WALDMAN, TALYA	11/28/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8631 W THIRD STREET	SUITE 740 EAST	LOS ANGELES	CA	90048	0000	00	06000	34.07361928	-118.3803143	Los Angeles County
309242	Non-Physician Medical Practitioner	None	1174948194	0	0	WU, VIVIAN J F NP	4/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	53 N EL MOLINO AVENUE	APT 250	PASADENA	CA	91101	5619	00	06000	34.14663687	-118.1369266	Los Angeles County
309243	Non-Physician Medical Practitioner	None	1851829931	0	0	WRIGHT, ROSA P	10/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	600 MAIN ST	None	SOLEDAD	CA	93960	2533	00	06000	36.43281182	-121.3243597	Monterey County
309265	Non-Physician Medical Practitioner	None	1649620790	0	0	WEINICK, EMILY PA	2/28/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	00	06000	34.06169385	-118.2044698	Los Angeles County
309282	Non-Physician Medical Practitioner	None	1962826271	0	0	WILLS, KARA	2/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5308 TUFTS ST	None	LAMESA	CA	91942	1702	00	06000	32.77641826	-117.0367205	San Diego County
309328	Non-Physician Medical Practitioner	None	1831595966	0	0	WHALEY, ANN MARIE	3/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
309333	Non-Physician Medical Practitioner	None	1639543853	0	0	WINGCO, RYAN P	12/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5 LAURENT	None	ALISO VIEJO	CA	92656	1701	00	06000	33.57801544	-117.7344794	Orange County
309359	Non-Physician Medical Practitioner	None	1104533298	0	0	WYMER, LISA PA	7/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3600 BROADWAY	None	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
309372	Non-Physician Medical Practitioner	None	1285815209	0	0	WAGNER, LINDSAY D	12/31/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1027 LARCH AVENUE	None	MORAGA	CA	94556	1848	00	06000	37.82876914	-122.1284721	Contra Costa County
309382	Non-Physician Medical Practitioner	None	1558766535	0	0	WILLIAMS, CHERISE L NP	11/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6161 S LAND PARK DR	None	SACRAMENTO	CA	95831	1837	00	06000	38.514438	-121.514886	Sacramento County
309390	Non-Physician Medical Practitioner	None	1922604727	0	0	WALKER, EBONY	8/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
309482	Non-Physician Medical Practitioner	None	1932179892	0	0	WAGNER, PAMELA	3/22/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2900 CHANTICLEER AVE.	None	SANTA CRUZ	CA	95065	1816	00	06000	36.98791813	-121.9781795	Santa Cruz County
309505	Non-Physician Medical Practitioner	None	1871770081	0	0	WETHERILL, PAUL MICHAEL	8/15/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1141 DESERTVIEW AVE	None	EL CENTRO	CA	92243	9150	00	06000	32.75726183	-115.5639745	Imperial County
309506	Non-Physician Medical Practitioner	None	1720041494	0	0	WHITAKER, ANITA NP	12/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	830 SCENIC DRIVE	None	MODESTO	CA	95350	6131	00	06000	37.64720049	-120.982338	Stanislaus County
309518	Non-Physician Medical Practitioner	None	1932655123	0	0	WILSON, BRENDA	3/7/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3113	00	06000	33.80318353	-118.0666665	Orange County
309538	Non-Physician Medical Practitioner	None	1861868275	0	0	WILSON, MONICA NP	4/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	00	06000	37.70554251	-121.873005	Alameda County
309649	Non-Physician Medical Practitioner	None	1831594670	0	0	WILLEMSE, JESSICA L NP	8/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2446 SPRING OAK DR	None	RUNNING SPRINGS	CA	92382	0000	00	06000	34.20974062	-117.1244005	San Bernardino County
309651	Non-Physician Medical Practitioner	None	1982752895	0	0	WIELENGA, JUANITA	4/16/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4000 14TH ST	SUITE #314	RIVERSIDE	CA	92501	4083	00	06000	33.97771007	-117.3818381	Riverside County
309654	Non-Physician Medical Practitioner	None	1417411349	0	0	WAGNER, RANDI PA-C	9/24/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	00	06000	38.74390969	-121.2319271	Placer County
309655	Non-Physician Medical Practitioner	None	1750931127	0	0	WILSON, HAYES R	8/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	333 MERCY AVENUE	None	MERCED	CA	95340	8319	00	06000	37.33875148	-120.467457	Merced County
309691	Non-Physician Medical Practitioner	None	1598080277	0	0	WAYNE, SUMMERS M	2/17/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
309705	Non-Physician Medical Practitioner	None	1306857255	0	0	WHEELER, LAURA G NP	8/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9894 LA JOLLA FARMS RD	None	LA JOLLA	CA	92037	1135	00	06000	32.88540416	-117.2486394	San Diego County
309716	Non-Physician Medical Practitioner	None	1134229107	0	0	WOODARD, LORIE J	4/30/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1160 SUNSET BLVD	None	ROCKLIN	CA	95765	3710	00	06000	38.8125	-121.2848698	Placer County
309773	Non-Physician Medical Practitioner	None	1265950448	0	0	WOLFF, SARAH Y	1/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1645 SANTA BARBARA AVE	None	GLENDALE	CA	91208	2020	00	06000	34.18853679	-118.2308404	Los Angeles County
309798	Non-Physician Medical Practitioner	None	1619997897	0	0	WOODWARD, LISA S NP	2/22/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	156 PINE ST	None	AUBURN	CA	95603	5247	00	06000	38.89949575	-121.0728398	Placer County
309882	Non-Physician Medical Practitioner	None	1588405914	0	0	WONG, SARAH A PA-C	7/11/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	193 E ORANGE GROVE BLVD	None	PASADENA	CA	91103	3487	00	06000	34.15787172	-118.1462979	Los Angeles County
309915	Non-Physician Medical Practitioner	None	1407885726	0	0	WARD, ARVIN M	10/14/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	607 SOUTHBRIDGE BLVD	None	SAVANNAH	GA	31405	1063	00	06000	32.07123817	-81.23027932	Chatham County
309920	Non-Physician Medical Practitioner	None	1174773121	0	0	WONG, IRENE	6/24/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5201 RAYMOND ST	None	ORLANDO	FL	32803	8208	00	06000	28.5791304	-81.32163212	Orange County
309935	Non-Physician Medical Practitioner	None	1699821959	0	0	WINICK, LISA MICHELLE	3/13/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1941 JOHNSON AVE	SUITE 202	SAN LUIS OBISPO	CA	93401	4140	00	06000	35.27804785	-120.649711	San Luis Obispo County
309973	Non-Physician Medical Practitioner	None	1265469712	0	0	WILSON, WILLIAM J PA-C	1/6/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18310 US HWY 18	STE 100	APPLE VALLEY	CA	92307	2206	00	06000	34.54034956	-117.2645069	San Bernardino County
310006	Non-Physician Medical Practitioner	None	1912186503	0	0	WEAVER, GINA G	1/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	836 W PENNSYLVANIA AVE	APT 304	SAN DIEGO	CA	92103	3861	00	06000	32.74535949	-117.170919	San Diego County
310045	Non-Physician Medical Practitioner	None	1215189402	0	0	WHITE, SONJA D PA-C	4/5/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4400 DUCKHORN DR	STE 100	SACRAMENTO	CA	95834	2589	00	06000	38.65086	-121.531833	Sacramento County
310051	Non-Physician Medical Practitioner	None	1427436492	0	0	WU, MEGAN J	3/13/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	770 MAGNOLIA AVE	STE 2A	CORONA	CA	92879	3122	00	06000	33.85936872	-117.5534605	Riverside County
310066	Non-Physician Medical Practitioner	None	1063783066	0	0	WILLIAMS, CAROL L NP	10/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1152 ARBOR VISTA WAY	None	SAN JOSE	CA	95126	0001	00	06000	37.30416946	-121.9180265	Santa Clara County
310078	Non-Physician Medical Practitioner	None	1962950188	0	0	WHALL, ANTHONY T PA	2/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	536 CAMINO MERCADO	STE.306	ARROYO GRANDE	CA	93420	1418	00	06000	35.12986992	-120.6006027	San Luis Obispo County
310090	Non-Physician Medical Practitioner	None	1649534603	0	0	WYMAN, VALERIE A NP	10/15/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25683 CARROLL CT	None	LOMA LINDA	CA	92354	3725	00	06000	34.04072828	-117.2442795	San Bernardino County
310130	Non-Physician Medical Practitioner	None	1629264486	0	0	WIEGAND, NEIL A PA	2/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
310190	Non-Physician Medical Practitioner	None	1578704623	0	0	WELBURN, DANIEL E	2/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5338 B W 119TH PLACE	None	INGLEWOOD	CA	90304	1020	00	06000	33.92544856	-118.3735162	Los Angeles County
310206	Non-Physician Medical Practitioner	None	1104544097	0	0	WILSON, CHAR'TARIAN PA-C	11/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
310208	Non-Physician Medical Practitioner	None	1013451194	0	0	WELLER, VERONIKA J NP	9/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6379 CALLE HERMOSO	None	RANCHO CUCAMONGA	CA	91737	3642	00	06000	34.1385079	-117.5896953	San Bernardino County
310218	Non-Physician Medical Practitioner	None	1336431691	0	0	WILSON, NATALIE D NP	11/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	707 STRAND ST	STE 2	SANTA MONICA	CA	90405	2426	00	06000	34.00930881	-118.4808365	Los Angeles County
310227	Non-Physician Medical Practitioner	None	1487970091	0	0	WRIGHT, MARY COSTELLO	5/18/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 LAWRENCE EXPY # 190	None	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
310265	Non-Physician Medical Practitioner	None	1588156236	0	0	WILLIAMS, JAROD G NP	7/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	869 N CHERRY ST	None	TULARE	CA	93274	2207	00	06000	36.220932	-119.337698	Tulare County
310388	Non-Physician Medical Practitioner	None	1437914538	0	0	WHALEN, BRITTON L	6/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	00	06000	35.356203	-119.0612695	Kern County
310412	Non-Physician Medical Practitioner	None	1770119083	0	0	WHITNEY, JACOB	12/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	33423 N 32ND AVE	None	PHOENIX	AZ	85085	8874	00	06000	33.786909	-112.129047	Maricopa County
310426	Non-Physician Medical Practitioner	None	1811262348	0	0	WELLSPACE HEALTH	12/31/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5 MEDICAL PLAZA DR	SUITE 170	ROSEVILLE	CA	95661	2865	00	06000	38.76604411	-121.2466761	Placer County
310459	Non-Physician Medical Practitioner	None	1487742607	0	0	WUSTERBARTH, JESSICA A	7/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 22ND ST	10	HERMOSA BEACH	CA	90254	2523	00	06000	33.8695289	-118.4033169	Los Angeles County
310468	Non-Physician Medical Practitioner	None	1063094449	0	0	WARDERH, CHIEMELE	8/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
310568	Non-Physician Medical Practitioner	None	1528533825	0	0	WALSH, RYAN M PA-C	11/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	00	06000	37.63347961	-122.0897735	Alameda County
310601	Non-Physician Medical Practitioner	None	1114993730	0	0	WOODWARD, JOANN M NP	4/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2001 EASTWOOD DRIVE	None	VACAVILLE	CA	95687	6173	00	06000	38.3398625	-121.9710313	Solano County
310631	Non-Physician Medical Practitioner	None	1396261046	0	0	WU, ERIC	10/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 GARDEN ST	STE 324	W SACRAMENTO	CA	95691	2869	00	06000	38.57582964	-121.517146	Yolo County
310645	Non-Physician Medical Practitioner	None	1407532377	0	0	WRIGHT, ALEXIS M PA	10/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
310715	Non-Physician Medical Practitioner	None	1508590142	0	0	WILSON, UNIKKA NP	11/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	00	06000	33.90290859	-117.4941562	Riverside County
310723	Non-Physician Medical Practitioner	None	1720521750	0	0	WILSON, CAROLINE CNM	5/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
310731	Non-Physician Medical Practitioner	None	1578055182	0	0	WINTHROP, DEANNA M NP	8/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15632 CARAVELLE AVE	None	FONTANA	CA	92336	4139	00	06000	34.1329815	-117.4636665	San Bernardino County
310743	Non-Physician Medical Practitioner	None	1386893089	0	0	WALSH, JOHN T	4/22/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	700 W EL NORTE PKWY	SUITE 201	ESCONDIDO	CA	92026	3923	00	06000	33.14611822	-117.1023285	San Diego County
310748	Non-Physician Medical Practitioner	None	1912202946	0	0	WESTHEIMER, GABRIEL	5/5/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	0000	00	06000	37.75548534	-122.4065362	San Francisco County
310764	Non-Physician Medical Practitioner	None	1275881633	0	0	WILLIAMS, MELISSA C NP	9/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2117 N TULARE CT	None	UPLAND	CA	91784	1425	00	06000	34.14031577	-117.6579582	San Bernardino County
310796	Non-Physician Medical Practitioner	None	1538140413	0	0	WILLIAM, MILLER D	4/23/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
310807	Non-Physician Medical Practitioner	None	1598068074	0	0	WAY, NAZARETH H	6/25/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1701 E CESAR E CHAVEZ AV	STE. 402	LOS ANGELES	CA	90033	2464	00	06000	34.05112725	-118.2173921	Los Angeles County
310856	Non-Physician Medical Practitioner	None	1891939138	0	0	WALKER, JULIET M PA	4/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
310875	Non-Physician Medical Practitioner	None	1265190128	0	0	WATANABE, LAUREN E PA	3/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 4TH ST	None	MARYSVILLE	CA	95901	5656	00	06000	39.13872267	-121.5944372	Yuba County
310913	Non-Physician Medical Practitioner	None	1154040665	0	0	WILSON, HAYLEE N NP	8/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
310914	Non-Physician Medical Practitioner	None	1730703877	0	0	WALSH, MCKENZIE L PA-C	1/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29100 PORTOLA PKWY	SUITE B	LAKE FOREST	CA	92630	8712	00	06000	33.66214655	-117.6532809	Orange County
310916	Non-Physician Medical Practitioner	None	1457544983	0	0	WAGNER, SUSAN KATALI	2/26/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6926 BROCKTON AVE	STE 9	RIVERSIDE	CA	92506	3800	00	06000	33.947919	-117.3967225	Riverside County
310948	Non-Physician Medical Practitioner	None	1770128373	0	0	WEST, LAURA E NP	1/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
311000	Non-Physician Medical Practitioner	None	1740909514	0	0	WASHINGTON, SHAWNTRES NP	12/5/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 NTUSTIN AVE	None	SANTA ANA	CA	92705	7817	00	06000	33.76245307	-117.8350708	Orange County
311004	Non-Physician Medical Practitioner	None	1043919962	0	0	WONG, SARA PA-C	5/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	00	06000	33.969141	-118.0489095	Los Angeles County
311035	Non-Physician Medical Practitioner	None	1760148639	0	0	WILLIAMS, ALYSIA G NP	6/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
311051	Non-Physician Medical Practitioner	None	1982115275	0	0	WICKWIRE, ANDREW N	1/18/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	33 SHEPARD STREET	APT 5	NASHVILLE	TN	37210	3438	00	06000	36.14419506	-86.76043689	Davidson County
311052	Non-Physician Medical Practitioner	None	1336227321	0	0	WILLIAMS, ANA T CNM	7/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2020 SUTTER PL	None	DAVIS	CA	95616	6201	00	06000	38.56287659	-121.7715536	Yolo County
311073	Non-Physician Medical Practitioner	None	1144099078	0	0	WASSINK, ANDREA J NP	3/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
311120	Non-Physician Medical Practitioner	None	1215618871	0	0	WALKER, RILEY NP	10/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	250 E CHASE AVE	STE 108	EL CAJON	CA	92020	6305	00	06000	32.78042748	-116.9591715	San Diego County
311130	Non-Physician Medical Practitioner	None	1336516632	0	0	WETHERBE, JESSIE RN PNP	5/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4560 ADMIRALTY WAY	SUITE 105	MARINA DEL REY	CA	90292	5423	00	06000	33.98364904	-118.4449069	Los Angeles County
311154	Non-Physician Medical Practitioner	None	1225184286	0	0	WALTER, DEBORAH LYNN	11/9/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3030 CHILDRENS WAY	SUITE 201	SAN DIEGO	CA	92123	4232	00	06000	32.798889	-117.150826	San Diego County
311172	Non-Physician Medical Practitioner	None	1457694226	0	0	WICKS, QUIANA PA-C	12/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
311203	Non-Physician Medical Practitioner	None	1477649119	0	0	WATTS HEALTHCARE CORPORATION	2/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10300 COMPTON AVENUE	None	LOS ANGELES	CA	90002	0000	00	06000	33.94274917	-118.2461916	Los Angeles County
311212	Non-Physician Medical Practitioner	None	1962836833	0	0	WOODS, JANICE X NP	4/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14146 GLADESIDE DR	None	LA MIRANDA	CA	90638	2871	00	06000	33.9079176	-118.0305184	Los Angeles County
311218	Non-Physician Medical Practitioner	None	1033619259	0	0	WRIGHT, TESS E NP	12/22/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	06000	33.478749	-112.0426515	Maricopa County
311231	Non-Physician Medical Practitioner	None	1417370685	0	0	WILHELM, SAMANTHA PA	5/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4560 ADMIRALTY WAY	SUITE 105	MARINA DEL REY	CA	90292	5423	00	06000	33.98364904	-118.4449069	Los Angeles County
311236	Non-Physician Medical Practitioner	None	1578034633	0	0	WILSON, ERIN E PA	12/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	00	06000	37.43920432	-122.162109	Santa Clara County
311244	Non-Physician Medical Practitioner	None	1811120850	0	0	WU, XIULI	11/25/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4335 LOMBARDIA WAY	None	EL DORADO HILLS	CA	95762	5446	00	06000	38.67297432	-121.0431497	El Dorado County
311251	Non-Physician Medical Practitioner	None	1487308821	0	0	WALOEWANDJA, NINA I NP	2/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
311258	Non-Physician Medical Practitioner	None	1669567475	0	0	WEIRSHAUSER, CATHERINE L PA-C	7/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
311289	Non-Physician Medical Practitioner	None	1902129521	0	0	WETHERHOLT, NICOLE AMY	11/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	00	06000	34.13189479	-116.2767026	San Bernardino County
311300	Non-Physician Medical Practitioner	None	1861809501	0	0	WEST COUNTY HEALTH CENTERS, INC.	2/18/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	652 PETALUMA AVE	None	SEBASTOPOL	CA	95472	4256	00	06000	38.39662494	-122.8201368	Sonoma County
311302	Non-Physician Medical Practitioner	None	1164166724	0	0	WOODLAND, DOMINIQUE M PA-C	5/4/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
311316	Non-Physician Medical Practitioner	None	1093404048	0	0	WILLIAMS, JASMINE NP	3/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3630 IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	00	06000	33.93112671	-118.2035532	Los Angeles County
311373	Non-Physician Medical Practitioner	None	1467422071	0	0	WASHOWICH, CAMILLE A NP	8/26/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	685 SKYWARD RD	None	APTOS	CA	95003	3014	00	06000	36.98579491	-121.8878345	Santa Cruz County
311435	Non-Physician Medical Practitioner	None	1841207560	0	0	WHERRY, CARL WATT	2/24/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 MEDICAL PLZ	SUITE B200	LOS ANGELES	CA	90095	0001	00	06000	34.06473399	-118.445865	Los Angeles County
311469	Non-Physician Medical Practitioner	None	1396762076	0	0	WRAY, AMY G	1/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	440 GLORIETTA BLVD	None	CORONADO	CA	92118	2912	00	06000	32.69084188	-117.1694706	San Diego County
311477	Non-Physician Medical Practitioner	None	1750813622	0	0	WERSAN, REBECCA H PA	11/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	170 COLUMBUS AVE	SUITE 110	SAN FRANCISCO	CA	94133	5160	00	06000	37.79680499	-122.4050031	San Francisco County
311486	Non-Physician Medical Practitioner	None	1164512240	0	0	WRIGHT, TIMOTHY J NP	1/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	820 S AKERS ST	STE 120	VISALIA	CA	93277	8306	00	06000	36.323757	-119.3491755	Tulare County
311489	Non-Physician Medical Practitioner	None	1033779707	0	0	WINN, LORETTA R PA-C	8/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	00	06000	38.66314048	-121.794696	Yolo County
311537	Non-Physician Medical Practitioner	None	1366525842	0	0	WATSON, ANNA K PA	1/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1038 E BROKAW ROAD	SUITE 30	SAN JOSE	CA	95131	2309	00	06000	37.3827822	-121.8982439	Santa Clara County
311551	Non-Physician Medical Practitioner	None	1750015855	0	0	WOODRUFF, ALEXANDRA PA	8/29/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5725 S SOTO ST	None	HUNTINGTON PARK	CA	90255	9993	00	06000	33.990444	-118.2193965	Los Angeles County
311573	Non-Physician Medical Practitioner	None	1023463890	0	0	WILSON, CAITLIN J PA-C	2/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
311576	Non-Physician Medical Practitioner	None	1366843831	0	0	WEBBER, ASHLEY M	11/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2613 CURTIS AVE	UNIT D	REDONDO BEACH	CA	90278	2236	00	06000	33.87759051	-118.363167	Los Angeles County
311581	Non-Physician Medical Practitioner	None	1679961429	0	0	WHITMER, HEATHER M PA	7/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8761 SVL BX	None	VICTORVILLE	CA	92395	5130	00	06000	0	0	None
311631	Non-Physician Medical Practitioner	None	1356546824	0	0	WAX, EVA M CNM	7/14/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1131 KING STREET	None	SANTA CRUZ	CA	95060	2459	00	06000	36.96871316	-122.0424936	Santa Cruz County
311683	Non-Physician Medical Practitioner	None	1689822181	0	0	WASHINGTON, MICHELLE RENEE	12/16/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15611 POMERADO RD	None	POWAY	CA	92064	2437	00	06000	32.99706	-117.05544	San Diego County
311738	Non-Physician Medical Practitioner	None	1598417099	0	0	WEKHOMBA, PATRICIA L NP	7/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6316 HOLMES AVE	None	LOS ANGELES	CA	90001	1824	00	06000	33.982263	-118.2411845	Los Angeles County
311748	Non-Physician Medical Practitioner	None	1851100184	0	0	WANG, MARY NP	2/26/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1530 E CHEVY CHASE DR	STE 202	GLENDALE	CA	91206	4139	00	06000	34.150689	-118.2303855	Los Angeles County
311762	Non-Physician Medical Practitioner	None	1194037481	0	0	WONG, ANNA NP	1/30/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	945 N HILL ST	None	LOS ANGELES	CA	90012	1714	00	06000	34.06570599	-118.2381125	Los Angeles County
311784	Non-Physician Medical Practitioner	None	1679895965	0	0	WHEELER, RACHEL	3/3/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2356 SUTTER ST	4TH FLOOR	SAN FRANCISCO	CA	94115	3006	00	06000	37.78536083	-122.4392192	San Francisco County
311791	Non-Physician Medical Practitioner	None	1326427469	0	0	WATERS, KAAREN K NP	8/5/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1653 HAZBETH LANE	None	GLENDALE	CA	91202	1343	00	06000	34.17057013	-118.2538458	Los Angeles County
311793	Non-Physician Medical Practitioner	None	1710769252	0	0	WU, JULIA PA-C	8/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	328 S. FIRST ST	F	ALHAMBRA	CA	91801	3790	00	06000	34.09104553	-118.1252904	Los Angeles County
311818	Non-Physician Medical Practitioner	None	1922179084	0	0	WONG, SIEW LIN	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	00	06000	36.84133078	-119.7824983	Fresno County
311826	Non-Physician Medical Practitioner	None	1093197923	0	0	WASTAK, ALLISON L NP	9/13/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1910 OUTLET CENTER DR	None	OXNARD	CA	93036	0677	00	06000	34.2202663	-119.1484221	Ventura County
311833	Non-Physician Medical Practitioner	None	1952485336	0	0	WAYNE, HEATHER J	7/26/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	06000	39.742182	-104.8408515	Adams County
311839	Non-Physician Medical Practitioner	None	1942529516	0	0	WATSON, KELLY A NP	12/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
311894	Non-Physician Medical Practitioner	None	1801564620	0	0	WARNSHUIS, DEVIN NP	3/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1845 CHICAGO AVE	B	RIVERSIDE	CA	92507	2366	00	06000	33.994269	-117.3485375	Riverside County
311935	Non-Physician Medical Practitioner	None	1376789412	0	0	WONG, CONNIE S	11/12/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3801 SACRAMENTO ST	2ND FLOOR	SAN FRANCISCO	CA	94118	1625	00	06000	37.78707021	-122.4555217	San Francisco County
311944	Non-Physician Medical Practitioner	None	1124664636	0	0	WRIGHT, LIONEL J PA	4/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
311957	Non-Physician Medical Practitioner	None	1134210768	0	0	WILEY, SCOTT THOMAS	11/20/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	06000	32.683167	-114.633459	Yuma County
311959	Non-Physician Medical Practitioner	None	1922307842	0	0	WILCOX, JESSICA SARAH	11/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	901 CAMPUS DR	SUITE 111	DALY CITY	CA	94015	4900	00	06000	37.66535778	-122.4763793	San Mateo County
311978	Non-Physician Medical Practitioner	None	1326236340	0	0	WYSOCKI, SHERI J NP	12/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39800 BOB HOPE DR	# C	RANCHO MIRAGE	CA	92270	3920	00	06000	33.759432	-116.408062	Riverside County
311986	Non-Physician Medical Practitioner	None	1245442904	0	0	WEST COUNTY MEDICAL CORP-NON PROFIT	1/26/1998	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 E MARKET ST	None	LONG BEACH	CA	90805	5924	00	06000	33.85427352	-118.193571	Los Angeles County
312008	Non-Physician Medical Practitioner	None	1750801874	0	0	WHITBEY, MISTY D NP	6/9/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1215 34TH ST	None	BAKERSFIELD	CA	93301	2107	00	06000	35.39050249	-119.015775	Kern County
312023	Non-Physician Medical Practitioner	None	1336525609	0	0	WONG, MICHELLE A	12/30/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3823 SILKWOOD PL	None	EL DORADO HILLS	CA	95762	7830	00	06000	38.69431528	-121.0768221	El Dorado County
312054	Non-Physician Medical Practitioner	None	1609810464	0	0	WEITZEL, DAVID F	11/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14839 JANINE DR	None	WHITTIER	CA	90605	1705	00	06000	33.95215542	-118.0092562	Los Angeles County
312062	Non-Physician Medical Practitioner	None	1801128756	0	0	WATSON, CHARLENE DAMATO	6/22/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
312073	Non-Physician Medical Practitioner	None	1699083675	0	0	WALTERS, MARIAM S PA-C	11/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1217	00	06000	34.131303	-117.3225325	San Bernardino County
312105	Non-Physician Medical Practitioner	None	1700823580	0	0	WILSON, PATRICIA A	8/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	38464 GARWAY DR	None	FREMONT	CA	94536	5921	00	06000	37.55030249	-121.9959151	Alameda County
312168	Non-Physician Medical Practitioner	None	1003167164	0	0	WEST, JUSTIN A	2/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15407 VIA BASSANO DR	None	BAKERSFIELD	CA	93306	9409	00	06000	35.40022816	-118.833276	Kern County
312195	Non-Physician Medical Practitioner	None	1982347522	0	0	WILSON, ANDREW PA	9/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3434 VILLA LANE	STE 150	NAPA	CA	94558	6405	00	06000	38.32515937	-122.2938358	Napa County
312259	Non-Physician Medical Practitioner	None	1114001567	0	0	WURZBURG, HEIDI	4/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 BICENTENNIAL WAY	SUITE 110	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
312285	Non-Physician Medical Practitioner	None	1255623542	0	0	WONG, KAM CHAK	9/12/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	260 E HOLT AVE	None	POMONA	CA	91767	5426	00	06000	34.06245101	-117.746655	Los Angeles County
312304	Non-Physician Medical Practitioner	None	1699929141	0	0	WATTENBARGER, REBECCA J	8/11/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	960 55TH STREET	None	SACRAMENTO	CA	95819	3318	00	06000	38.565396	-121.435884	Sacramento County
312324	Non-Physician Medical Practitioner	None	1083778484	0	0	WALSH, LAURIE FRIDAY	11/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	00	06000	38.602089	-121.3925895	Sacramento County
312341	Non-Physician Medical Practitioner	None	1528421146	0	0	WONG, DELENIE NP	4/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	234 2ND AVENUE	APT 1	SAN FRANCISCO	CA	94118	2412	00	06000	37.78431767	-122.4602132	San Francisco County
312364	Non-Physician Medical Practitioner	None	1194885467	0	0	WILKINS, CHRISTOPHER S	11/25/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	103 GREENWICH CT	None	SAN RAMON	CA	94582	2800	00	06000	37.75449591	-121.9376326	Contra Costa County
312377	Non-Physician Medical Practitioner	None	1093957847	0	0	WITHEE, VANESSA	3/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4126 W GALAXY AVE	None	FRESNO	CA	93722	6004	00	06000	36.81716068	-119.8654198	Fresno County
312381	Non-Physician Medical Practitioner	None	1164501649	0	0	WISWALL, CLAIRE E PA-C	4/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
312407	Non-Physician Medical Practitioner	None	1790122331	0	0	WILLMER, ANNA K	9/4/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3033 RUSSELL ST	None	SAN DIEGO	CA	92106	1934	00	06000	32.73245674	-117.2232702	San Diego County
312425	Non-Physician Medical Practitioner	None	1154941011	0	0	WERMUND, KYLIE PA-C	10/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
312426	Non-Physician Medical Practitioner	None	1912937095	0	0	WINCHELL, STACY	3/19/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43348 47TH ST W	None	LANCASTER	CA	93536	5514	00	06000	34.67068071	-118.214553	Los Angeles County
312433	Non-Physician Medical Practitioner	None	1821530163	0	0	WEST, MICHELLE K NP	3/17/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5353 G STREET	None	CHINO	CA	91710	5249	00	06000	34.00987149	-117.6880905	San Bernardino County
312453	Non-Physician Medical Practitioner	None	1720191885	0	0	WHEELER, ANISE T NP	4/14/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1235 W VINE ST # 20	None	LODI	CA	95240	5109	00	06000	38.12279179	-121.2879362	San Joaquin County
312484	Non-Physician Medical Practitioner	None	1336928720	0	0	WONG, WING KWAN NP	2/28/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14117 LIMONITE AVE	310	EASTVALE	CA	92880	3864	00	06000	33.97532151	-117.5914845	Riverside County
312495	Non-Physician Medical Practitioner	None	1740769157	0	0	WAILES, JULIE NP	12/20/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6926 BROCKTON AVE	SUITE 6	RIVERSIDE	CA	92506	3804	00	06000	33.947919	-117.3967225	Riverside County
312498	Non-Physician Medical Practitioner	None	1346535507	0	0	WONG, KATE DIEP	7/19/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39141 CIVIC CENTER DR	SUITE 335	FREMONT	CA	94538	5818	00	06000	37.55436307	-121.9764708	Alameda County
312501	Non-Physician Medical Practitioner	None	1518051077	0	0	WILL, SCOTT J NP	6/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 CORPORATE POINTE	STE 465	CULVER CITY	CA	90230	8706	00	06000	33.98867148	-118.3837334	Los Angeles County
312517	Non-Physician Medical Practitioner	None	1649603036	0	0	WAGONER, ERIC M	5/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	250 N COLLEGE PARK DR	UNIT 23	UPLAND	CA	91786	8883	00	06000	34.09679282	-117.7004502	San Bernardino County
312531	Non-Physician Medical Practitioner	None	1477787604	0	0	WHITE, JENNIFER A	1/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3852 JEWELL ST	APT P302	SAN DIEGO	CA	92109	6417	00	06000	32.79015295	-117.2359896	San Diego County
312551	Non-Physician Medical Practitioner	None	1942607239	0	0	WITEK, BERNARDETTA NP	6/5/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
312649	Non-Physician Medical Practitioner	None	1962225789	0	0	WINEGARNER, NICOLE NP	1/21/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5196 HILL RD E	STE 201	LAKEPORT	CA	95453	6362	00	06000	39.10527946	-122.9080599	Lake County
312662	Non-Physician Medical Practitioner	None	1215238100	0	0	WARREN, MAUREEN GERARD	2/5/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 W FERN AVE	None	REDLANDS	CA	92373	5916	00	06000	34.05016907	-117.1793443	San Bernardino County
312665	Non-Physician Medical Practitioner	None	1164854816	0	0	WILSON, RYAN P PA-C	1/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
312690	Non-Physician Medical Practitioner	None	1255692455	0	0	WESTSIDE INFANT-FAMILY NETWORK	12/5/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5721 W SLAUSON AVE	SUITE 200	CULVER CITY	CA	90230	6554	00	06000	33.98898953	-118.3818077	Los Angeles County
312731	Non-Physician Medical Practitioner	None	1962865519	0	0	WOLAK, JACQUELINE J NP	5/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7910 FROST ST	None	SAN DIEGO	CA	92123	2771	00	06000	32.80027449	-117.153846	San Diego County
312736	Non-Physician Medical Practitioner	None	1275591356	0	0	WETTER, CHARLES F	12/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1175 DUNSUMIR CIRCLE	None	CORONA	CA	92881	8781	00	06000	33.83071646	-117.557027	Riverside County
312739	Non-Physician Medical Practitioner	None	1710003918	0	0	WILLNER, PAUL M	2/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	00	06000	33.904782	-117.469323	Riverside County
312775	Non-Physician Medical Practitioner	None	1861991564	0	0	WILSON, CHRISTINA A	8/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	00	06000	37.66383747	-122.4671404	San Mateo County
312793	Non-Physician Medical Practitioner	None	1528226891	0	0	WOLF, ALISON K	4/2/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5696 MARNE AVE	None	SAN DIEGO	CA	92120	4707	00	06000	32.78244994	-117.0614066	San Diego County
312797	Non-Physician Medical Practitioner	None	1669838637	0	0	WALKER, DENNISE NP	12/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1890 W MAIN ST	110	BARSTOW	CA	92311	3725	00	06000	34.89321455	-117.0507578	San Bernardino County
312840	Non-Physician Medical Practitioner	None	1245563816	0	0	WATKINS, GAIL L	7/11/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	175 BARNEY WAY	None	WEST POINT	CA	95255	0000	00	06000	38.38814797	-120.5218127	Calaveras County
312898	Non-Physician Medical Practitioner	None	1306253315	0	0	WALKER, EMILY M NP	5/20/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7593 SYLVAN CREEK COURT	None	CITRUS HEIGHTS	CA	95610	4472	00	06000	38.688993	-121.285935	Sacramento County
312907	Non-Physician Medical Practitioner	None	1942563937	0	0	WEI, REBECCA S	12/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	640 N WASHINGTON AVE	None	GLENDORA	CA	91741	2049	00	06000	34.14604207	-117.8689353	Los Angeles County
312912	Non-Physician Medical Practitioner	None	1902383284	0	0	WANG, LILLIAN C	3/5/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1200 S GRAND AVE	UNIT 569	LOS ANGELES	CA	90015	3955	00	06000	34.03962756	-118.2637684	Los Angeles County
313038	Non-Physician Medical Practitioner	None	1699326108	0	0	WANG, MICHAEL W NP	1/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	00	06000	37.43920432	-122.162109	Santa Clara County
313039	Non-Physician Medical Practitioner	None	1467896753	0	0	WILSON, MARY JANE NP	2/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	440 W FOOTHILL BLVD	None	GLENDORA	CA	91741	3361	00	06000	34.13599629	-117.8714999	Los Angeles County
313067	Non-Physician Medical Practitioner	None	1568640217	0	0	WHITE, MEGHAN MARY	4/15/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD.	None	SACRAMENTO	CA	95817	0000	00	06000	38.555181	-121.4566785	Sacramento County
313089	Non-Physician Medical Practitioner	None	1720467509	0	0	WOLF, LIBBY S NP	2/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1046 MASON ST	APT 5	SAN FRANCISCO	CA	94108	1923	00	06000	37.7933494	-122.4110642	San Francisco County
313136	Non-Physician Medical Practitioner	None	1689256190	0	0	WACHTARZ, AMBER NP	11/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2415 HIGH SCHOOL AVE	SUITE 700	CONCORD	CA	94520	1879	00	06000	37.98481374	-122.0347555	Contra Costa County
313213	Non-Physician Medical Practitioner	None	1154857050	0	0	WRIGHT, TIFFANY NP	2/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	10620 SOUTHERN HIGHLAND	# 110-403	LAS VEGAS	NV	89141	4371	00	06000	35.99615301	-115.2074506	Clark County
313242	Non-Physician Medical Practitioner	None	1669897849	0	0	WAJVODA, ZACHARY R	7/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1785 NEWARK CT	None	LINCOLN	CA	95648	3021	00	06000	38.90923539	-121.3218738	Placer County
313312	Non-Physician Medical Practitioner	None	1316208804	0	0	WOODS, ONGDEE L	6/24/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	276 BELHAVEN AVENUE	None	DALY CITY	CA	94015	4209	00	06000	37.67402966	-122.486993	San Mateo County
313349	Non-Physician Medical Practitioner	None	1922768860	0	0	WHITE, KYLE PA	10/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5565 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3020	00	06000	32.77978322	-117.0094766	San Diego County
313367	Non-Physician Medical Practitioner	None	1851667976	0	0	WATSON, RENEE	1/23/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
313390	Non-Physician Medical Practitioner	None	1144574062	0	0	WILLEY, MARTI L NP	5/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	157 VILLAGE GREEN	None	ENCINITAS	CA	92024	3036	00	06000	33.04802304	-117.2480803	San Diego County
313392	Non-Physician Medical Practitioner	None	1871588715	0	0	WYBLE, ANGELA RENE	1/2/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2725 MENDOCINO AVE	None	SANTA ROSA	CA	95403	2805	00	06000	38.46672	-122.720724	Sonoma County
313409	Non-Physician Medical Practitioner	None	1578082525	0	0	WHANN, BRANDON T	8/17/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2352 PINTURO WAY	None	RANCHO CORDOVA	CA	95670	5247	00	06000	38.609568	-121.284666	Sacramento County
313420	Non-Physician Medical Practitioner	None	1699702662	0	0	WORLEY, CHARLES B	7/14/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 HILL STREET	None	SANTA MONICA	CA	90405	5019	00	06000	34.01256153	-118.4625856	Los Angeles County
313444	Non-Physician Medical Practitioner	None	1487041521	0	0	WOLFE, ELIZABETH C NP	11/23/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1271 HOLLYSPRINGS LANE	None	SANTA MARIA	CA	93455	5157	00	06000	34.86290237	-120.4117382	Santa Barbara County
313481	Non-Physician Medical Practitioner	None	1841470507	0	0	WILSON, KEITH ALAN	12/13/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12550 HESPERIA ROAD	SUITE100	VICTORVILLE	CA	92395	0000	00	06000	34.47928534	-117.2909553	San Bernardino County
313521	Non-Physician Medical Practitioner	None	1073799300	0	0	WADE, PAMELA MARIA	12/8/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2125 SANTA FE AVE	None	LONG BEACH	CA	90810	3547	00	06000	33.795585	-118.215548	Los Angeles County
313526	Non-Physician Medical Practitioner	None	1679935589	0	0	WOLFE, JUSTIN	6/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1513 FREMONT BLVD	E1	SEASIDE	CA	93955	4319	00	06000	36.60786927	-121.8463495	Monterey County
313539	Non-Physician Medical Practitioner	None	1548441355	0	0	WOO, KATHY KIM	11/30/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10833 LE CONTE AVE	SUITE 265	LOS ANGELES	CA	90095	0001	00	06000	34.06373445	-118.443537	Los Angeles County
313553	Non-Physician Medical Practitioner	None	1508147661	0	0	WILLIAMSON, MICHELLE D	9/29/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11161 WASHINGTON BLVD	None	WHITTIER	CA	90606	3007	00	06000	33.97207835	-118.0719621	Los Angeles County
313564	Non-Physician Medical Practitioner	None	1942028972	0	0	WOODRUFF, NATALIE J PA-C	2/10/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13925 INDIAN ST	None	MORENO VALLEY	CA	92553	5718	00	06000	33.91832269	-117.2350208	Riverside County
313591	Non-Physician Medical Practitioner	None	1841953585	0	0	WIGLEY, KAYLA M PA-C	7/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	00	06000	37.98252	-121.8030615	Contra Costa County
313618	Non-Physician Medical Practitioner	None	1285741991	0	0	WONDER, PETER C NP	12/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1713 LINNEA LANE	None	MODESTO	CA	95355	1218	00	06000	37.66938501	-120.9346168	Stanislaus County
313632	Non-Physician Medical Practitioner	None	1346773819	0	0	WANG, TZU-YI	7/29/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	600 COFFEE RD	None	MODESTO	CA	95355	4201	00	06000	37.653219	-120.975542	Stanislaus County
313664	Non-Physician Medical Practitioner	None	1902014111	0	0	WILSON, KARLA D NP	9/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	516 W PALM AVE	None	MONROVIA	CA	91016	2633	00	06000	34.14900942	-118.010562	Los Angeles County
313677	Non-Physician Medical Practitioner	None	1841557055	0	0	WELLS, JOY L	5/7/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3369 JOSEPHINE ST	None	LYNWOOD	CA	90262	4202	00	06000	33.92138109	-118.2107033	Los Angeles County
313700	Non-Physician Medical Practitioner	None	1134541287	0	0	WILLIAMS, KANEESHA J NP	4/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4003 1/2 LEEWARD AVE	None	LOS ANGELES	CA	90005	3542	00	06000	34.05899904	-118.3146717	Los Angeles County
313707	Non-Physician Medical Practitioner	None	1275288037	0	0	WALIA, MONIKA	6/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3755 BEACON AVE	None	FREMONT	CA	94538	1411	00	06000	37.54813209	-121.9825183	Alameda County
313725	Non-Physician Medical Practitioner	None	1467792051	0	0	WARREN, JANET A NP	11/5/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19341 BEAR VALLEY RD	STE 105	APPLE VALLEY	CA	92308	5152	00	06000	34.47101125	-117.2412548	San Bernardino County
313763	Non-Physician Medical Practitioner	None	1720492143	0	0	WONG, ELIZABETH S M	12/11/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8045 EMERSON PL	None	ROSEMEAD	CA	91770	2455	00	06000	34.06628382	-118.093484	Los Angeles County
313814	Non-Physician Medical Practitioner	None	1881161701	0	0	WIX, JESSICA PA	7/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	888 LAKESIDE VILLAGE COM	None	CHICO	CA	95926	2281	00	06000	39.750084	-121.7934327	Butte County
313832	Non-Physician Medical Practitioner	None	1235318601	0	0	WHITE, ROSSLYN A	12/29/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	150 W 1ST ST	SUITE 270	CLAREMONT	CA	91711	4750	00	06000	34.09447348	-117.7161026	Los Angeles County
313855	Non-Physician Medical Practitioner	None	1851427397	0	0	WILLIAMS, IMANI	8/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12021 WILMINGTON AVE	None	LOS ANGELES	CA	90059	3019	00	06000	33.922863	-118.2431655	Los Angeles County
313882	Non-Physician Medical Practitioner	None	1720605702	0	0	WATKINS, JALEESA C PA	9/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	00	06000	34.12811155	-118.2577764	Los Angeles County
313948	Non-Physician Medical Practitioner	None	1649677402	0	0	WINANS, SARI J NP	4/15/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	260 CALLE DEL SOL	None	NIPOMO	CA	93444	8845	00	06000	35.01128518	-120.5097	San Luis Obispo County
313964	Non-Physician Medical Practitioner	None	1679957740	0	0	WONG, KIMBERLY A NP	1/15/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26 RANCHO DEL MAR	None	APTOS	CA	95003	3973	00	06000	36.97832273	-121.9080422	Santa Cruz County
314062	Non-Physician Medical Practitioner	None	1245481514	0	0	WILEY, JAMES ROBERT	11/6/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 W FERN AVE	None	REDLANDS	CA	92373	5916	00	06000	34.05016907	-117.1793443	San Bernardino County
314142	Non-Physician Medical Practitioner	None	1811400708	0	0	WRIGHT, KIMBERLY D NP	8/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	00	06000	32.99706	-117.05544	San Diego County
314157	Non-Physician Medical Practitioner	None	1679069165	0	0	WIKKELING, HANNAH PA	4/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23931375	-121.8014189	Santa Clara County
314161	Non-Physician Medical Practitioner	None	1073917464	0	0	WENDEL, MARA A NP	9/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16404 SUNSTONE DRIVE	None	SAN DIEGO	CA	92127	4405	00	06000	33.0108883	-117.1123194	San Diego County
314162	Non-Physician Medical Practitioner	None	1366128027	0	0	WALSH, COURTNEY J PA-C	10/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
314211	Non-Physician Medical Practitioner	None	1811082696	0	0	WAINSCOAT, TONIA LYNN	9/14/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	751 S BASCOM AVE	OB/GYN DEPT	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
314213	Non-Physician Medical Practitioner	None	1144369943	0	0	WIEMANN, PATRICIA	10/17/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W 30TH ST	#1100	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
314231	Non-Physician Medical Practitioner	None	1346523438	0	0	WRIGHT, CORI R	9/6/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2403 CASTILLO ST	SUITE 203	SANTA BARBARA	CA	93105	5316	00	06000	34.43053648	-119.7243139	Santa Barbara County
314250	Non-Physician Medical Practitioner	None	1790830404	0	0	WHEALON, CANDICE E NP	2/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4728 FACULTY AVENUE	None	LONG BEACH	CA	90808	1011	00	06000	33.84389792	-118.1371358	Los Angeles County
314273	Non-Physician Medical Practitioner	None	1932813425	0	0	WATTERS, RACHEL M PA-C	6/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2375 S MELROSE DR	None	VISTA	CA	92081	8788	00	06000	33.14409946	-117.2417711	San Diego County
314274	Non-Physician Medical Practitioner	None	1639550965	0	0	WOODS, ALEISHA J CNM	5/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
314290	Non-Physician Medical Practitioner	None	1093590010	0	0	WALKER, ANGELA NP	1/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4821 PANAMA LN	STE A-C	BAKERSFIELD	CA	93313	3480	00	06000	35.29587848	-119.056005	Kern County
314297	Non-Physician Medical Practitioner	None	1578833166	0	0	WASHINGTON, MICHELLE E NP	11/12/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	897 N RED ROBIN STREET	None	ORANGE	CA	92869	1955	00	06000	33.802236	-117.801964	Orange County
314321	Non-Physician Medical Practitioner	None	1265503510	0	0	WACHA, LEIGH A NP	12/12/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2841 LADOGA AVENUE	None	LONG BEACH	CA	90815	1529	00	06000	33.80806758	-118.1036244	Los Angeles County
314327	Non-Physician Medical Practitioner	None	1558951236	0	0	WISNER, TAYLOR L NP	6/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25170 HANCOCK AVE	SUITE 200	MURRIETA	CA	92562	5969	00	06000	33.565149	-117.1823815	Riverside County
314334	Non-Physician Medical Practitioner	None	1396438537	0	0	WENG, TIMOTHY S PA-C	9/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	00	06000	37.37715796	-122.0651926	Santa Clara County
314363	Non-Physician Medical Practitioner	None	1538539861	0	0	WATSON, JAMES D	11/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1005 E COLTON AVE	None	REDLANDS	CA	92374	3638	00	06000	34.06284853	-117.169083	San Bernardino County
314376	Non-Physician Medical Practitioner	None	1447677141	0	0	WALKER, ERIN PA	7/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5201 NORRIS CANYON ROAD	SUITE 220	SAN RAMON	CA	94583	5405	00	06000	37.77779028	-121.9600626	Contra Costa County
314477	Non-Physician Medical Practitioner	None	1457503526	0	0	WASHINGTON, JASON D PA-C	6/2/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3201 S STREET	APT 366	SACRAMENTO	CA	95816	7088	00	06000	38.562948	-121.467726	Sacramento County
314482	Non-Physician Medical Practitioner	None	1285314120	0	0	WHITAKER, ASHLEY PA-C	12/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	00	06000	33.89552551	-117.186021	Riverside County
314496	Non-Physician Medical Practitioner	None	1477897684	0	0	WONG, DOUGLAS E	2/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1492 CHALGROVE DR	None	CORONA	CA	92882	4729	00	06000	33.86645405	-117.5989316	Riverside County
314513	Non-Physician Medical Practitioner	None	1760920391	0	0	WARYAM, ASHEE A	2/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11569 LAUREL AVE	None	LOMA LINDA	CA	92354	6717	00	06000	34.04302245	-117.2254347	San Bernardino County
314528	Non-Physician Medical Practitioner	None	1871227660	0	0	WHITE, ANNE M PA-C	10/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
314534	Non-Physician Medical Practitioner	None	1073260436	0	0	WALTON, JULIANA PA-C	7/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4001 J STREET	None	SACRAMENTO	CA	95819	3626	00	06000	38.570526	-121.4521695	Sacramento County
314558	Non-Physician Medical Practitioner	None	1255029377	0	0	WEST, ZACHARY M PA-C	6/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
314573	Non-Physician Medical Practitioner	None	1972507416	0	0	WEYLAND, PATRICIA G NP	1/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	00	06000	36.98191238	-121.9975767	Santa Cruz County
314589	Non-Physician Medical Practitioner	None	1154639623	0	0	WASHINGTON, ANJALI H	8/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	351 BRIGHTON AVENUE	APT 532	SAN FRANCISCO	CA	94112	2377	00	06000	37.72371324	-122.4551126	San Francisco County
314605	Non-Physician Medical Practitioner	None	1538972328	0	0	WEED, ROSE MARY PA	4/18/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23931375	-121.8014189	Santa Clara County
314612	Non-Physician Medical Practitioner	None	1518977883	0	0	WU, FREDERICK	9/26/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 N NOYES ST	None	VISALIA	CA	93291	9116	00	06000	36.345321	-119.344599	Tulare County
314620	Non-Physician Medical Practitioner	None	1164073276	0	0	WALSH, NATHANIEL PA	10/24/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
314663	Non-Physician Medical Practitioner	None	1356877328	0	0	WILLIS, EDIE E PA-C	3/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
314682	Non-Physician Medical Practitioner	None	1578912937	0	0	WORMLEY, JOSHUA S NP	7/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5412 DEEPDALE WAY	None	ELK GROVE	CA	95758	6835	00	06000	38.437569	-121.441176	Sacramento County
314683	Non-Physician Medical Practitioner	None	1245650134	0	0	WHEELER, KIMBERLY A NP	5/21/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	888 LAKESIDE VILLAGE COM	None	CHICO	CA	95926	2281	00	06000	39.750084	-121.7934327	Butte County
314711	Non-Physician Medical Practitioner	None	1518291640	0	0	WURZ, JENNIFER M	1/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13855 E 14TH ST	SAN LEANDRO HOSPITAL ED	SAN LEANDRO	CA	94578	2611	00	06000	37.712385	-122.143428	Alameda County
314721	Non-Physician Medical Practitioner	None	1245875780	0	0	WANG, HELEN NP	8/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	00	06000	34.13489987	-118.0424069	Los Angeles County
314769	Non-Physician Medical Practitioner	None	1245857259	0	0	WITT, KENDRA R PA	11/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1330 N INDIAN CANYON DR	STE F	PALM SPRINGS	CA	92262	4880	00	06000	33.84144	-116.5455715	Riverside County
314772	Non-Physician Medical Practitioner	None	1801901574	0	0	WEIN, DARYL A	12/14/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3720 WINDWOOD PLACE	None	MODESTO	CA	95355	3621	00	06000	37.6613365	-120.9264501	Stanislaus County
314781	Non-Physician Medical Practitioner	None	1144560616	0	0	WATSON, SCOTT BRANDON	6/21/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2690 PACIFIC AVE STE 290	UNITED STATES OF AMERICA	LONG BEACH	CA	90806	2631	00	06000	33.805854	-118.1936805	Los Angeles County
314807	Non-Physician Medical Practitioner	None	1699838615	0	0	WASEM, SCOTT C	3/11/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6116 W LARK	None	VISALIA	CA	93291	8762	00	06000	36.356247	-119.3597055	Tulare County
314809	Non-Physician Medical Practitioner	None	1356869184	0	0	WONG, LESLEY NP	6/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4113 VERCELLI COURT	None	YORBA LINDA	CA	92886	8657	00	06000	33.90082045	-117.7880635	Orange County
314847	Non-Physician Medical Practitioner	None	1831173111	0	0	WILLIAMSON, MATTHEW A	5/15/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19828 SIX POINT CT	None	TWAIN HARTE	CA	95383	9000	00	06000	38.04398619	-120.2045652	Tuolumne County
314894	Non-Physician Medical Practitioner	None	1679679682	0	0	WESTERN, JOHN R	2/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9739 W CANYON TER	UNIT 2	SAN DIEGO	CA	92123	4670	00	06000	32.80327394	-117.1186735	San Diego County
314907	Non-Physician Medical Practitioner	None	1306324645	0	0	WEST, ERIN C NP	1/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
314928	Non-Physician Medical Practitioner	None	1871960708	0	0	WONG, CASSANDRA N NP	8/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	583 RADCLIFFE AVE	None	PACAFIC PALISADES	CA	90066	7142	00	06000	34.04056728	-118.5307146	Los Angeles County
315044	Non-Physician Medical Practitioner	None	1467180315	0	0	WALL, ERICA Z PA-C	1/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	00	06000	34.27771547	-119.2540344	Ventura County
315052	Non-Physician Medical Practitioner	None	1528510930	0	0	WAGNER, CHASE C NP	1/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	459 AMPARO DR	None	ESCONDIDO	CA	92025	6657	00	06000	33.09840632	-117.0607499	San Diego County
315060	Non-Physician Medical Practitioner	None	1093401465	0	0	WEST, TANYA NP	1/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	00	06000	34.1010559	-117.6369445	San Bernardino County
315080	Non-Physician Medical Practitioner	None	1548565740	0	0	WILBORN, ASHA J NP	3/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6115 CHRISTINE LN	None	LAKEWOOD	CA	90713	1170	00	06000	33.866163	-118.117938	Los Angeles County
315132	Non-Physician Medical Practitioner	None	1366643256	0	0	WILLIAMS HAWKINS, DARLA G	3/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5613 GARTH AVE	None	LOS ANGELES	CA	90056	1310	00	06000	33.99003875	-118.371839	Los Angeles County
315134	Non-Physician Medical Practitioner	None	1093729824	0	0	WILSON, LYDIA K NP	5/20/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21601 MULHOLLAND DRIVE	None	WOODLAND	CA	91364	5347	00	06000	34.14778226	-118.601068	Los Angeles County
315139	Non-Physician Medical Practitioner	None	1477360303	0	0	WANG, JINCHUN NP	3/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	201 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6385	00	06000	37.36812305	-122.0312314	Santa Clara County
315164	Non-Physician Medical Practitioner	None	1710920640	0	0	WEE, TRACEY	3/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
315237	Non-Physician Medical Practitioner	None	1225367345	0	0	WELLMAN, JEREMY MASON	1/12/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	00	06000	40.57278686	-122.3958519	Shasta County
315322	Non-Physician Medical Practitioner	None	1861911570	0	0	WHITBORD, MATTHEW T	2/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3281 MORITZ DR	None	HUNTINGTON BEACH	CA	92649	1875	00	06000	33.7242402	-118.0727251	Orange County
315467	Non-Physician Medical Practitioner	None	1518673177	0	0	WANG, GINA PA-C	8/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	925 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4442	00	06000	34.08499473	-118.1230937	Los Angeles County
315481	Non-Physician Medical Practitioner	None	1588311393	0	0	WAHIDI, WAHEED NP	1/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	325 GELLERT BLVD	None	DALY CITY	CA	94015	2613	00	06000	37.66753085	-122.4686194	San Mateo County
315494	Non-Physician Medical Practitioner	None	1477156982	0	0	WOLF, ANITA M NP	9/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	00	06000	33.934059	-117.2789475	Riverside County
315521	Non-Physician Medical Practitioner	None	1659070076	0	0	WEBB, GARRETT D PA-C	6/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	00	06000	36.696987	-121.633164	Monterey County
315532	Non-Physician Medical Practitioner	None	1972175354	0	0	WILEY, JUVY F NP	7/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25775 MCBEAN PKWY	202, 215	VALENCIA	CA	91355	3702	00	06000	34.40042013	-118.5511416	Los Angeles County
315552	Non-Physician Medical Practitioner	None	1447939707	0	0	WILKERSON, ENZA NP	2/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 WEST CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	00	06000	34.133598	-118.1534895	Los Angeles County
315640	Non-Physician Medical Practitioner	None	1376734053	0	0	WITSCHGER, TAMMY	8/25/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1555 SOQUEL DR	EMERGENCY DEPARTMENT	SANTA CRUZ	CA	95065	1705	00	06000	36.98863619	-121.9830754	Santa Cruz County
315661	Non-Physician Medical Practitioner	None	1982225819	0	0	WIERCINSKI, EMILY PA-C	4/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
315702	Non-Physician Medical Practitioner	None	1568921187	0	0	WU, HO YAN PA-C	5/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	00	06000	37.66508443	-120.9962589	Stanislaus County
315716	Non-Physician Medical Practitioner	None	1174875793	0	0	WILLIFORD, JASON C	10/28/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1424 WOODSIDE DRIVE	APARTMENT B	SAN LUIS OBISPO	CA	93405	5929	00	06000	35.26543643	-120.6389885	San Luis Obispo County
315742	Non-Physician Medical Practitioner	None	1881926335	0	0	WAINSCOTT, JEANNEE PA	11/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3941 J ST	370	SACRAMENTO	CA	95819	3633	00	06000	38.570652	-121.4535465	Sacramento County
315749	Non-Physician Medical Practitioner	None	1063168094	0	0	WHARRAM, JENNIFER G	8/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 E ROMIE LN	A	SALINAS	CA	93901	4031	00	06000	36.65998191	-121.6461895	Monterey County
315776	Non-Physician Medical Practitioner	None	1902402506	0	0	WATERS, TONYA J NP	9/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	00	06000	33.9760587	-117.3800672	Riverside County
315786	Non-Physician Medical Practitioner	None	1063813475	0	0	WOLFE, AMANDA NP	3/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15525 POMERADO RD	STE B-1	POWAY	CA	92064	2425	00	06000	32.99479918	-117.0579468	San Diego County
315803	Non-Physician Medical Practitioner	None	1194159350	0	0	WATSON, NICOLE	1/2/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	06000	36.180999	-115.3174815	Clark County
315814	Non-Physician Medical Practitioner	None	1437281979	0	0	WILLIAMS, ROSALIND J	4/23/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	445 E ANAHEIM ST STE H	None	WILMINGTON	CA	90744	4600	00	06000	33.78025372	-118.2579305	Los Angeles County
315823	Non-Physician Medical Practitioner	None	1952457467	0	0	WYCKOFF, MARY	1/9/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON AVE	None	SACRAMENTO	CA	95817	0000	00	06000	38.555181	-121.4566785	Sacramento County
315925	Non-Physician Medical Practitioner	None	1700986858	0	0	WATSON, JACK R	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	550A WATER ST	None	SANTA CRUZ	CA	95060	0000	00	06000	36.98016167	-122.0194054	Santa Cruz County
315930	Non-Physician Medical Practitioner	None	1720508864	0	0	WRIGLEY, SARAH	12/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	627 GRANT ST	APT B	SANTA MONICA	CA	90405	1286	00	06000	34.00989033	-118.4832828	Los Angeles County
315937	Non-Physician Medical Practitioner	None	1538596036	0	0	WEBB, STEPHANIE A NP	2/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	00	06000	37.51438187	-122.2607682	San Mateo County
315954	Non-Physician Medical Practitioner	None	1386608438	0	0	WELKER, MAUREEN U NP	10/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8 TAWNY PORT	None	DANA POINT	CA	92629	3235	00	06000	33.49054193	-117.7015771	Orange County
315965	Non-Physician Medical Practitioner	None	1659717197	0	0	WARD, BRITTANY	10/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
316015	Non-Physician Medical Practitioner	None	1992112809	0	0	WALKUSH, ANN M NP	2/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	750 FREMONT ST	None	MENLO PARK	CA	94025	5014	00	06000	37.44577996	-122.1847619	San Mateo County
316032	Non-Physician Medical Practitioner	None	1508943358	0	0	WENDLAND, BARBARA S	8/12/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
316095	Ordering, Referring, Prescribing	N/A	1003110156	0	0	WANG, EMILY I LMFT	8/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT104465	N/A	N/A	N/A	N/A	N/A	200 W SANTA ANA BLVD	STE 801	SANTA ANA	CA	92701	4134	00	06000	33.74970951	-117.8691975	Orange County
316100	Ordering, Referring, Prescribing	N/A	1003116005	0	0	WALLER, AMY	3/27/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH46560	N/A	N/A	N/A	N/A	N/A	7544 GIRARD AVE	None	LA JOLLA	CA	92037	5101	00	06000	32.84185671	-117.2729557	San Diego County
316149	Ordering, Referring, Prescribing	N/A	1003183591	0	0	WU, JACK Z PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52764	N/A	N/A	N/A	N/A	N/A	5695 ALTON PKWY	None	IRVINE	CA	92618	4059	00	06000	33.66846665	-117.786127	Orange County
316172	Ordering, Referring, Prescribing	N/A	1003213729	0	0	WINISTORFER, KATHLEEN E LCSW	6/12/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101939	N/A	N/A	N/A	N/A	N/A	8912 VOLUNTEER LANE	None	SACRAMENTO	CA	95826	3221	00	06000	38.55438	-121.3756965	Sacramento County
316180	Ordering, Referring, Prescribing	N/A	1003225129	0	0	WEBB, HOLLY LMFT	3/12/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110413	N/A	N/A	N/A	N/A	N/A	8243 E STOCKTON BLVD	SUITE A	SACRAMENTO	CA	95828	8204	00	06000	38.459565	-121.409235	Sacramento County
316182	Ordering, Referring, Prescribing	N/A	1003225707	0	0	WAHIDI, SALMA PSYD	5/18/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	30852	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
316198	Ordering, Referring, Prescribing	N/A	1003244906	0	0	WILL, STEVEN LMFT	11/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103954	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7906	00	06000	33.62516256	-117.7353393	Orange County
316232	Ordering, Referring, Prescribing	N/A	1003291709	0	0	WHITLOW, AMBER K LCSW	3/10/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107236	N/A	N/A	N/A	N/A	N/A	1801 PARK COURT PL	BLDG H	SANTA ANA	CA	92701	5028	00	06000	33.74986153	-117.8429355	Orange County
316236	Ordering, Referring, Prescribing	N/A	1003296708	0	0	WINTON, JAMES M PHARMD	9/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	48648	N/A	N/A	N/A	N/A	N/A	205 W SHAW AVE	None	CLOVIS	CA	93612	3602	00	06000	36.8086	-119.7143248	Fresno County
316237	Ordering, Referring, Prescribing	N/A	1003266578	0	0	WEISWERDA, AVIAN M LCSW	2/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100125	N/A	N/A	N/A	N/A	N/A	5000 W HOLLYWOOD BLVD	None	LOS ANGELES	CA	90027	1604	00	06000	34.101742	-118.2987933	Los Angeles County
316239	Ordering, Referring, Prescribing	N/A	1003299033	0	0	WANG, JESSICA NP	7/15/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002105	N/A	N/A	N/A	N/A	N/A	8399 GARVEY AVE	None	ROSEMEAD	CA	91770	2650	00	06000	34.06268752	-118.086759	Los Angeles County
316248	Ordering, Referring, Prescribing	N/A	1003307356	0	0	WILSON, JASMINE D LCSW	12/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99171	N/A	N/A	N/A	N/A	N/A	2243 W. BALL ROAD	None	ANAHEIM	CA	92804	5314	00	06000	33.817798	-117.9610599	Orange County
316265	Ordering, Referring, Prescribing	N/A	1003345992	0	0	WILINSKI, JESSICA E LCSW	6/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	102038	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	BUILDING 4	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
316290	Ordering, Referring, Prescribing	N/A	1003375007	0	0	WONG, ERIC R DO	6/19/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20363	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVENUE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
316294	Ordering, Referring, Prescribing	N/A	1003382540	0	0	WILSON, STEPHANIE LMFT	7/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	140341	N/A	N/A	N/A	N/A	N/A	2130 STOCKTON BLVD	300	SACRAMENTO	CA	95817	1337	00	06000	38.557593	-121.4616735	Sacramento County
316320	Ordering, Referring, Prescribing	N/A	1003417080	0	0	WILLIAMS, MARY LMFT	3/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124891	N/A	N/A	N/A	N/A	N/A	4190 DOUGLAS BLVD	300	ROSEVILLE	CA	95746	5918	00	06000	38.740617	-121.2229935	Placer County
316401	Ordering, Referring, Prescribing	N/A	1003566571	0	0	WEAVER, DANIELLE R PHARMD	11/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85593	N/A	N/A	N/A	N/A	N/A	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	00	06000	37.76850146	-122.3949365	San Francisco County
316419	Ordering, Referring, Prescribing	N/A	1003801820	0	0	WILLERUP, ELIZABETH B CNP	2/22/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	6826	N/A	N/A	N/A	N/A	N/A	1965 LIVE OAK BLVD	None	YUBA CITY	CA	95991	8850	00	06000	39.15563037	-121.620091	Sutter County
316426	Ordering, Referring, Prescribing	N/A	1003846254	0	0	WALIANY, RAYMOND MD	9/20/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A50053	N/A	N/A	N/A	N/A	N/A	1450 E HOLT AVE	None	POMONA	CA	91767	5822	00	06000	34.06299829	-117.7215562	Los Angeles County
316491	Ordering, Referring, Prescribing	N/A	1013020288	0	0	WENSTRUP, SUSIE M MD	3/25/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A55289	N/A	N/A	N/A	N/A	N/A	12619 BENTLEY STREET	None	WATERFORD	CA	95386	9011	00	06000	37.64073442	-120.7613165	Stanislaus County
316521	Ordering, Referring, Prescribing	N/A	1013076033	0	0	WHITTINGTON, YOLANDA Y LCSW	3/21/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20531	N/A	N/A	N/A	N/A	N/A	3756 SANTA ROSALIA DR.	219	LOS ANGELES	CA	90008	3616	00	06000	34.00888336	-118.3389334	Los Angeles County
316582	Ordering, Referring, Prescribing	N/A	1013184498	0	0	WONG, JEFFERY Y	8/22/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D30131	N/A	N/A	N/A	N/A	N/A	2950 INTERNATIONAL BLVD	None	OAKLAND	CA	94601	2228	00	06000	37.77893032	-122.2284286	Alameda County
316661	Ordering, Referring, Prescribing	N/A	1013316389	0	0	WONG, HARMONIE M LCSW	6/22/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101551	N/A	N/A	N/A	N/A	N/A	720 SACRAMENTO ST.	None	SAN FRANCISCO	CA	94108	2535	00	06000	37.79355846	-122.4050846	San Francisco County
316666	Ordering, Referring, Prescribing	N/A	1013322965	0	0	WATERS, LAURA L PSYD	2/3/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	31585	N/A	N/A	N/A	N/A	N/A	11721 TELEGRAPH RD	A	SANTA FE SPRINGS	CA	90670	3674	00	06000	33.94629336	-118.0832752	Los Angeles County
316668	Ordering, Referring, Prescribing	N/A	1013331685	0	0	WEINER, STEFFAN CNP	9/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95000258	N/A	N/A	N/A	N/A	N/A	19 EAST MISSION STREET	SUITE A	SANTA BARBARA	CA	93101	2459	00	06000	34.43132088	-119.7142252	Santa Barbara County
316684	Ordering, Referring, Prescribing	N/A	1013350750	0	0	WEYERBACHER, JONATHAN S MD MPH	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A168941	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	0000	00	06000	38.555181	-121.4566785	Sacramento County
316704	Ordering, Referring, Prescribing	N/A	1013378967	0	0	WARD, ANTHONY CNP	12/17/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002238	N/A	N/A	N/A	N/A	N/A	1200 WILSHIRE BLVD	210	LOS ANGELES	CA	90017	1908	00	06000	34.05307427	-118.2651099	Los Angeles County
316715	Ordering, Referring, Prescribing	N/A	1013388842	0	0	WONG, GENEVIEVE C NP	3/8/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003281	N/A	N/A	N/A	N/A	N/A	1316 THIRD ST PROMENADE	SUITE 201	SANTA MONICA	CA	90401	1382	00	06000	34.01670895	-118.497462	Los Angeles County
316744	Ordering, Referring, Prescribing	N/A	1013437680	0	0	WARNERT, HANNAH M LMFT	8/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121422	N/A	N/A	N/A	N/A	N/A	232 E. GISH RD.	None	SAN JOSE	CA	95112	4706	00	06000	37.36411044	-121.9052075	Santa Clara County
316747	Ordering, Referring, Prescribing	N/A	1013441989	0	0	WELLS, ALYSSA LMFT	6/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116557	N/A	N/A	N/A	N/A	N/A	1904 RICHLAND AVE	C2	CERES	CA	95307	4562	00	06000	37.60031128	-120.9658226	Stanislaus County
316811	Ordering, Referring, Prescribing	N/A	1013555291	0	0	WALKER, ELEASHA LMFT	4/29/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132559	N/A	N/A	N/A	N/A	N/A	1695 S SAN JACINTO AVE	ACD	SAN JACINTO	CA	92583	5103	00	06000	33.770961	-116.954649	Riverside County
316838	Ordering, Referring, Prescribing	N/A	1013678838	0	0	WANG, WUN-JI D LCSW	8/16/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	103213	N/A	N/A	N/A	N/A	N/A	3575 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3212	00	06000	37.78122373	-122.4579478	San Francisco County
316852	Ordering, Referring, Prescribing	N/A	1013790021	0	0	WALKER, NATHAN PA	11/1/2023	Taxonomy not applicable	NA	n/a	000	Unknown	63612	N/A	N/A	N/A	N/A	N/A	116 S PALISADE DR	STE 200	SANTA MARIA	CA	93454	0001	00	06000	34.9523869	-120.4120717	Santa Barbara County
316857	Ordering, Referring, Prescribing	N/A	1013941988	0	0	WARNER, DOUGLAS K MD	9/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	29437	N/A	N/A	N/A	N/A	N/A	10820 PARKSIDE DR	None	KNOXVILLE	TN	37934	1956	00	06000	35.90003918	-84.14416556	Knox County
316920	Ordering, Referring, Prescribing	N/A	1023134228	0	0	WARD, NICHELLE LCSW	2/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28570	N/A	N/A	N/A	N/A	N/A	8019 E. COMPTON AVENUE	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
316924	Ordering, Referring, Prescribing	N/A	1023154267	0	0	WELLS, BROOKE A LCSW	4/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29459	N/A	N/A	N/A	N/A	N/A	260 COHASSETT RD	STE 100	CHICO	CA	95926	2282	00	06000	39.754035	-121.851117	Butte County
316931	Ordering, Referring, Prescribing	N/A	1023189008	0	0	WINCKLER, JOHN R	2/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43220	N/A	N/A	N/A	N/A	N/A	315 CAMINO DEL REMEDIO	B	SANTA BARBARA	CA	93110	1332	00	06000	34.444881	-119.7793725	Santa Barbara County
316954	Ordering, Referring, Prescribing	N/A	1023231313	0	0	WYSS, DANA A LMFT	6/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48355	N/A	N/A	N/A	N/A	N/A	4025 W 226TH ST	None	TORRANCE	CA	90505	2340	00	06000	33.82360754	-118.3560922	Los Angeles County
316968	Ordering, Referring, Prescribing	N/A	1023274396	0	0	WADEMAN, JENNIFER E OD	5/7/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	13507	N/A	N/A	N/A	N/A	N/A	425 W BONITA AVE	STE 110B	SAN DIMAS	CA	91773	2543	00	06000	34.10669347	-117.814932	Los Angeles County
316981	Ordering, Referring, Prescribing	N/A	1023306503	0	0	WAGNON, LINDSEY PHARMD	3/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64945	N/A	N/A	N/A	N/A	N/A	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
316989	Ordering, Referring, Prescribing	N/A	1023315470	0	0	WINSLOW, MARIAH G LCSW	7/9/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	109050	N/A	N/A	N/A	N/A	N/A	33 ENCINA AVE	None	PALO ALTO	CA	94301	2343	00	06000	37.43913037	-122.1608344	Santa Clara County
317025	Ordering, Referring, Prescribing	N/A	1023391109	0	0	WONG, TINA PHARMD	7/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56716	N/A	N/A	N/A	N/A	N/A	27983 SLOAN CANYON RD	None	CASTAIC	CA	91384	2594	00	06000	34.49476297	-118.6260515	Los Angeles County
317064	Ordering, Referring, Prescribing	N/A	1023440906	0	0	WEBB, NICOLE PHARMD	1/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	59787	N/A	N/A	N/A	N/A	N/A	1120 E CLARK AVE	None	ORCUTT	CA	93455	5123	00	06000	34.86500248	-120.417299	Santa Barbara County
317107	Ordering, Referring, Prescribing	N/A	1023508900	0	0	WESTIEN, INGEBORG MD	2/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173571	N/A	N/A	N/A	N/A	N/A	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
317121	Ordering, Referring, Prescribing	N/A	1023529484	0	0	WU, JOHN Y PA-C	9/27/2020	Taxonomy not applicable	NA	n/a	000	Unknown	55176	N/A	N/A	N/A	N/A	N/A	1101 N CHERRY ST	None	TULARE	CA	93274	2231	00	06000	36.22333808	-119.337575	Tulare County
317261	Ordering, Referring, Prescribing	N/A	1033154984	0	0	WOSK, BERNARD	8/19/2023	Taxonomy not applicable	NA	n/a	000	Unknown	A49350	N/A	N/A	N/A	N/A	N/A	2630 FIRST AVE	None	SAN DIEGO	CA	92103	6599	00	06000	32.73288727	-117.1639712	San Diego County
317274	Ordering, Referring, Prescribing	N/A	1033220462	0	0	WILLIAM-WHITE, LORRAINE Y	1/7/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27977	N/A	N/A	N/A	N/A	N/A	830 SCENIC DR	STE A	MODESTO	CA	95350	6131	00	06000	37.64720049	-120.982338	Stanislaus County
317289	Ordering, Referring, Prescribing	N/A	1033240155	0	0	WERNER-CROHN, MINDY A MD	8/16/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G53827	N/A	N/A	N/A	N/A	N/A	23622 CALABASAS RD	320	CALABASAS	CA	91302	1574	00	06000	34.15634882	-118.6418781	Los Angeles County
317307	Ordering, Referring, Prescribing	N/A	1033270988	0	0	WINIARSKI, STEVEN S DO	6/19/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A10993	N/A	N/A	N/A	N/A	N/A	818 WEST SEVENTH STREET	SUITE 930	LOS ANGELES	CA	90017	3407	00	06000	34.04892591	-118.259182	Los Angeles County
317333	Ordering, Referring, Prescribing	N/A	1033310032	0	0	WU, LINDA H LCSW	3/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26681	N/A	N/A	N/A	N/A	N/A	720 SACRAMENTO ST	None	SAN FRANCISCO	CA	94108	2535	00	06000	37.79355846	-122.4050846	San Francisco County
317335	Ordering, Referring, Prescribing	N/A	1033311105	0	0	WHITE, TONI B LCSW	9/6/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23373	N/A	N/A	N/A	N/A	N/A	4709 PALOMINO WAY	None	ANTIOCH	CA	94531	0000	00	06000	37.97130105	-121.7528148	Contra Costa County
317341	Ordering, Referring, Prescribing	N/A	1033316005	0	0	WILLIAMS, KATHERINE N PHD	6/25/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	22387	N/A	N/A	N/A	N/A	N/A	3665 KEARNY VILLA RD	101	SAN DIEGO	CA	92123	1953	00	06000	32.80816826	-117.1510112	San Diego County
317352	Ordering, Referring, Prescribing	N/A	1033361241	0	0	WILLIAMS, VERONICA NP	5/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95017374	N/A	N/A	N/A	N/A	N/A	605 CROUCH ST	BLDG C	OCEANSIDE	CA	92054	4415	00	06000	33.19619156	-117.3537219	San Diego County
317371	Ordering, Referring, Prescribing	N/A	1033391925	0	0	WONG, KENNETH L PHARMD	5/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	36523	N/A	N/A	N/A	N/A	N/A	14501 HINDRY AVE	None	HAWTHORNE	CA	90250	6748	00	06000	33.89988119	-118.3721861	Los Angeles County
317396	Ordering, Referring, Prescribing	N/A	1033429535	0	0	WILLIAMS, MEADE H LMFT	4/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92697	N/A	N/A	N/A	N/A	N/A	1830 S CENTRAL ST	None	VISALIA	CA	93277	4418	00	06000	36.314271	-119.311362	Tulare County
317407	Ordering, Referring, Prescribing	N/A	1033447339	0	0	WHITMORE, ALINA PSYD	6/30/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	30454	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
317451	Ordering, Referring, Prescribing	N/A	1033498654	0	0	WONG, LINH P PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65539	N/A	N/A	N/A	N/A	N/A	910 MARSHALL STREET	ROOM 118	REDWOOD	CA	94062	2052	00	06000	37.4876781	-122.2249265	San Mateo County
317492	Ordering, Referring, Prescribing	N/A	1033556022	0	0	WOLCHOK, LAUREN MD	12/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132883	N/A	N/A	N/A	N/A	N/A	1845 N. FAIR OAKS AVE. G	None	PASADENA	CA	91103	1620	00	06000	34.177806	-118.1507985	Los Angeles County
317499	Ordering, Referring, Prescribing	N/A	1033569371	0	0	WINTERS, NICOLE LCSW	8/24/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97351	N/A	N/A	N/A	N/A	N/A	799 H STREET	1092	ARCATA	CA	95521	6240	00	06000	40.86822289	-124.0871843	Humboldt County
317542	Ordering, Referring, Prescribing	N/A	1033637236	0	0	WU, BRIAN	8/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159332	N/A	N/A	N/A	N/A	N/A	9990 COUNTY FARM RD	None	RIVERSIDE	CA	92503	3542	00	06000	33.9201112	-117.4577963	Riverside County
317544	Ordering, Referring, Prescribing	N/A	1033642871	0	0	WANG, EILEEN MD	5/16/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A172748	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
317560	Ordering, Referring, Prescribing	N/A	1033657705	0	0	WILLIAMS, JENNIFER I LMFT	6/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119509	N/A	N/A	N/A	N/A	N/A	370 W. CRENSHAW BLVD.	E-100	TORRANCE	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles County
317620	Ordering, Referring, Prescribing	N/A	1033776968	0	0	WU, JOSHUA	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80307	N/A	N/A	N/A	N/A	N/A	3009 BROADWAY	None	OAKLAND	CA	94611	5712	00	06000	37.81907291	-122.2621457	Alameda County
317636	Ordering, Referring, Prescribing	N/A	1033834023	0	0	WONG, BRITNEY LMFT	12/26/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152277	N/A	N/A	N/A	N/A	N/A	26137 LA PAZ RD	230	MISSION VIEJO	CA	92691	5319	00	06000	33.60038172	-117.6735855	Orange County
317676	Ordering, Referring, Prescribing	N/A	1043239403	0	0	WEST, THOMAS J	1/25/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D44279	N/A	N/A	N/A	N/A	N/A	425 N DATE ST	None	ESCONDIDO	CA	92025	3413	00	06000	33.1292461	-117.0716509	San Diego County
317718	Ordering, Referring, Prescribing	N/A	1043375231	0	0	WASTILA, LISA MD	9/17/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A60801	N/A	N/A	N/A	N/A	N/A	1501 IMPERIAL AVE	None	SAN DIEGO	CA	92101	7638	00	06000	32.70625742	-117.1498948	San Diego County
317727	Ordering, Referring, Prescribing	N/A	1043381023	0	0	WESLEY, PATRICIA F	12/22/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G56188	N/A	N/A	N/A	N/A	N/A	8337 TELEGRAPH ROAD	None	PICO RIVERA	CA	90660	4957	00	06000	33.96454327	-118.1134473	Los Angeles County
317736	Ordering, Referring, Prescribing	N/A	1043389786	0	0	WEXLER, MICHAEL J MD	2/3/2020	Taxonomy not applicable	NA	n/a	000	Unknown	A61110	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	200	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
317741	Ordering, Referring, Prescribing	N/A	1043405525	0	0	WILSON, BIANCA M LMFT	12/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52736	N/A	N/A	N/A	N/A	N/A	3217 COHASSET RD	None	CHICO	CA	95973	5404	00	06000	39.77489588	-121.8437439	Butte County
317771	Ordering, Referring, Prescribing	N/A	1043474927	0	0	WRIGHT, DELLA LMFT	9/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84703	N/A	N/A	N/A	N/A	N/A	1400 EMELINE AVE	None	SANTA CRUZ	CA	95060	1976	00	06000	36.99276804	-122.0178271	Santa Cruz County
317776	Ordering, Referring, Prescribing	N/A	1043488455	0	0	WIND, GINA PHD	9/26/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25441	N/A	N/A	N/A	N/A	N/A	5425 CARPINTERIA AVE	UNIT 991	CARPINTERIA	CA	93014	7001	00	06000	34.39482116	-119.5135246	Santa Barbara County
317779	Ordering, Referring, Prescribing	N/A	1043499262	0	0	WOO, MAGGIE PHARMD	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH59813	N/A	N/A	N/A	N/A	N/A	3100 DUBLIN BLVD	None	DUBLIN	CA	94568	0000	00	06000	37.70453535	-121.8586496	Alameda County
317852	Ordering, Referring, Prescribing	N/A	1043625650	0	0	WILLIAMS, SHANNON LMFT	12/3/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116336	N/A	N/A	N/A	N/A	N/A	2121 W TEMPLE ST	None	LOS ANGELES	CA	90026	4915	00	06000	34.07053729	-118.268744	Los Angeles County
317858	Ordering, Referring, Prescribing	N/A	1043638687	0	0	WU, MICHELLE D	12/8/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D62946	N/A	N/A	N/A	N/A	N/A	7843 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91605	2523	00	06000	34.213581	-118.3878055	Los Angeles County
317939	Ordering, Referring, Prescribing	N/A	1043746621	0	0	WYMAN, JIWON HELEN MD	7/6/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159214	N/A	N/A	N/A	N/A	N/A	2010 ZONAL AVE	1ST FLOOR 1P51	LOS ANGELES	CA	90033	1026	00	06000	34.05986523	-118.2057472	Los Angeles County
317955	Ordering, Referring, Prescribing	N/A	1043776263	0	0	WAITE, JORDAN N LMFT	1/11/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	137124	N/A	N/A	N/A	N/A	N/A	2750 SUTTERVILLE RD	None	SACRAMENTO	CA	95820	1024	00	06000	38.540124	-121.4786745	Sacramento County
317969	Ordering, Referring, Prescribing	N/A	1043797871	0	0	WATKINS, J	9/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC4200	N/A	N/A	N/A	N/A	N/A	948 SACRAMENTO AVE	None	WEST SACRAMENTO	CA	95605	1904	00	06000	38.58935106	-121.5252207	Yolo County
317971	Ordering, Referring, Prescribing	N/A	1043796931	0	0	WEI, CHLOE E LMFT	6/2/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133073	N/A	N/A	N/A	N/A	N/A	232 E GISH RD	None	SAN JOSE	CA	95112	4706	00	06000	37.36411044	-121.9052075	Santa Clara County
317983	Ordering, Referring, Prescribing	N/A	1043834302	0	0	WATSON, LACEY E NP	5/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014622	N/A	N/A	N/A	N/A	N/A	3701 J ST	201	SACRAMENTO	CA	95816	5562	00	06000	38.571237	-121.4566245	Sacramento County
317996	Ordering, Referring, Prescribing	N/A	1043849607	0	0	WRIGHT, JAYSON MD	5/13/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178620	N/A	N/A	N/A	N/A	N/A	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	00	06000	34.07607952	-118.373418	Los Angeles County
318014	Ordering, Referring, Prescribing	N/A	1043883044	0	0	WU, DAISY W DMD	11/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	108338	N/A	N/A	N/A	N/A	N/A	1033 CLEMENT ST	None	SAN FRANCISCO	CA	94118	2112	00	06000	37.78261628	-122.470294	San Francisco County
318093	Ordering, Referring, Prescribing	N/A	1053328104	0	0	WARWICK-SMITH, KATHLEEN	10/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40025	N/A	N/A	N/A	N/A	N/A	19449 RIVERSIDE DRIVE	STE 202	SONOMA	CA	95476	6358	00	06000	38.29448921	-122.4779588	Sonoma County
318161	Ordering, Referring, Prescribing	N/A	1053495978	0	0	WARD, ISIDOR S MD	2/22/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G76996	N/A	N/A	N/A	N/A	N/A	2640 INDUSTRY WAY	SUITE B	LYNWOOD	CA	90262	4284	00	06000	33.92359693	-118.2252816	Los Angeles County
318173	Ordering, Referring, Prescribing	N/A	1053514588	0	0	WALKER, IMANI DO	1/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A9660	N/A	N/A	N/A	N/A	N/A	900 E MAIN ST STE 201	STE 201	GRASS VALLEY	CA	95945	5853	00	06000	39.22827201	-121.0517684	Nevada County
318177	Ordering, Referring, Prescribing	N/A	1053525816	0	0	WILCHEK, SCOTT A DO	9/22/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A18956	N/A	N/A	N/A	N/A	N/A	17822 BEACH BLVD	STE 430	HUNTINGTON BEACH	CA	92647	7508	00	06000	33.70331388	-117.9890471	Orange County
318228	Ordering, Referring, Prescribing	N/A	1053621300	0	0	WILSON, KAROL	2/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	40066	N/A	N/A	N/A	N/A	N/A	1405 W CAMERON AVE	None	VISALIA	CA	93277	9527	00	06000	36.292698	-119.306538	Tulare County
318292	Ordering, Referring, Prescribing	N/A	1053711994	0	0	WELBORN, LAYLA	1/4/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95001181	N/A	N/A	N/A	N/A	N/A	3850 17TH ST	None	SAN FRANCISCO	CA	94114	2031	00	06000	37.76272129	-122.4318522	San Francisco County
318306	Ordering, Referring, Prescribing	N/A	1053729012	0	0	WILLIS, SHARON L NP	6/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000838	N/A	N/A	N/A	N/A	N/A	628 W MICHELTORENA ST	None	SANTA BARBARA	CA	93101	4131	00	06000	34.41910081	-119.7158618	Santa Barbara County
318313	Ordering, Referring, Prescribing	N/A	1053741082	0	0	WIENER, CHELSEA M LCSW	11/21/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW75032	N/A	N/A	N/A	N/A	N/A	3002 ARMSTRONG ST	None	SAN DIEGO	CA	92111	5702	00	06000	32.80043242	-117.165431	San Diego County
318418	Ordering, Referring, Prescribing	N/A	1053891028	0	0	WROBEL, MAKENNA PSYD	8/16/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	34471	N/A	N/A	N/A	N/A	N/A	800 N ECKHOFF ST	None	ORANGE	CA	92868	1008	00	06000	33.79960624	-117.8741126	Orange County
318423	Ordering, Referring, Prescribing	N/A	1053894717	0	0	WASIK, ELIZABETH W NP	12/8/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95013662	N/A	N/A	N/A	N/A	N/A	4327 GOLDEN DRIVE	None	PLACERVILLE	CA	95667	6816	00	06000	38.70662835	-120.8276613	El Dorado County
318499	Ordering, Referring, Prescribing	N/A	1063100477	0	0	WITHERSPOON, ASHLEY D NP	4/21/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024916	N/A	N/A	N/A	N/A	N/A	4212 MISSOURI FLAT ROAD	None	PLACERVILLE	CA	95667	6269	00	06000	38.706228	-120.834891	El Dorado County
318554	Ordering, Referring, Prescribing	N/A	1063502151	0	0	WENTERS, JOAN S PHD	6/28/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY8909	N/A	N/A	N/A	N/A	N/A	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
318561	Ordering, Referring, Prescribing	N/A	1063514511	0	0	WONG, DEEANN MD	3/29/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A62462	N/A	N/A	N/A	N/A	N/A	900 LARKSPUR LANDING CIR	285	LARKSPUR	CA	94939	1765	00	06000	37.94831035	-122.5097161	Marin County
318590	Ordering, Referring, Prescribing	N/A	1063549228	0	0	WOODSON, LESA R DDS	8/13/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D59194	N/A	N/A	N/A	N/A	N/A	10259 PEDRA DO SOL	None	ELK GROVE	CA	95757	3475	00	06000	38.385405	-121.418289	Sacramento County
318647	Ordering, Referring, Prescribing	N/A	1063661486	0	0	WHALL, MARY K LMFT	10/6/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51407	N/A	N/A	N/A	N/A	N/A	275 BECK AVE	MS 5-250	FAIRFIELD	CA	94533	6804	00	06000	38.23532718	-122.0663968	Solano County
318673	Ordering, Referring, Prescribing	N/A	1063710903	0	0	WOO, LISA P LMFT	4/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139266	N/A	N/A	N/A	N/A	N/A	5100 GARFIELD AVE	APT 79	SACRAMENTO	CA	95841	3821	00	06000	38.659581	-121.336911	Sacramento County
318731	Ordering, Referring, Prescribing	N/A	1063793669	0	0	WONG, RAYMOND S	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64901	N/A	N/A	N/A	N/A	N/A	100 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	0000	00	06000	38.01968283	-122.5339655	Marin County
318766	Ordering, Referring, Prescribing	N/A	1063825271	0	0	WONG, WAI TAI PHARMD	4/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH65080	N/A	N/A	N/A	N/A	N/A	8237 ROCHESTER AVE	120	RANCHO CUCAMONGA	CA	91730	0717	00	06000	34.103952	-117.5435325	San Bernardino County
318804	Ordering, Referring, Prescribing	N/A	1063884864	0	0	WILLIAMS, BREAHNA A NP	12/29/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001840	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
318816	Ordering, Referring, Prescribing	N/A	1063896900	0	0	WOODLEY, JAMIE L DO	9/16/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	15026	N/A	N/A	N/A	N/A	N/A	2690 PACIFIC AVENUE	370	LONG BEACH	CA	90806	2661	00	06000	33.805854	-118.1936805	Los Angeles County
318922	Ordering, Referring, Prescribing	N/A	1073074670	0	0	WITCHEY, LAUREN M MD	9/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A181883	N/A	N/A	N/A	N/A	N/A	3828 SCHAUFELE AVE	200	LONG BEACH	CA	90808	1791	00	06000	33.8283	-118.1479725	Los Angeles County
318925	Ordering, Referring, Prescribing	N/A	1073076220	0	0	WISHART, JOANNA CNP	8/4/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95026505	N/A	N/A	N/A	N/A	N/A	33 ENCINA AVE	103	PALO ALTO	CA	94301	2300	00	06000	37.43913037	-122.1608344	Santa Clara County
318928	Ordering, Referring, Prescribing	N/A	1073077822	0	0	WORKS, EMILY K LMFT	7/13/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126927	N/A	N/A	N/A	N/A	N/A	470 EL PASEO DR.	None	OAKLAND	CA	94603	3565	00	06000	37.72804352	-122.1774883	Alameda County
318954	Ordering, Referring, Prescribing	N/A	1073126009	0	0	WOO, SAMANTHA PHARMD	8/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH82075	N/A	N/A	N/A	N/A	N/A	3201 DIVISADERO ST	None	SAN FRANCISCO	CA	94123	2501	00	06000	37.79924295	-122.4427197	San Francisco County
318963	Ordering, Referring, Prescribing	N/A	1073138269	0	0	WILLIAMS, AUSTIN B	2/11/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	106995	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	660	MAMMOTH LAKES	CA	93546	0660	00	06000	37.64575895	-118.9638914	Mono County
318976	Ordering, Referring, Prescribing	N/A	1073172722	0	0	WONG, WILLIAM	3/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	36304	N/A	N/A	N/A	N/A	N/A	1322 EL CAMINO REAL	None	SAN BRUNO	CA	94066	1304	00	06000	37.63962865	-122.4228561	San Mateo County
319003	Ordering, Referring, Prescribing	N/A	1073288221	0	0	WILLIAMS, TERESA Y CCC-SLP	9/14/2020	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	29548	N/A	N/A	N/A	N/A	N/A	27070 SUN CITY BLVD	106	MENIFEE	CA	92586	2509	00	06000	33.71084652	-117.1932563	Riverside County
319058	Ordering, Referring, Prescribing	N/A	1073648887	0	0	WOODSON, ALAN B	5/23/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D35359	N/A	N/A	N/A	N/A	N/A	1125 W 6TH ST	STE 103	LOS ANGELES	CA	90017	1896	00	06000	34.05441139	-118.2628642	Los Angeles County
319083	Ordering, Referring, Prescribing	N/A	1073714572	0	0	WRIGHT-AVESON, DIANA LMFT	5/28/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48699	N/A	N/A	N/A	N/A	N/A	1050 WISCONSIN ST	None	SAN FRANCISCO	CA	94107	3328	00	06000	37.7540295	-122.3986796	San Francisco County
319108	Ordering, Referring, Prescribing	N/A	1073794368	0	0	WANG, LINDA MD	6/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G81232	N/A	N/A	N/A	N/A	N/A	10861 CHERRY ST	SUITE 308	LOS ALAMITOS	CA	90720	5403	00	06000	33.80465174	-118.0680053	Orange County
319109	Ordering, Referring, Prescribing	N/A	1073796686	0	0	WHEELER, RACHEL MD	12/4/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	187330-1205	N/A	N/A	N/A	N/A	N/A	961 WEST EDGEHILL LANE	None	ST GEORGE	UT	84770	6104	00	06000	37.06869764	-113.6044054	Washington County
319147	Ordering, Referring, Prescribing	N/A	1073879391	0	0	WANG, EMILY PA-C	1/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	22610	N/A	N/A	N/A	N/A	N/A	2975 ZOE AVE	None	HUNTINGTON PARK	CA	90255	5278	00	06000	33.9793863	-118.216134	Los Angeles County
319182	Ordering, Referring, Prescribing	N/A	1073936712	0	0	WICKERSHAM, CAROLYN NP	3/15/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	818193	N/A	N/A	N/A	N/A	N/A	12450 VAN NUYS BLVD.	100	PACOIMA	CA	91331	0000	00	06000	34.27894489	-118.4044363	Los Angeles County
319230	Ordering, Referring, Prescribing	N/A	1083007702	0	0	WILLIAMS, KATHERINE M LCSW	3/14/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	121581	N/A	N/A	N/A	N/A	N/A	101 JOSE FIGUERES AVE	50	SAN JOSE	CA	95116	2022	00	06000	37.35869865	-121.8481586	Santa Clara County
319260	Ordering, Referring, Prescribing	N/A	1083032528	0	0	WHITESIDES, DANIEL B MD	9/27/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139934	N/A	N/A	N/A	N/A	N/A	751 LOMBARDI CT	None	SANTA ROSA	CA	95407	6793	00	06000	38.427804	-122.7493035	Sonoma County
319281	Ordering, Referring, Prescribing	N/A	1083068001	0	0	WONG, MICHELE J MD	6/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A153137	N/A	N/A	N/A	N/A	N/A	2574 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1505	00	06000	37.72907852	-122.4042585	San Francisco County
319301	Ordering, Referring, Prescribing	N/A	1083099956	0	0	WARD, TRACY LCSW	9/12/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW26243	N/A	N/A	N/A	N/A	N/A	4605 APRIL CT	None	VALLEJO	CA	94591	6378	00	06000	38.13226058	-122.2036115	Solano County
319310	Ordering, Referring, Prescribing	N/A	1083117048	0	0	WU, XIAOJIE NP	4/2/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95056302	N/A	N/A	N/A	N/A	N/A	260 HOSPITAL DR	STE 207	UKIAH	CA	95482	4533	00	06000	39.15349918	-123.2039443	Mendocino County
319415	Ordering, Referring, Prescribing	N/A	1083292569	0	0	WONG, STEPHANIE MD	6/19/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A187150	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE	100	LOS ANGELES	CA	90018	1353	00	06000	34.037415	-118.3176815	Los Angeles County
319419	Ordering, Referring, Prescribing	N/A	1083324362	0	0	WILLIAMS, OLGA	5/29/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	36487	N/A	N/A	N/A	N/A	N/A	1205 E GRAND AVE	None	ARROYO GRANDE	CA	93420	2419	00	06000	35.12050747	-120.6006256	San Luis Obispo County
319500	Ordering, Referring, Prescribing	N/A	1083760292	0	0	WALKER, LORRAINE A MD	5/29/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G57329	N/A	N/A	N/A	N/A	N/A	1450 E HOLT AVENUE	None	POMONA	CA	91767	5822	00	06000	34.06299829	-117.7215562	Los Angeles County
319526	Ordering, Referring, Prescribing	N/A	1083815682	0	0	WILLIAMS, DONNA R LCSW	6/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	89444	N/A	N/A	N/A	N/A	N/A	7200 BANCROFT AVE	125A	OAKLAND	CA	94605	2457	00	06000	37.768221	-122.17608	Alameda County
319560	Ordering, Referring, Prescribing	N/A	1083890529	0	0	WARMSLEY, KIMBERLY A	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW86639	N/A	N/A	N/A	N/A	N/A	42 W 8TH ST,	None	TRACY	CA	95376	9537	00	06000	37.73643578	-121.4267871	San Joaquin County
319561	Ordering, Referring, Prescribing	N/A	1083899504	0	0	WANG, LINDA L MD	11/6/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A101509	N/A	N/A	N/A	N/A	N/A	450 BAUCHET ST	None	LOS ANGELES	CA	90012	2907	00	06000	34.05925347	-118.230941	Los Angeles County
319568	Ordering, Referring, Prescribing	N/A	1083914634	0	0	WOO, LISA	3/28/2018	Taxonomy not applicable	NA	n/a	000	Unknown	42023	N/A	N/A	N/A	N/A	N/A	369 MAGNOLIA AVE	None	CORONA	CA	92879	3300	00	06000	33.85312751	-117.5653159	Riverside County
319572	Ordering, Referring, Prescribing	N/A	1083913321	0	0	WADE, TIMOTHY S LMFT	3/9/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124814	N/A	N/A	N/A	N/A	N/A	530 KINGS COUNTY DRIVE	106	HANFORD	CA	93230	5954	00	06000	36.33019889	-119.66862	Kings County
319614	Ordering, Referring, Prescribing	N/A	1083990980	0	0	WONG, CINDY S PHARMD	3/20/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH52700	N/A	N/A	N/A	N/A	N/A	38995 SKY CANYON DRIVE	None	MURRIETA	CA	92563	2618	00	06000	33.55419166	-117.1377125	Riverside County
319636	Ordering, Referring, Prescribing	N/A	1093008153	0	0	WONG, FREEDA PHARMD	7/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47267	N/A	N/A	N/A	N/A	N/A	1750 NORIEGA ST	None	SAN FRANCISCO	CA	94122	4308	00	06000	37.75400557	-122.4826488	San Francisco County
319652	Ordering, Referring, Prescribing	N/A	1093041964	0	0	WALKER, GINETTE G LMFT	3/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	93268	N/A	N/A	N/A	N/A	N/A	2830 G ST	SUITE C-5	EUREKA	CA	95501	4446	00	06000	40.78218776	-124.1624709	Humboldt County
319701	Ordering, Referring, Prescribing	N/A	1093135311	0	0	WILSON, TREVOR C MD	12/9/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A140144	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE # A	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
319745	Ordering, Referring, Prescribing	N/A	1093190498	0	0	WESLEY, VIVIAN LCSW	7/6/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	92879	N/A	N/A	N/A	N/A	N/A	928 BROADWAY	None	SAN DIEGO	CA	92101	5514	00	06000	32.71575045	-117.1560915	San Diego County
319769	Ordering, Referring, Prescribing	N/A	1093227308	0	0	WOO, DENNY	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77245	N/A	N/A	N/A	N/A	N/A	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	00	06000	38.57535	-121.407633	Sacramento County
319792	Ordering, Referring, Prescribing	N/A	1093260358	0	0	WILLIAMS, MOLLY LMFT	5/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT118279	N/A	N/A	N/A	N/A	N/A	207 37TH ST	None	RICHMOND	CA	94805	0001	00	06000	37.93329292	-122.3343935	Contra Costa County
319826	Ordering, Referring, Prescribing	N/A	1093338873	0	0	WILMOT, COURTNEY M	3/13/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014203	N/A	N/A	N/A	N/A	N/A	1125 10TH STREET	None	SACRAMENTO	CA	95814	0000	00	06000	38.57890563	-121.4939739	Sacramento County
319866	Ordering, Referring, Prescribing	N/A	1093442964	0	0	WEI, LINNA PHARMD	6/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH71550	N/A	N/A	N/A	N/A	N/A	3945 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2440	00	06000	34.02394552	-118.187748	Los Angeles County
319877	Ordering, Referring, Prescribing	N/A	1093485344	0	0	WIRCH, JAMES LMFT	12/10/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	151917	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
319925	Ordering, Referring, Prescribing	N/A	1093840761	0	0	WRIGHT, KABRETTA O PHD	11/4/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY18744	N/A	N/A	N/A	N/A	N/A	1339 20TH STREET	None	SANTA MONICA	CA	90404	2033	00	06000	34.02917949	-118.4805651	Los Angeles County
319941	Ordering, Referring, Prescribing	N/A	1093866063	0	0	WHITE, O. C MD	1/6/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A87429	N/A	N/A	N/A	N/A	N/A	10421 S FIGUEROA ST	None	LOS ANGELES	CA	90003	4423	00	06000	33.941736	-118.2826495	Los Angeles County
319947	Ordering, Referring, Prescribing	N/A	1093848269	0	0	WOJEK, IRENE M NP	9/28/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	552922	N/A	N/A	N/A	N/A	N/A	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
319950	Ordering, Referring, Prescribing	N/A	1093876690	0	0	WONG, WINNIE W PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49840	N/A	N/A	N/A	N/A	N/A	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	00	06000	38.596581	-121.4303535	Sacramento County
320006	Ordering, Referring, Prescribing	N/A	1093971046	0	0	WESTERGREN, GABRIELLE	9/4/2018	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	1354	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
320024	Ordering, Referring, Prescribing	N/A	1104020841	0	0	WATANABE, MARK D	1/23/2017	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	37324	N/A	N/A	N/A	N/A	N/A	1380 HOWARD STREET	ROOM 130	SAN FRANCISCO	CA	94103	2638	00	06000	37.77424669	-122.4141502	San Francisco County
320073	Ordering, Referring, Prescribing	N/A	1104112507	0	0	WOOD, ALYCIA E LCSW	5/6/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW25336	N/A	N/A	N/A	N/A	N/A	8363 SEPULVEDA BLVD.	None	NORTHRIDGE	CA	91324	4694	00	06000	34.22281625	-118.4677938	Los Angeles County
320086	Ordering, Referring, Prescribing	N/A	1104142892	0	0	WILLIAMS, LINDSEY A RN BS	8/14/2019	Taxonomy not applicable	NA	n/a	000	Unknown	704191	N/A	N/A	N/A	N/A	N/A	2800 NICOLAUS RD	None	LINCOLN	CA	95648	9659	00	06000	38.89740783	-121.3293051	Placer County
320088	Ordering, Referring, Prescribing	N/A	1104156702	0	0	WERT, LINDSEY LMFT	10/17/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT81233	N/A	N/A	N/A	N/A	N/A	2455 BENNETT VALLEY RD	STE B201	SANTA ROSA	CA	95404	5663	00	06000	38.434284	-122.6918565	Sonoma County
320135	Ordering, Referring, Prescribing	N/A	1104228592	0	0	WANG, YIFAN	7/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT119859	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	None	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
320191	Ordering, Referring, Prescribing	N/A	1104319896	0	0	WOLFF, KARLA LMFT	12/5/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT136201	N/A	N/A	N/A	N/A	N/A	3665 KEARNY VILLA RD	SUITE 101	SAN DIEGO	CA	92123	1953	00	06000	32.80816826	-117.1510112	San Diego County
320227	Ordering, Referring, Prescribing	N/A	1104367846	0	0	WONG, HEATHER Y Y	4/12/2017	Taxonomy not applicable	NA	n/a	000	Unknown	54226	N/A	N/A	N/A	N/A	N/A	1501 E HOLT AVE	SUITE A	POMONA	CA	91767	5823	00	06000	34.06321709	-117.7205804	Los Angeles County
320241	Ordering, Referring, Prescribing	N/A	1104378850	0	0	WILLIAMS, CRYSTAL	3/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136015	N/A	N/A	N/A	N/A	N/A	1950 MARKET ST	None	RIVERSIDE	CA	92501	1720	00	06000	34.00316496	-117.3767967	Riverside County
320272	Ordering, Referring, Prescribing	N/A	1104449933	0	0	WANG, ROCHELLE P MD	5/12/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL4607	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
320297	Ordering, Referring, Prescribing	N/A	1104496850	0	0	WILSON, ALEXANDRIA C NP	6/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017522	N/A	N/A	N/A	N/A	N/A	1873 COMMERCENTER W	None	SAN BERNARDINO	CA	92408	3303	00	06000	34.067781	-117.286122	San Bernardino County
320301	Ordering, Referring, Prescribing	N/A	1104536549	0	0	WILLIS, ELIZABETH CNP	5/24/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017303	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3314	00	06000	38.62729851	-122.8637785	Sonoma County
320358	Ordering, Referring, Prescribing	N/A	1104954379	0	0	WEINGARTEN, AMY S LCSW	4/19/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW15027	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVENUE	None	SAN JOSE	CA	95128	2407	00	06000	37.31712017	-121.9185451	Santa Clara County
320388	Ordering, Referring, Prescribing	N/A	1104998855	0	0	WALTON, STACIE MD	9/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	G69089	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
320396	Ordering, Referring, Prescribing	N/A	1114017043	0	0	WONG, CECILIA OD	11/6/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT10792	N/A	N/A	N/A	N/A	N/A	11230 GARVEY AVE	J	EL MONTE	CA	91733	2475	00	06000	34.06282552	-118.0311435	Los Angeles County
320410	Ordering, Referring, Prescribing	N/A	1114046034	0	0	WAGNER, CYNTHIA E LCSW	2/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	18736	N/A	N/A	N/A	N/A	N/A	439 W 97TH ST	None	LOS ANGELES	CA	90003	3968	00	06000	33.94831439	-118.282325	Los Angeles County
320494	Ordering, Referring, Prescribing	N/A	1114207271	0	0	WONG, CLIFFORD C PHARMD	4/11/2022	Taxonomy not applicable	NA	n/a	000	Unknown	29961	N/A	N/A	N/A	N/A	N/A	7400 ELK GROVE BLVD	None	ELK GROVE	CA	95757	6299	00	06000	38.405799	-121.4134875	Sacramento County
320498	Ordering, Referring, Prescribing	N/A	1114211091	0	0	WHITE, KELLY A MD	2/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A156556	N/A	N/A	N/A	N/A	N/A	93 LA PATERA DR	B	CAMARILLO	CA	93010	8460	00	06000	34.24059418	-119.0785419	Ventura County
320565	Ordering, Referring, Prescribing	N/A	1114334497	0	0	WEAVER, MICHAELA B LCSW	1/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84353	N/A	N/A	N/A	N/A	N/A	66 HURLBUT ST	None	PASADENA	CA	91105	4025	00	06000	34.12993251	-118.1516625	Los Angeles County
320585	Ordering, Referring, Prescribing	N/A	1114373347	0	0	WOLMARANS, KAYLA J	3/26/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120257	N/A	N/A	N/A	N/A	N/A	341 IRWIN LANE	None	SANTA ROSA	CA	95401	1111	00	06000	38.43621084	-122.7882082	Sonoma County
320623	Ordering, Referring, Prescribing	N/A	1114418605	0	0	WOLFF, ALYSHA M	11/17/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129289	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	SUITE 201	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
320637	Ordering, Referring, Prescribing	N/A	1114454832	0	0	WILLIAMS, COURTNEY M LMFT	3/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111739	N/A	N/A	N/A	N/A	N/A	6001 CLARA ST	None	BELL GARDENS	CA	90201	4723	00	06000	33.96259296	-118.1593487	Los Angeles County
320652	Ordering, Referring, Prescribing	N/A	1114471026	0	0	WHITE, SHANTAL J	8/31/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	100497	N/A	N/A	N/A	N/A	N/A	237 HANBURY RD E	UNIT 304	CHESAPEAKE	VA	23322	6622	00	06000	36.685782	-76.2251535	Chesapeake city
320658	Ordering, Referring, Prescribing	N/A	1114476868	0	0	WATTS, LINDEN L	10/6/2016	Taxonomy not applicable	NA	n/a	008	CHRISTIAN SCIENCE PRACTIONER	0000000	N/A	N/A	N/A	N/A	N/A	18457 MADISON AVE	None	CASTRO VALLEY	CA	94546	1637	00	06000	37.71329669	-122.0637383	Alameda County
320679	Ordering, Referring, Prescribing	N/A	1114534518	0	0	WU, DANNY PHARMD	8/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83320	N/A	N/A	N/A	N/A	N/A	1344 STOCKTON ST	None	SAN FRANCISCO	CA	94133	0000	00	06000	37.79820871	-122.408678	San Francisco County
320684	Ordering, Referring, Prescribing	N/A	1114552759	0	0	WREN, JENNIFER LMFT	4/18/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	146474	N/A	N/A	N/A	N/A	N/A	1260 MORENA BLVD	None	SAN DIEGO	CA	92110	3889	00	06000	32.77077343	-117.2018542	San Diego County
320691	Ordering, Referring, Prescribing	N/A	1114538121	0	0	WU, WINNIE PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82423	N/A	N/A	N/A	N/A	N/A	550 16TH ST	ROOM 1200	SAN FRANCISCO	CA	94518	0000	00	06000	37.769553	-122.390109	San Francisco County
320693	Ordering, Referring, Prescribing	N/A	1114558582	0	0	WU, ALBERT PHARMD	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82048	N/A	N/A	N/A	N/A	N/A	2811 MIDDLEFIELD RD	None	PALO ALTO	CA	94306	2522	00	06000	37.43244792	-122.1277424	Santa Clara County
320699	Ordering, Referring, Prescribing	N/A	1114568185	0	0	WESTBROOK, HARRISON C LMFT	3/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138294	N/A	N/A	N/A	N/A	N/A	4625 MOUNTAIN LAKES BLVD	None	REDDING	CA	96003	1450	00	06000	40.63180037	-122.3839462	Shasta County
320713	Ordering, Referring, Prescribing	N/A	1114612694	0	0	WANGDU, TASHI PHARMD	2/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH87691	N/A	N/A	N/A	N/A	N/A	774 ADMIRAL CALLAGHAN LN	None	VALLEJO	CA	94591	3650	00	06000	38.12591271	-122.2280142	Solano County
320720	Ordering, Referring, Prescribing	N/A	1114637451	0	0	WHITE, CHELSEA N PHARMD	5/2/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH86503	N/A	N/A	N/A	N/A	N/A	2143 FOOTHILL BLVD	None	LA VERNE	CA	91750	2942	00	06000	34.11289169	-117.7633964	Los Angeles County
320763	Ordering, Referring, Prescribing	N/A	1114940863	0	0	WILLIAMS, MARIA M LCSW	5/19/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20171	N/A	N/A	N/A	N/A	N/A	77 CASA ST	None	SAN LUIS OBISPO	CA	93405	5803	00	06000	35.29306786	-120.6650709	San Luis Obispo County
320781	Ordering, Referring, Prescribing	N/A	1124053301	0	0	WUESTHOFF, THOMAS F	4/10/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D37612	N/A	N/A	N/A	N/A	N/A	250 N SEE VEE LN	None	BISHOP	CA	93514	8130	00	06000	37.365066	-118.410912	Inyo County
320787	Ordering, Referring, Prescribing	N/A	1124105085	0	0	WULFF, KENNETH R MD	4/20/2020	Taxonomy not applicable	NA	n/a	000	Unknown	G32683	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVE	STE 100	GILROY	CA	95020	3675	00	06000	37.03080985	-121.5741639	Santa Clara County
320788	Ordering, Referring, Prescribing	N/A	1124100193	0	0	WOODS, MARY F LMFT	3/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	33603	N/A	N/A	N/A	N/A	N/A	1080 MARINA VILLAGE PKWY	100	ALAMEDA	CA	94501	6427	00	06000	37.78544731	-122.270323	Alameda County
320822	Ordering, Referring, Prescribing	N/A	1124148671	0	0	WILLENS, RICH B LMFT	12/1/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	36896	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PARK	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
320835	Ordering, Referring, Prescribing	N/A	1124162102	0	0	WILLIAMS, KARL LCSW	9/24/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	22691	N/A	N/A	N/A	N/A	N/A	1170 INDUSTRIAL ST	None	REDDING	CA	96002	0734	00	06000	40.57474549	-122.3503065	Shasta County
320841	Ordering, Referring, Prescribing	N/A	1124170154	0	0	WINFREY, KATHLEEN A NP	8/14/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	590607	N/A	N/A	N/A	N/A	N/A	6010 HIDDEN VALLEY ROAD	None	CARLSBAD	CA	92011	4213	00	06000	33.12288368	-117.3058276	San Diego County
320865	Ordering, Referring, Prescribing	N/A	1124219720	0	0	WILBORN, AMY L LMFT	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49090	N/A	N/A	N/A	N/A	N/A	500 W FOSTER RD	None	SANTA MARIA	CA	93455	3620	00	06000	34.88351329	-120.4428974	Santa Barbara County
320876	Ordering, Referring, Prescribing	N/A	1124247085	0	0	WAKODE, ARCHANA V	3/1/2005	Taxonomy not applicable	NA	n/a	099	DENTIST	D47205	N/A	N/A	N/A	N/A	N/A	821 JEFFERSON BLVD	STE 260	WEST SACRAMENTO	CA	95691	3205	00	06000	38.57955482	-121.5261617	Yolo County
320879	Ordering, Referring, Prescribing	N/A	1124243472	0	0	WILSON-HEUN, JENNIFER RN MA	6/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	15764	N/A	N/A	N/A	N/A	N/A	414 S JEFFERSON ST	None	NAPA	CA	94559	4515	00	06000	38.28405322	-122.2938729	Napa County
320932	Ordering, Referring, Prescribing	N/A	1124360284	0	0	WILCOX, ERIC F LMFT	1/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103760	N/A	N/A	N/A	N/A	N/A	404 H ST	None	EUREKA	CA	95501	1022	00	06000	40.80282438	-124.164002	Humboldt County
320956	Ordering, Referring, Prescribing	N/A	1124403175	0	0	WILRIDGE, AMBER M LMFT	6/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT115020	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	SUITE 220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
320984	Ordering, Referring, Prescribing	N/A	1124438577	0	0	WILLIAMS, MARCIA K LMFT	3/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT106411	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	210	SANTA ROSA	CA	95407	5478	00	06000	38.425266	-122.749875	Sonoma County
320985	Ordering, Referring, Prescribing	N/A	1124439211	0	0	WATRY, JESSICA L LMFT	4/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125439	N/A	N/A	N/A	N/A	N/A	101 WIKIUP DR	None	SANTA ROSA	CA	95403	1375	00	06000	38.50788547	-122.7587646	Sonoma County
320987	Ordering, Referring, Prescribing	N/A	1124449426	0	0	WILLIAMS, CARMON N LCSW	10/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	111646	N/A	N/A	N/A	N/A	N/A	23638 NEWHALL AVE	STE 6 #424	NEWHALL	CA	91321	4234	00	06000	34.36975599	-118.5130803	Los Angeles County
320988	Ordering, Referring, Prescribing	N/A	1124443122	0	0	WIGGINS, LUKE M MD	8/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A128044	N/A	N/A	N/A	N/A	N/A	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	00	06000	34.06189518	-118.203256	Los Angeles County
321048	Ordering, Referring, Prescribing	N/A	1124543186	0	0	WEST, CRYSTAL A LMFT	3/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125040	N/A	N/A	N/A	N/A	N/A	212 GROVE STREET	J	BISHOP	CA	93514	2620	00	06000	37.36459054	-118.396476	Inyo County
321153	Ordering, Referring, Prescribing	N/A	1124760111	0	0	WONG, SHIRLEY M PHARMD	4/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85989	N/A	N/A	N/A	N/A	N/A	2901 RAILROAD AVE	None	PITTSBURG	CA	94565	5224	00	06000	38.00974746	-121.8920249	Contra Costa County
321157	Ordering, Referring, Prescribing	N/A	1124800214	0	0	WHITEHURST, UNIQUE NP	6/29/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025757	N/A	N/A	N/A	N/A	N/A	4050 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	00	06000	32.5582775	-117.046881	San Diego County
321166	Ordering, Referring, Prescribing	N/A	1124857768	0	0	WANG, HERU NP	7/19/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031236	N/A	N/A	N/A	N/A	N/A	1800 31ST AVE	None	SAN FRANCISCO	CA	94122	4229	00	06000	37.75345413	-122.4892859	San Francisco County
321183	Ordering, Referring, Prescribing	N/A	1134189277	0	0	WOLFINGER, JESSICA L LCSW	6/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW93376	N/A	N/A	N/A	N/A	N/A	2620 26TH AVE	None	OAKLAND	CA	94601	1907	00	06000	37.79088756	-122.2231716	Alameda County
321204	Ordering, Referring, Prescribing	N/A	1134229388	0	0	WEBSTER-LONGIN, MARIA L	6/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A88914	N/A	N/A	N/A	N/A	N/A	3505 LONE TREE WAY	STE 1	ANTIOCH	CA	94509	6067	00	06000	37.98725411	-121.8065036	Contra Costa County
321294	Ordering, Referring, Prescribing	N/A	1134417561	0	0	WILTEY, JESSE LCSW	3/31/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94096	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
321302	Ordering, Referring, Prescribing	N/A	1134422991	0	0	WALTCHER, STEPHEN MD	12/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G88413	N/A	N/A	N/A	N/A	N/A	5858 EMPIRE GRADE	None	SANTA CRUZ	CA	95060	9603	00	06000	37.047681	-122.1069195	Santa Cruz County
321393	Ordering, Referring, Prescribing	N/A	1134580061	0	0	WAN, MICHAEL	2/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	74190	N/A	N/A	N/A	N/A	N/A	520 N LONE HILL AVE	None	SAN DIMAS	CA	91773	1725	00	06000	34.111836	-117.825957	Los Angeles County
321408	Ordering, Referring, Prescribing	N/A	1134598741	0	0	WORDEN, DAVID W LCSW	8/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	95967	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
321421	Ordering, Referring, Prescribing	N/A	1134631211	0	0	WILES, BREANA	9/12/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108432	N/A	N/A	N/A	N/A	N/A	11800 CENTRAL AVE	225	CHINO	CA	91710	7201	00	06000	34.0388092	-117.689654	San Bernardino County
321436	Ordering, Referring, Prescribing	N/A	1134650005	0	0	WONG, VANESSA MD	7/31/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A130899	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
321445	Ordering, Referring, Prescribing	N/A	1134662638	0	0	WRIGHT, SASKIA NP	4/11/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95005528	N/A	N/A	N/A	N/A	N/A	685 MORRO AVE	STE C	MORRO BAY	CA	93442	2233	00	06000	35.364564	-120.8511755	San Luis Obispo County
321484	Ordering, Referring, Prescribing	N/A	1134707680	0	0	WEI, PETER DO	1/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22170	N/A	N/A	N/A	N/A	N/A	264 N HIGHLAND SPRINGS	D	BANNING	CA	92220	3082	00	06000	33.93063	-116.946864	Riverside County
321492	Ordering, Referring, Prescribing	N/A	1134760317	0	0	WOLLER, BRANDI LMFT	8/23/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	134372	N/A	N/A	N/A	N/A	N/A	1145 E CLARK AVE	G	SANTA MARIA	CA	93455	5105	00	06000	34.8650893	-120.4170345	Santa Barbara County
321500	Ordering, Referring, Prescribing	N/A	1134769490	0	0	WALSH, EMILY A LMFT	8/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	141158	N/A	N/A	N/A	N/A	N/A	1016 OUTER RD	None	SAN DIEGO	CA	92154	1351	00	06000	32.57795659	-117.0825179	San Diego County
321504	Ordering, Referring, Prescribing	N/A	1134780208	0	0	WANG, EDWARD PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79468	N/A	N/A	N/A	N/A	N/A	3022 SANTA CLARA AVE	None	EL CERRITO	CA	94530	3468	00	06000	37.90265105	-122.3073393	Contra Costa County
321521	Ordering, Referring, Prescribing	N/A	1134883010	0	0	WALKER, KAREN R PA-C	10/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60284	N/A	N/A	N/A	N/A	N/A	3111 PROFESSIONAL DRIVE	None	AUBURN	CA	95603	2456	00	06000	38.940327	-121.1007585	Placer County
321524	Ordering, Referring, Prescribing	N/A	1134880263	0	0	WASHINGTON, MAYA LMFT	2/3/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152978	N/A	N/A	N/A	N/A	N/A	175 W COURT ST	None	WOODLAND	CA	95695	2913	00	06000	38.67889514	-121.7923678	Yolo County
321525	Ordering, Referring, Prescribing	N/A	1134935653	0	0	WARN, DEANNA	4/3/2024	Taxonomy not applicable	NA	n/a	000	Unknown	4515	N/A	N/A	N/A	N/A	N/A	304 N ACACIA AVE	None	RIPON	CA	95366	2404	00	06000	37.7421049	-121.1284661	San Joaquin County
321547	Ordering, Referring, Prescribing	N/A	1144222084	0	0	WONG, PERRY S	3/22/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D41327	N/A	N/A	N/A	N/A	N/A	730 N I ST	202	MADERA	CA	93637	3077	00	06000	36.96528452	-120.0693616	Madera County
321560	Ordering, Referring, Prescribing	N/A	1144300138	0	0	WONG, RACHEL C PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57259	N/A	N/A	N/A	N/A	N/A	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	00	06000	37.79735353	-121.2443415	San Joaquin County
321679	Ordering, Referring, Prescribing	N/A	1144540113	0	0	WOMACK, WILLIAM D LMFT	2/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109211	N/A	N/A	N/A	N/A	N/A	303 S C ST	None	LOMPOC	CA	93436	7305	00	06000	34.63525845	-120.451628	Santa Barbara County
321704	Ordering, Referring, Prescribing	N/A	1144600958	0	0	WONG, DAISY M PHARMD	10/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	69845	N/A	N/A	N/A	N/A	N/A	543 SWEETWATER RD	None	SPRING VALLEY	CA	91977	0000	00	06000	32.708178	-117.008559	San Diego County
321718	Ordering, Referring, Prescribing	N/A	1144618646	0	0	WALKER, JESSICA M LMFT	7/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133928	N/A	N/A	N/A	N/A	N/A	4441 E KINGS CANYON RD	None	FRESNO	CA	93702	3604	00	06000	36.738144	-119.753361	Fresno County
321723	Ordering, Referring, Prescribing	N/A	1144621236	0	0	WINSLOW II, MARK S	6/13/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D63899	N/A	N/A	N/A	N/A	N/A	4058 WILLOWS RD	None	ALPINE	CA	91901	1668	00	06000	32.836428	-116.7257385	San Diego County
321769	Ordering, Referring, Prescribing	N/A	1144686056	0	0	WEST, JESSICA L NP	12/18/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003153	N/A	N/A	N/A	N/A	N/A	1999 MOWRY AVE	STE 3B	FREMONT	CA	94587	1738	00	06000	37.55783419	-121.9808484	Alameda County
321799	Ordering, Referring, Prescribing	N/A	1144724493	0	0	WEE, BRETT MD	8/10/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174437	N/A	N/A	N/A	N/A	N/A	2210 E ILLINOIS AVE	STE 206	FRESNO	CA	93701	2125	00	06000	36.74500687	-119.7846885	Fresno County
321831	Ordering, Referring, Prescribing	N/A	1144772187	0	0	WU, ALENA PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH75284	N/A	N/A	N/A	N/A	N/A	217 ALMA ST	STE 200	PALO ALTO	CA	94301	1017	00	06000	37.44563438	-122.1673764	Santa Clara County
321834	Ordering, Referring, Prescribing	N/A	1144775461	0	0	WRIGHT, LEAH E LCSW	3/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80806	N/A	N/A	N/A	N/A	N/A	1955 LONG BEACH BLVD	None	LONG BEACH	CA	90806	5501	00	06000	33.79290697	-118.1895017	Los Angeles County
321950	Ordering, Referring, Prescribing	N/A	1154036465	0	0	WALKER, LEONIE LCSW	6/16/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW108575	N/A	N/A	N/A	N/A	N/A	658 E. BRIER DRIVE	SUITE 200	SAN BERNARDINO	CA	92408	0033	00	06000	34.07137738	-117.2702805	San Bernardino County
322009	Ordering, Referring, Prescribing	N/A	1154409969	0	0	WAMMACK, KARIN E MD	2/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G48739	N/A	N/A	N/A	N/A	N/A	826 E MANNING AVE	None	REEDLEY	CA	93654	2232	00	06000	36.60418846	-119.4408009	Fresno County
322032	Ordering, Referring, Prescribing	N/A	1154455780	0	0	WOLFE, SHANNON S LMFT	11/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49341	N/A	N/A	N/A	N/A	N/A	5300 ANGELES VISTA BLVD	None	VIEW PARK	CA	90043	1648	00	06000	33.99473949	-118.34271	Los Angeles County
322066	Ordering, Referring, Prescribing	N/A	1154526168	0	0	WONG, JENNIFER J LMFT	4/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50996	N/A	N/A	N/A	N/A	N/A	126 W 25TH AVE	200	SAN MATEO	CA	94403	2208	00	06000	37.54372082	-122.3074883	San Mateo County
322149	Ordering, Referring, Prescribing	N/A	1154685998	0	0	WEINSTEIN, REANNIN LCSW	1/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	77206	N/A	N/A	N/A	N/A	N/A	25910 ACERO	160	MISSION VIEJO	CA	92691	2790	00	06000	33.61712389	-117.6780482	Orange County
322191	Ordering, Referring, Prescribing	N/A	1154748689	0	0	WINGFIELD, SHANELL LMFT	1/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117425	N/A	N/A	N/A	N/A	N/A	209 E 7TH ST	None	MADERA	CA	93638	3780	00	06000	36.96069768	-120.0559841	Madera County
322227	Ordering, Referring, Prescribing	N/A	1154816387	0	0	WOHLFEILER, ELEANOR R LMFT	10/18/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128735	N/A	N/A	N/A	N/A	N/A	1450 CIVIC CT	200	CONCORD	CA	94520	7955	00	06000	37.9718675	-122.0496338	Contra Costa County
322233	Ordering, Referring, Prescribing	N/A	1154829042	0	0	WIRTH, JUSTIN A LMFT	12/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT123498	N/A	N/A	N/A	N/A	N/A	290 IOOF DR.	None	GILROY	CA	95020	5204	00	06000	37.01377513	-121.5685719	Santa Clara County
322282	Ordering, Referring, Prescribing	N/A	1154896785	0	0	WONG, JAKE LCSW	12/26/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106350	N/A	N/A	N/A	N/A	N/A	8775 AERO DR	APT 132	SAN DIEGO	CA	92123	1792	00	06000	32.80965551	-117.1391563	San Diego County
322313	Ordering, Referring, Prescribing	N/A	1154959781	0	0	WEE, CINDY CNM	7/1/2020	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236125	N/A	N/A	N/A	N/A	N/A	518 GARDEN ST	None	SANTA BARBARA	CA	93101	0101	00	06000	34.42054634	-119.6928135	Santa Barbara County
322332	Ordering, Referring, Prescribing	N/A	1164004842	0	0	WIGGIN, JAMIE	10/12/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL7725	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
322343	Ordering, Referring, Prescribing	N/A	1164030573	0	0	WONG, ISABELLE B PHARMD	9/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85314	N/A	N/A	N/A	N/A	N/A	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23948065	-121.8005798	Santa Clara County
322346	Ordering, Referring, Prescribing	N/A	1154981041	0	0	WANG, AARON S MD DO	5/19/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178833	N/A	N/A	N/A	N/A	N/A	6043 HOLLYWOOD BLVD	LOS ANGELES CA 90028	LOS ANGELES	CA	90048	3401	00	06000	34.1016835	-118.321569	Los Angeles County
322383	Ordering, Referring, Prescribing	N/A	1164085593	0	0	WOODY-GODSAVE, LINDA A NP	5/1/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95011321	N/A	N/A	N/A	N/A	N/A	2336 SANTA MONICA BLVD	304	SANTA MONICA	CA	90404	2067	00	06000	34.03136627	-118.4766854	Los Angeles County
322573	Ordering, Referring, Prescribing	N/A	1164750816	0	0	WILLIAMS, TINA A LMFT	8/29/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135280	N/A	N/A	N/A	N/A	N/A	6711 ARLINGTON AVE	None	RIVERSIDE	CA	92504	1955	00	06000	33.9459035	-117.442989	Riverside County
322574	Ordering, Referring, Prescribing	N/A	1164742714	0	0	WIDERA - YOCAM, RENEE E DO	1/7/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A8350	N/A	N/A	N/A	N/A	N/A	1530 W 17TH ST	JSC 110	SANTA ANA	CA	92706	3398	00	06000	33.757794	-117.888822	Orange County
322578	Ordering, Referring, Prescribing	N/A	1164751392	0	0	WIELAND, JESSICA N LPCC	3/12/2020	Taxonomy not applicable	NA	n/a	000	Unknown	173	N/A	N/A	N/A	N/A	N/A	1212 N. CALIFORNIA ST	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
322610	Ordering, Referring, Prescribing	N/A	1164810487	0	0	WILSON, GERALDINE T LMFT	12/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108134	N/A	N/A	N/A	N/A	N/A	2101 COURAGE DR	MS 10-270	FAIRFIELD	CA	94533	6717	00	06000	38.23737478	-122.0676832	Solano County
322617	Ordering, Referring, Prescribing	N/A	1164823100	0	0	WEISS, KAYLA LCSW	7/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	89980	N/A	N/A	N/A	N/A	N/A	21507 E CLIFF DR	None	SANTA CRUZ	CA	95062	4844	00	06000	36.96330203	-121.9900666	Santa Cruz County
322631	Ordering, Referring, Prescribing	N/A	1164841532	0	0	WANG, DAVID C MD	5/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149014	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	CARSON	CA	90810	1408	00	06000	33.83174719	-118.2070628	Los Angeles County
322738	Ordering, Referring, Prescribing	N/A	1174024277	0	0	WURTZ, MEGAN LCSW	11/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88536	N/A	N/A	N/A	N/A	N/A	2313 I ST	None	EUREKA	CA	95501	4244	00	06000	40.78679534	-124.1601037	Humboldt County
322762	Ordering, Referring, Prescribing	N/A	1174073738	0	0	WRIGHT, ZACHARY D PHARMD	9/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75008	N/A	N/A	N/A	N/A	N/A	880 SUTTON WAY	None	GRASS VALLEY	CA	95945	5167	00	06000	39.23520763	-121.0340543	Nevada County
322766	Ordering, Referring, Prescribing	N/A	1174072060	0	0	WOLFE, LISA LCSW	12/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99118	N/A	N/A	N/A	N/A	N/A	1722 S LEWIS RD	None	CAMARILLO	CA	93012	8520	00	06000	34.18921316	-119.0340743	Ventura County
322799	Ordering, Referring, Prescribing	N/A	1174137160	0	0	WESTERLAND, MARISSA N MD	9/21/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A191052	N/A	N/A	N/A	N/A	N/A	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
322867	Ordering, Referring, Prescribing	N/A	1174385108	0	0	WOODSON, MACI NP	2/22/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029202	N/A	N/A	N/A	N/A	N/A	1530 S. OLIVE ST.	None	LOS ANGELES	CA	90015	3023	00	06000	34.03542552	-118.2652073	Los Angeles County
322925	Ordering, Referring, Prescribing	N/A	1174689657	0	0	WHITE, NATALIE P	9/30/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38145	N/A	N/A	N/A	N/A	N/A	3225 CORINTH AVENUE	None	LOS ANGELES	CA	90066	1310	00	06000	34.02241707	-118.4298301	Los Angeles County
322955	Ordering, Referring, Prescribing	N/A	1174743520	0	0	WILLIAMS, MAUREEN A LCSW	1/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS20132	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
322959	Ordering, Referring, Prescribing	N/A	1174730782	0	0	WOODARD, VALERIE L PA-C	3/27/2018	Taxonomy not applicable	NA	n/a	000	Unknown	15580	N/A	N/A	N/A	N/A	N/A	130 W ROUTE 66	SUITE 100	GLENDORA	CA	91740	6249	00	06000	34.12865951	-117.8651745	Los Angeles County
322985	Ordering, Referring, Prescribing	N/A	1174804579	0	0	WILLIAMS, RACHEL LMFT	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT92774	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
322989	Ordering, Referring, Prescribing	N/A	1174808703	0	0	WISE, STERLING PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	37408	N/A	N/A	N/A	N/A	N/A	937 NORTH H ST	None	LOMPOC	CA	93436	4148	00	06000	34.65297442	-120.4577595	Santa Barbara County
322993	Ordering, Referring, Prescribing	N/A	1174817837	0	0	WAT, HUYNH PHARMD	6/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62497	N/A	N/A	N/A	N/A	N/A	12751 HARBOR BLVD	None	GARDEN GROVE	CA	92840	5800	00	06000	33.77746612	-117.9151381	Orange County
323019	Ordering, Referring, Prescribing	N/A	1174870018	0	0	WONG, MAPLE PHARMD	10/9/2018	Taxonomy not applicable	NA	n/a	000	Unknown	CA67004	N/A	N/A	N/A	N/A	N/A	15549 UNION AVE	None	LOS GATOS	CA	95032	0000	00	06000	37.24258308	-121.9312446	Santa Clara County
323045	Ordering, Referring, Prescribing	N/A	1174895635	0	0	WADLOW, REBECCA L	7/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57776	N/A	N/A	N/A	N/A	N/A	828 NEWVILLE RD	None	ORLAND	CA	95963	1109	00	06000	39.74883854	-122.2008838	Glenn County
323052	Ordering, Referring, Prescribing	N/A	1174892863	0	0	WEY, THAIN HO PHARMD	3/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	66369	N/A	N/A	N/A	N/A	N/A	3900 BROAD ST	12	SAN LUIS OBISPO	CA	93401	7015	00	06000	35.24966646	-120.643747	San Luis Obispo County
323054	Ordering, Referring, Prescribing	N/A	1174907539	0	0	WHELAN, JENNIFER L LMFT	5/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT108032	N/A	N/A	N/A	N/A	N/A	840 COLUSA AVE	None	BERKELEY	CA	94707	1858	00	06000	37.89247299	-122.2801315	Alameda County
323062	Ordering, Referring, Prescribing	N/A	1174912331	0	0	WEEKES, JHAMILLIA E NP	2/11/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	811698	N/A	N/A	N/A	N/A	N/A	1328 SOUTH MISSION ROAD	None	FALLBROOK	CA	92028	4006	00	06000	33.36868654	-117.2507699	San Diego County
323075	Ordering, Referring, Prescribing	N/A	1174933865	0	0	WEBBER, JEFFREY A LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	107820	N/A	N/A	N/A	N/A	N/A	303 E VANDERBILT WAY	None	SAN BERNARDINO	CA	92415	0026	00	06000	34.06872265	-117.2775832	San Bernardino County
323087	Ordering, Referring, Prescribing	N/A	1174947865	0	0	WENG, ELYSE Y	6/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68079	N/A	N/A	N/A	N/A	N/A	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
323113	Ordering, Referring, Prescribing	N/A	1174982813	0	0	WILKINSON, ANDREEA D LMFT	2/20/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124442	N/A	N/A	N/A	N/A	N/A	2440 TULARE ST	STE. 200	FRESNO	CA	93721	2281	00	06000	36.73727495	-119.7852493	Fresno County
323147	Ordering, Referring, Prescribing	N/A	1184026734	0	0	WILLIAMS, ERIC NP	9/8/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001141	N/A	N/A	N/A	N/A	N/A	6551 VAN NUYS BLVD	201	VAN NUYS	CA	91401	1566	00	06000	34.189902	-118.448758	Los Angeles County
323155	Ordering, Referring, Prescribing	N/A	1184033821	0	0	WALKER, SARAH E DDS	10/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DDS63826	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
323161	Ordering, Referring, Prescribing	N/A	1184040230	0	0	WITHROW, BILLIE J LMFT	1/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	29930	N/A	N/A	N/A	N/A	N/A	3839 SILVERA RANCH DRIVE	None	DUBLIN	CA	94568	3760	00	06000	37.73138041	-121.8694717	Alameda County
323164	Ordering, Referring, Prescribing	N/A	1184042731	0	0	WATKINS, BRITTANY R LMFT	1/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96175	N/A	N/A	N/A	N/A	N/A	50 E FOOTHILL BLVD	3RD FLOOR	ARCADIA	CA	91006	2314	00	06000	34.15096965	-118.0295442	Los Angeles County
323184	Ordering, Referring, Prescribing	N/A	1184065930	0	0	WALL, JESSICA L MD	1/30/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145258	N/A	N/A	N/A	N/A	N/A	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	00	06000	38.57535	-121.407633	Sacramento County
323214	Ordering, Referring, Prescribing	N/A	1184102014	0	0	WILLIAMS, CHRISTINA K LMFT	6/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112942	N/A	N/A	N/A	N/A	N/A	370 W. CRENSHAW BLVD	E-100	TORRANCE	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles County
323256	Ordering, Referring, Prescribing	N/A	1184169757	0	0	WONG, STEPHANIE J PHARMD	8/13/2019	Taxonomy not applicable	NA	n/a	000	Unknown	75929	N/A	N/A	N/A	N/A	N/A	2424 MISSION STREET	None	SAN FRANCISCO	CA	94110	2415	00	06000	37.75816928	-122.4190376	San Francisco County
323296	Ordering, Referring, Prescribing	N/A	1184252280	0	0	WHITING, WHITNEY E DO	11/21/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22297	N/A	N/A	N/A	N/A	N/A	2509 PICO BLVD	None	SANTA MONICA	CA	90405	1828	00	06000	34.02287459	-118.4631175	Los Angeles County
323343	Ordering, Referring, Prescribing	N/A	1184357188	0	0	WILSON, GABRIELLA M	7/5/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021553	N/A	N/A	N/A	N/A	N/A	6095 N 1ST ST	None	FRESNO	CA	93710	5444	00	06000	36.82524765	-119.7723922	Fresno County
323376	Ordering, Referring, Prescribing	N/A	1184652695	0	0	WATERS, TIFFANY PA-C	2/10/2024	Taxonomy not applicable	NA	n/a	000	Unknown	17246	N/A	N/A	N/A	N/A	N/A	193 FAIRVIEW LN	None	SONORA	CA	95370	4828	00	06000	37.97880957	-120.3912459	Tuolumne County
323400	Ordering, Referring, Prescribing	N/A	1184735201	0	0	WITCZAK, IZABELA MD	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A71311	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
323411	Ordering, Referring, Prescribing	N/A	1184751612	0	0	WONG, DENISE L PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59556	N/A	N/A	N/A	N/A	N/A	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	00	06000	37.66312028	-122.4631592	San Mateo County
323432	Ordering, Referring, Prescribing	N/A	1184771206	0	0	WONG, ANNE LCSW	2/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	15035	N/A	N/A	N/A	N/A	N/A	9353 E. VALLEY BLVD	None	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
323488	Ordering, Referring, Prescribing	N/A	1184900060	0	0	WONG, RONALD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54634	N/A	N/A	N/A	N/A	N/A	2120 POLK ST	None	SAN FRANCISCO	CA	94109	2507	00	06000	37.79633377	-122.4218183	San Francisco County
323495	Ordering, Referring, Prescribing	N/A	1184906067	0	0	WU, JESSICA Z	7/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58462	N/A	N/A	N/A	N/A	N/A	459 POWELL STREET	None	SAN FRANCISCO	CA	94102	1503	00	06000	37.78902921	-122.4085938	San Francisco County
323510	Ordering, Referring, Prescribing	N/A	1184931263	0	0	WOO, PHYLLIS D NP	11/14/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005265	N/A	N/A	N/A	N/A	N/A	1530 HILLHURST AVENUE	None	LOS ANGELES	CA	90027	5516	00	06000	34.098921	-118.287374	Los Angeles County
323511	Ordering, Referring, Prescribing	N/A	1184926909	0	0	WEST, LACEY LMFT	11/27/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129482	N/A	N/A	N/A	N/A	N/A	707 14TH ST	None	MODESTO	CA	95354	2506	00	06000	37.64072107	-120.9933527	Stanislaus County
323529	Ordering, Referring, Prescribing	N/A	1184959868	0	0	WRIGHT, LOVELY L LCSW	5/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80320	N/A	N/A	N/A	N/A	N/A	3730 HOPYARD RD	103	PLEASANTON	CA	94588	8562	00	06000	37.68061724	-121.9038915	Alameda County
323532	Ordering, Referring, Prescribing	N/A	1184941098	0	0	WARREN, GIANNA A PA	11/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	20940	N/A	N/A	N/A	N/A	N/A	7821 S. AVALON AVE	None	LOS ANGELES	CA	90003	2358	00	06000	33.969393	-118.265197	Los Angeles County
323565	Ordering, Referring, Prescribing	N/A	1194016139	0	0	WILLIAMS, DOLORES L LCSW	5/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26155	N/A	N/A	N/A	N/A	N/A	24301 SOUTHLAND AVE	None	HAYWARD	CA	94545	0000	00	06000	37.65344508	-122.1045736	Alameda County
323577	Ordering, Referring, Prescribing	N/A	1194037481	0	0	WONG, ANNA CNP	12/14/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	19899	N/A	N/A	N/A	N/A	N/A	709 N HILL ST	18	LOS ANGELES	CA	90012	2361	00	06000	34.06103994	-118.2404034	Los Angeles County
323605	Ordering, Referring, Prescribing	N/A	1194104372	0	0	WRIGHT, XKIZIN LMFT	12/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT123370	N/A	N/A	N/A	N/A	N/A	3125 MYERS ST	None	RIVERSIDE	CA	92503	5527	00	06000	33.90932558	-117.4428095	Riverside County
323654	Ordering, Referring, Prescribing	N/A	1194185942	0	0	WANG, HELEN	3/15/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH71320	N/A	N/A	N/A	N/A	N/A	4145 30TH ST	None	SAN DIEGO	CA	92104	1905	00	06000	32.753079	-117.130173	San Diego County
323664	Ordering, Referring, Prescribing	N/A	1194206177	0	0	WAASDORP, SUSAN LCSW	9/4/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20164	N/A	N/A	N/A	N/A	N/A	390 N. EUCLID AVE.	None	UPLAND	CA	91786	4763	00	06000	34.09818429	-117.6509833	San Bernardino County
323682	Ordering, Referring, Prescribing	N/A	1194234104	0	0	WADE, JONIE K NP	9/16/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007429	N/A	N/A	N/A	N/A	N/A	1441 LIBERTY ST	None	REDDING	CA	96001	0811	00	06000	40.5857177	-122.3870781	Shasta County
323699	Ordering, Referring, Prescribing	N/A	1194254169	0	0	WEISENBORN, GLORIA S LMFT	9/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT121596	N/A	N/A	N/A	N/A	N/A	1750 W WALNUT AVE	STE B	VISALIA	CA	93277	6233	00	06000	36.313335	-119.3114205	Tulare County
323710	Ordering, Referring, Prescribing	N/A	1194261032	0	0	WAGNER, REBECCA LMFT	5/27/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126197	N/A	N/A	N/A	N/A	N/A	3300 GLENWOOD ST	None	EUREKA	CA	95501	3463	00	06000	40.78641759	-124.1310057	Humboldt County
323790	Ordering, Referring, Prescribing	N/A	1194590125	0	0	WAARBROEK, JAMIE FAUVE TANGLAO NP	12/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028447	N/A	N/A	N/A	N/A	N/A	3580 WILSHIRE BLVD	None	LOS ANGELES	CA	90010	2501	00	06000	34.06170677	-118.302787	Los Angeles County
323819	Ordering, Referring, Prescribing	N/A	1194812149	0	0	WALTON, TERESA A LMFT	8/2/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT32930	N/A	N/A	N/A	N/A	N/A	861 AUTO CENTER DRIVE	SUITE D	PALMDALE	CA	93551	4493	00	06000	34.59142164	-118.14665	Los Angeles County
323825	Ordering, Referring, Prescribing	N/A	1194842625	0	0	WHYTE, ROGELIO L MD	1/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C39717	N/A	N/A	N/A	N/A	N/A	10155 COLIMA ROAD	None	WHITTIER	CA	90603	2042	00	06000	33.94349601	-118.0106968	Los Angeles County
323852	Ordering, Referring, Prescribing	N/A	1194867192	0	0	WILLIAMS, MELODY LMFT	7/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140362	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S STE	STE 201	SAN DIEGO	CA	92108	3505	00	06000	32.76094819	-117.1611994	San Diego County
323882	Ordering, Referring, Prescribing	N/A	1194923839	0	0	WALKER, JASON E DC	12/12/2017	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	28549	N/A	N/A	N/A	N/A	N/A	121 BARBOZA ST	None	MENDOTA	CA	93640	1901	00	06000	36.76619136	-120.3839072	Fresno County
323895	Ordering, Referring, Prescribing	N/A	1194964189	0	0	WAN, INNESS M PHARMD	3/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	49291	N/A	N/A	N/A	N/A	N/A	13463 WASHINGTON BLVD	None	MARINA DEL REY	CA	90292	5658	00	06000	33.993054	-118.4472405	Los Angeles County
324030	Ordering, Referring, Prescribing	N/A	1205237682	0	0	WAN, LIN PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71340	N/A	N/A	N/A	N/A	N/A	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	00	06000	37.70755227	-121.7149933	Alameda County
324032	Ordering, Referring, Prescribing	N/A	1205241148	0	0	WILDER, INGA D MD	8/17/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A138883	N/A	N/A	N/A	N/A	N/A	21138 PASO ROBLES HWY	None	LOST HILLS	CA	93249	0306	00	06000	35.6161173	-119.695251	Kern County
324058	Ordering, Referring, Prescribing	N/A	1205285079	0	0	WU, JANE	11/20/2017	Taxonomy not applicable	NA	n/a	000	Unknown	53482	N/A	N/A	N/A	N/A	N/A	901 W ORANGETHORPE AVE	None	FULLERTON	CA	92832	2826	00	06000	33.85940147	-117.939735	Orange County
324065	Ordering, Referring, Prescribing	N/A	1205295243	0	0	WATERS, JAMES A MD	4/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A138367	N/A	N/A	N/A	N/A	N/A	544 N GLENDALE AVE	None	GLENDALE	CA	91206	3301	00	06000	34.15454904	-118.2429872	Los Angeles County
324070	Ordering, Referring, Prescribing	N/A	1205308590	0	0	WOLAK, KRYSTEN N CCC-SLP	9/23/2022	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	34120	N/A	N/A	N/A	N/A	N/A	3907 ROSEMEAD BLVD	220	ROSEMEAD	CA	91770	0001	00	06000	34.07877813	-118.0732428	Los Angeles County
324081	Ordering, Referring, Prescribing	N/A	1205311438	0	0	WALKOWIAK, TIFFANI N RN	10/30/2017	Taxonomy not applicable	NA	n/a	000	Unknown	834109	N/A	N/A	N/A	N/A	N/A	1001 W MAIN ST	None	VISALIA	CA	93291	5919	00	06000	36.329787	-119.302173	Tulare County
324100	Ordering, Referring, Prescribing	N/A	1205340999	0	0	WANG, XIYUE LMFT	1/12/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT130596	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	300	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
324116	Ordering, Referring, Prescribing	N/A	1205367232	0	0	WAGREICH, ERIC MD	1/24/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A161162	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	BUILDING 2	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
324123	Ordering, Referring, Prescribing	N/A	1205371002	0	0	WATSON, MOLLY K LCSW	10/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW98145	N/A	N/A	N/A	N/A	N/A	720 NINTH ST	None	RAMONA	CA	92065	2348	00	06000	33.0389069	-116.8638919	San Diego County
324131	Ordering, Referring, Prescribing	N/A	1205381787	0	0	WALLACE, DIERDRE LMFT	8/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121224	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVE	None	OAKLAND	CA	94602	2534	00	06000	37.8007257	-122.2064578	Alameda County
324164	Ordering, Referring, Prescribing	N/A	1205457157	0	0	WONG, VIVIAN W PHARMD	7/29/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81333	N/A	N/A	N/A	N/A	N/A	101 THE CITY DRIVE S	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
324253	Ordering, Referring, Prescribing	N/A	1205951571	0	0	WILLIAMS, LAURIE M LMFT	11/24/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT40275	N/A	N/A	N/A	N/A	N/A	20101 HAMILTON AVENUE	160	TORRANCE	CA	90502	0000	00	06000	33.84828383	-118.2860386	Los Angeles County
324280	Ordering, Referring, Prescribing	N/A	1215004312	0	0	WONG-SASAKI, AMY PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH49207	N/A	N/A	N/A	N/A	N/A	25825 S. VERMONT AVE	None	HARBOR CITY	CA	90710	0000	00	06000	33.7892965	-118.2937327	Los Angeles County
324287	Ordering, Referring, Prescribing	N/A	1215011432	0	0	WORLEY, JEFFERY M PHARMD	3/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49263	N/A	N/A	N/A	N/A	N/A	1840 SHAW AVE	STE 105 -141	CLOVIS	CA	93611	4078	00	06000	36.80847947	-119.680011	Fresno County
324330	Ordering, Referring, Prescribing	N/A	1215095369	0	0	WIEBE-REBOIN, SARAH T LMFT	5/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT43185	N/A	N/A	N/A	N/A	N/A	4825 KENNETH AVE	None	CARMICHAEL	CA	95608	4607	00	06000	38.614122	-121.3519545	Sacramento County
324335	Ordering, Referring, Prescribing	N/A	1215098595	0	0	WONG, RICHIE P PSYD	11/16/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23687	N/A	N/A	N/A	N/A	N/A	19231 VICTORY BLVD	SUITE 110	RESEDA	CA	91335	6300	00	06000	34.18659852	-118.552221	Los Angeles County
324338	Ordering, Referring, Prescribing	N/A	1215106448	0	0	WONG, KELLY T MD DO	7/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A10595	N/A	N/A	N/A	N/A	N/A	711 W COLLEGE ST	208	LOS ANGELES	CA	90012	1163	00	06000	34.06541412	-118.2414102	Los Angeles County
324347	Ordering, Referring, Prescribing	N/A	1215118997	0	0	WARNER, THOMAS A JR	4/23/2017	Taxonomy not applicable	NA	n/a	000	Unknown	19494	N/A	N/A	N/A	N/A	N/A	250 WEST 5TH ST	None	HANFORD	CA	93230	5029	00	06000	36.32439821	-119.6472235	Kings County
324422	Ordering, Referring, Prescribing	N/A	1215253224	0	0	WHITED, MICHAEL M NP	11/3/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005776	N/A	N/A	N/A	N/A	N/A	522 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	2102	00	06000	34.0436196	-118.2442541	Los Angeles County
324445	Ordering, Referring, Prescribing	N/A	1215303458	0	0	WUSSTIG, ANGALINE M PHARMD	6/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69944	N/A	N/A	N/A	N/A	N/A	3955 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	5208	00	06000	38.714409	-120.839742	El Dorado County
324447	Ordering, Referring, Prescribing	N/A	1215302344	0	0	WISE-AGUILAR, NATALIE PT	9/1/2020	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	22196	N/A	N/A	N/A	N/A	N/A	909 S. FAIR OAKS AVE.	None	PASADENA	CA	91105	2625	00	06000	34.13056002	-118.1503751	Los Angeles County
324448	Ordering, Referring, Prescribing	N/A	1215309711	0	0	WILLIAMS, MICHELE T LMFT	3/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138504	N/A	N/A	N/A	N/A	N/A	50 DOUGLAS DR	391	MARTINEZ	CA	94553	4098	00	06000	37.99347206	-122.1247162	Contra Costa County
324462	Ordering, Referring, Prescribing	N/A	1215326103	0	0	WHITE, JAMES E NP	9/29/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001557	N/A	N/A	N/A	N/A	N/A	11980 MOUNT VERNON AVENU	None	GRAND TERRACE	CA	92313	5172	00	06000	34.036353	-117.3136565	San Bernardino County
324477	Ordering, Referring, Prescribing	N/A	1215353842	0	0	WONG-AGEE, CAMEO LMFT	3/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT95953	N/A	N/A	N/A	N/A	N/A	1309 EVANS AVE	SUITE A/B	SAN FRANCISCO	CA	94124	1705	00	06000	37.74005234	-122.3834106	San Francisco County
324542	Ordering, Referring, Prescribing	N/A	1215466933	0	0	WEBER, FRANCISCA M LCSW	12/1/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112362	N/A	N/A	N/A	N/A	N/A	4525 W ADAMS BLVD	None	LOS ANGELES	CA	90016	3021	00	06000	34.03261147	-118.3388535	Los Angeles County
324545	Ordering, Referring, Prescribing	N/A	1215465018	0	0	WILBURG, BRIGITTE PHD	3/2/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29167	N/A	N/A	N/A	N/A	N/A	200 S WELLS ROAD	250	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
324550	Ordering, Referring, Prescribing	N/A	1215473822	0	0	WOO, KYONG HA PHARMD	6/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	78495	N/A	N/A	N/A	N/A	N/A	5918 STONERIDGE MALL RD	None	PLEASANTON	CA	94588	3229	00	06000	37.696693	-121.9317572	Alameda County
324616	Ordering, Referring, Prescribing	N/A	1215601356	0	0	WONG, HELEN W PHARMD	8/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84667	N/A	N/A	N/A	N/A	N/A	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	00	06000	34.06477215	-117.9845382	Los Angeles County
324627	Ordering, Referring, Prescribing	N/A	1215629407	0	0	WRIGHT, HIEDI M NP	3/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024569	N/A	N/A	N/A	N/A	N/A	550 E. WASHINGTON BLVD	100	CRESCENT CITY	CA	95531	8342	00	06000	41.77274546	-124.19892	Del Norte County
324650	Ordering, Referring, Prescribing	N/A	1215765995	0	0	WILSON, ANTINIQUE NP	8/23/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025241	N/A	N/A	N/A	N/A	N/A	1104 BUCHANAN RD	C10	ANTIOCH	CA	94509	4205	00	06000	37.99867244	-121.823243	Contra Costa County
324662	Ordering, Referring, Prescribing	N/A	1215932207	0	0	WARMOTH, MICHAEL R MD	4/12/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C144504	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
324674	Ordering, Referring, Prescribing	N/A	1225019557	0	0	WATKINS, ELAINE J DO MD	8/17/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6234	N/A	N/A	N/A	N/A	N/A	1075 CAMINO DEL RIO S	None	SAN DIEGO	CA	92108	3538	00	06000	32.76444721	-117.1537188	San Diego County
324682	Ordering, Referring, Prescribing	N/A	1225056856	0	0	WU, MICHAEL H DMD MSD	10/14/2020	Taxonomy not applicable	NA	n/a	000	Unknown	53502	N/A	N/A	N/A	N/A	N/A	302 NORTHGATE DRIVE	None	MANTECA	CA	95336	3139	00	06000	37.81902087	-121.2206405	San Joaquin County
324686	Ordering, Referring, Prescribing	N/A	1225095532	0	0	WACHTEL, KAREN B LMFT	1/12/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130601	N/A	N/A	N/A	N/A	N/A	1620 SANTA CLARA DR	100	ROSEVILLE	CA	95661	3558	00	06000	38.74243973	-121.2620867	Placer County
324713	Ordering, Referring, Prescribing	N/A	1225155567	0	0	WHIPPLE, HANNAH L NP	3/28/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95029626	N/A	N/A	N/A	N/A	N/A	251 LANDIS AVENUE	None	CHULA VISTA	CA	91910	2628	00	06000	32.6425313	-117.0814859	San Diego County
324742	Ordering, Referring, Prescribing	N/A	1225193667	0	0	WILLIAMS, ROBERT B MD	5/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A92069	N/A	N/A	N/A	N/A	N/A	4434 MISSION STREET	None	SAN FRANCISCO	CA	94112	1927	00	06000	37.72675413	-122.4332747	San Francisco County
324797	Ordering, Referring, Prescribing	N/A	1225315088	0	0	WONG, ANTHONY K PHARMD	9/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH57003	N/A	N/A	N/A	N/A	N/A	1591 GEER RD	None	TURLOCK	CA	95380	3200	00	06000	37.506834	-120.848997	Stanislaus County
324799	Ordering, Referring, Prescribing	N/A	1225315807	0	0	WONG, JEFFREY G PHARMD	8/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH45485	N/A	N/A	N/A	N/A	N/A	2376 E COLORADO BLVD	None	PASADENA	CA	91107	4249	00	06000	34.1460495	-118.1013165	Los Angeles County
324825	Ordering, Referring, Prescribing	N/A	1225356561	0	0	WONG, KIMBERLY M LMFT	2/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT48058	N/A	N/A	N/A	N/A	N/A	12970 3RD ST	None	CHINO	CA	91710	3464	00	06000	34.01815857	-117.695635	San Bernardino County
324832	Ordering, Referring, Prescribing	N/A	1225385271	0	0	WILLIG, RINA CCC-SLP	9/25/2022	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	24394	N/A	N/A	N/A	N/A	N/A	2240 OLD RIVER RD	None	UKIAH	CA	95482	7074	00	06000	39.1293897	-123.1645436	Mendocino County
324854	Ordering, Referring, Prescribing	N/A	1225405368	0	0	WILLIAMS, BREEA LMFT	12/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114597	N/A	N/A	N/A	N/A	N/A	11601 S. WESTERN AVE.	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
324871	Ordering, Referring, Prescribing	N/A	1225442585	0	0	WONG, CHRISTINA J PHARMD	2/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69583	N/A	N/A	N/A	N/A	N/A	200 MUIR RD	None	MARTINEZ	CA	94553	4614	00	06000	37.99430233	-122.1107194	Contra Costa County
324913	Ordering, Referring, Prescribing	N/A	1225505480	0	0	WILLIAMS, MARGARET M	12/8/2017	Taxonomy not applicable	NA	n/a	000	Unknown	3149	N/A	N/A	N/A	N/A	N/A	255 PICO AVE	SUITE 250	SAN MARCOS	CA	92069	3712	00	06000	33.1421054	-117.1656188	San Diego County
324927	Ordering, Referring, Prescribing	N/A	1225516370	0	0	WILLIAMSON, JENNIFER N LMFT	4/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113254	N/A	N/A	N/A	N/A	N/A	3717 MT PINOS WAY	C AND D	FRAZIER PARK	CA	93225	0000	00	06000	34.82273575	-118.9474749	Kern County
324933	Ordering, Referring, Prescribing	N/A	1225523020	0	0	WADHWANI, RAVINA LPCC	4/24/2024	Taxonomy not applicable	NA	n/a	000	Unknown	16404	N/A	N/A	N/A	N/A	N/A	222 W 6TH ST	230	SAN PEDRO	CA	90731	3332	00	06000	33.73876969	-118.2824628	Los Angeles County
324965	Ordering, Referring, Prescribing	N/A	1225561939	0	0	WILLIAMSON, TYLER R MD	4/20/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177935	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK ROAD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
325041	Ordering, Referring, Prescribing	N/A	1225782352	0	0	WILSON, JENIFER LMFT	10/28/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT117107	N/A	N/A	N/A	N/A	N/A	5000 BECHELLI LANE	SUITE 103	REDDING	CA	96002	3553	00	06000	40.53859067	-122.354796	Shasta County
325043	Ordering, Referring, Prescribing	N/A	1225778608	0	0	WANG, ALEX MD	7/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A188114	N/A	N/A	N/A	N/A	N/A	22471 ASPAN ST	SUITE 103	LAKE FOREST	CA	92630	1642	00	06000	33.63624985	-117.7119697	Orange County
325050	Ordering, Referring, Prescribing	N/A	1225888357	0	0	WANG, MICHAEL	8/9/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL15325	N/A	N/A	N/A	N/A	N/A	2051 MARENGO ST	None	LOS ANGELES	CA	90033	1352	00	06000	34.05627579	-118.2064774	Los Angeles County
325092	Ordering, Referring, Prescribing	N/A	1235258500	0	0	WHEAT, BRIANA L LMSW	4/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	62409	N/A	N/A	N/A	N/A	N/A	1801 PARK COURT PL	None	SANTA ANA	CA	92701	5002	00	06000	33.74986153	-117.8429355	Orange County
325100	Ordering, Referring, Prescribing	N/A	1235269820	0	0	WILLIAMS, AZITA M	5/9/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53849	N/A	N/A	N/A	N/A	N/A	182 E. WALNUT AVE.	None	RIALTO	CA	92376	3530	00	06000	34.12866149	-117.3689595	San Bernardino County
325167	Ordering, Referring, Prescribing	N/A	1235406216	0	0	WU, WENDY PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52886	N/A	N/A	N/A	N/A	N/A	18308 E COLIMA RD	None	ROWLAND HTS	CA	91748	2761	00	06000	33.9883111	-117.9052922	Los Angeles County
325181	Ordering, Referring, Prescribing	N/A	1235417445	0	0	WONG, MELISSA PHARMD	5/10/2018	Taxonomy not applicable	NA	n/a	000	Unknown	50402	N/A	N/A	N/A	N/A	N/A	8938 TRAUTWEIN RD	None	RIVERSIDE	CA	92508	9401	00	06000	33.88993729	-117.3244363	Riverside County
325182	Ordering, Referring, Prescribing	N/A	1235417874	0	0	WU, DAFNA	1/10/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP20293	N/A	N/A	N/A	N/A	N/A	134 GOLDEN GATE AVE	None	SAN FRANCISCO	CA	94102	3810	00	06000	37.78204768	-122.4129337	San Francisco County
325186	Ordering, Referring, Prescribing	N/A	1235430596	0	0	WILLIAMS, FREDDIE E LMFT	11/5/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT106687	N/A	N/A	N/A	N/A	N/A	20151 NORDHOFF ST	None	CHATSWORTH	CA	91311	6215	00	06000	34.23182352	-118.572948	Los Angeles County
325191	Ordering, Referring, Prescribing	N/A	1235434895	0	0	WANJAU, LYDIAH K LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103312	N/A	N/A	N/A	N/A	N/A	1330 W RAMSEY ST	None	BANNING	CA	92220	4477	00	06000	33.92538854	-116.8912035	Riverside County
325217	Ordering, Referring, Prescribing	N/A	1235484155	0	0	WRIGHT, JACLYN LCSW	10/31/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	111650	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
325279	Ordering, Referring, Prescribing	N/A	1235577255	0	0	WONG, JORDAN PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66934	N/A	N/A	N/A	N/A	N/A	4131 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3101	00	06000	37.78096053	-122.4637512	San Francisco County
325315	Ordering, Referring, Prescribing	N/A	1235631672	0	0	WELLS, TAELOR M LMFT	12/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129967	N/A	N/A	N/A	N/A	N/A	4441 E KINGS CANYON RD	None	FRESNO	CA	93702	3604	00	06000	36.738144	-119.753361	Fresno County
325320	Ordering, Referring, Prescribing	N/A	1235644824	0	0	WOLFROM, CYNTHIA L LMFT	2/25/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124584	N/A	N/A	N/A	N/A	N/A	1550 CALIFORNIA STREET	None	REDDING	CA	96001	1003	00	06000	40.58394236	-122.3921749	Shasta County
325345	Ordering, Referring, Prescribing	N/A	1235671439	0	0	WAN, KAREN R PHARMD	3/27/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74059	N/A	N/A	N/A	N/A	N/A	250 EAST PARKCENTER BOUL	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
325349	Ordering, Referring, Prescribing	N/A	1235680059	0	0	WANBERG, LUCIE CCC-SLP	6/13/2021	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	SP16109	N/A	N/A	N/A	N/A	N/A	801 EMPIRE ST	None	FAIRFIELD	CA	94533	5702	00	06000	38.25031147	-122.0435415	Solano County
325360	Ordering, Referring, Prescribing	N/A	1235718123	0	0	WONG, CRISTINE	9/18/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017100	N/A	N/A	N/A	N/A	N/A	14762 MANOR PLACE	None	FONTANA	CA	92336	0001	00	06000	34.16387691	-117.4826498	San Bernardino County
325363	Ordering, Referring, Prescribing	N/A	1235720368	0	0	WILLIAMS, LISA LMFT	8/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	140829	N/A	N/A	N/A	N/A	N/A	406 SUNRISE AVE	300	ROSEVILLE	CA	95661	4106	00	06000	38.73944898	-121.2720559	Placer County
325395	Ordering, Referring, Prescribing	N/A	1235804295	0	0	WELLER, CODY L	10/25/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	LEP4136	N/A	N/A	N/A	N/A	N/A	3100 ACTIS ST	None	BAKERSFIELD	CA	93309	5911	00	06000	35.3271387	-119.0521818	Kern County
325420	Ordering, Referring, Prescribing	N/A	1235957341	0	0	WRIGHT, BRIANA	12/4/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95033198	N/A	N/A	N/A	N/A	N/A	533 E PALMDALE BLVD	533-A1	PALMDALE	CA	93550	2374	00	06000	34.5796702	-118.1198284	Los Angeles County
325440	Ordering, Referring, Prescribing	N/A	1245206556	0	0	WINTHER, LYNN C MD	5/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G170352	N/A	N/A	N/A	N/A	N/A	2178 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	4535	00	06000	35.27488974	-120.6468257	San Luis Obispo County
325441	Ordering, Referring, Prescribing	N/A	1245234996	0	0	WAI, SAN S	6/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A56447	N/A	N/A	N/A	N/A	N/A	2211 W MAGNOLIA BLVD	230	BURBANK	CA	91506	1753	00	06000	34.1728873	-118.3320905	Los Angeles County
325464	Ordering, Referring, Prescribing	N/A	1245319276	0	0	WYSOCKI, STEPHEN R PHD	4/6/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY6143	N/A	N/A	N/A	N/A	N/A	9089 BASELINE RD.	200	RANCHO CUCAMONGA	CA	91730	1295	00	06000	34.12151248	-117.6074505	San Bernardino County
325498	Ordering, Referring, Prescribing	N/A	1245357367	0	0	WILKINS, KENDRA E LCSW	11/7/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61783	N/A	N/A	N/A	N/A	N/A	7821 S. AVALON BLVD	None	LOS ANGELES	CA	90003	2358	00	06000	33.969393	-118.265197	Los Angeles County
325551	Ordering, Referring, Prescribing	N/A	1245470384	0	0	WOSOUGHIAN, EDNA LMFT	10/29/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	142143	N/A	N/A	N/A	N/A	N/A	1400 E JANSS RD	None	THOUSAND OAKS	CA	91362	2133	00	06000	34.19964827	-118.8541386	Ventura County
325569	Ordering, Referring, Prescribing	N/A	1245514082	0	0	WONG, RANDY T PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65924	N/A	N/A	N/A	N/A	N/A	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	00	06000	34.06477215	-117.9845382	Los Angeles County
325609	Ordering, Referring, Prescribing	N/A	1245563816	0	0	WATKINS, GAIL L PA	10/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	20484	N/A	N/A	N/A	N/A	N/A	554-850 MEDICAL CENTER D	None	BIEBER	CA	96009	8000	00	06000	0	0	None
325619	Ordering, Referring, Prescribing	N/A	1245596659	0	0	WHITE, EMILY LMFT	4/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102680	N/A	N/A	N/A	N/A	N/A	714 W. MAIN ST.	None	GRASS VALLEY	CA	95945	6410	00	06000	39.22048887	-121.0678757	Nevada County
325654	Ordering, Referring, Prescribing	N/A	1245635564	0	0	WOLF, CELIA C NP	6/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001899	N/A	N/A	N/A	N/A	N/A	4065 3RD AVE	None	SAN DIEGO	CA	92103	2184	00	06000	32.75123948	-117.1627318	San Diego County
325664	Ordering, Referring, Prescribing	N/A	1245664366	0	0	WELTZ, KALEENA CCC-SLP	6/30/2019	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	22128	N/A	N/A	N/A	N/A	N/A	1901 N RICE AVE	STE 170	OXNARD	CA	93030	7912	00	06000	34.21960355	-119.1421345	Ventura County
325680	Ordering, Referring, Prescribing	N/A	1245682061	0	0	WAN, KATY OD	2/28/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	33388	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	100	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
325691	Ordering, Referring, Prescribing	N/A	1245694124	0	0	WILLIAMS-HERTZ, AUTUMN LMFT	11/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118101	N/A	N/A	N/A	N/A	N/A	2750 SUTTERVILLE RD	None	SACRAMENTO	CA	95820	1024	00	06000	38.540124	-121.4786745	Sacramento County
325782	Ordering, Referring, Prescribing	N/A	1245839463	0	0	WU, TIFFANY H	5/24/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014623	N/A	N/A	N/A	N/A	N/A	965 EL CAMINO AVE	None	SACRAMENTO	CA	95815	2530	00	06000	38.611638	-121.4444745	Sacramento County
325795	Ordering, Referring, Prescribing	N/A	1245859941	0	0	WHITTY, CAROLE A LMFT	11/14/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135816	N/A	N/A	N/A	N/A	N/A	4928 E CLINTON WAY	108	FRESNO	CA	93727	1526	00	06000	36.77211792	-119.7303894	Fresno County
325901	Ordering, Referring, Prescribing	N/A	1255402160	0	0	WALLACE, SUSAN L MD	6/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G42602	N/A	N/A	N/A	N/A	N/A	1707 EYE ST # 100	None	BAKERSFIELD	CA	93301	5208	00	06000	35.37461686	-119.020062	Kern County
325928	Ordering, Referring, Prescribing	N/A	1255464434	0	0	WELLS, MICHELLE L LCSW	6/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW18281	N/A	N/A	N/A	N/A	N/A	16360 ROSCOE BLVD	2ND FLOOR	VAN NUYS	CA	91406	1206	00	06000	34.22126852	-118.490805	Los Angeles County
325940	Ordering, Referring, Prescribing	N/A	1255481990	0	0	WALKER, ANDREA L LMFT	5/19/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT41482	N/A	N/A	N/A	N/A	N/A	140 MAYHEW WAY STE 300	STE 300	PLEASANT HILL	CA	94523	4398	00	06000	37.93664097	-122.0572179	Contra Costa County
325969	Ordering, Referring, Prescribing	N/A	1255535159	0	0	WONG, DAVID OD	11/13/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	13211	N/A	N/A	N/A	N/A	N/A	8450 LA PALMA AVE	None	BUENA PARK	CA	90620	3210	00	06000	33.8466207	-117.9862725	Orange County
325970	Ordering, Referring, Prescribing	N/A	1255532149	0	0	WEATHERS, NNENNA CNP	1/4/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	9235	N/A	N/A	N/A	N/A	N/A	12377 LEWIS STREET	105	GARDEN GROVE	CA	92840	4691	00	06000	33.78307129	-117.8990576	Orange County
325990	Ordering, Referring, Prescribing	N/A	1255589131	0	0	WHITE, ELLISHA B LMFT	4/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT85638	N/A	N/A	N/A	N/A	N/A	982 MISSION STREET	None	SAN FRANCISCO	CA	94103	1608	00	06000	37.7813638	-122.4082438	San Francisco County
326007	Ordering, Referring, Prescribing	N/A	1255615225	0	0	WILLIAMS, RHONDA M PHARMD	7/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	48015	N/A	N/A	N/A	N/A	N/A	3300 BUENA VISTA RD	BUILDING A	BAKERSFIELD	CA	93311	1111	00	06000	35.322642	-119.1278625	Kern County
326032	Ordering, Referring, Prescribing	N/A	1255666228	0	0	WAN, DEVON L DMD	10/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DDS60547	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
326040	Ordering, Referring, Prescribing	N/A	1255673893	0	0	WILSON, SALLY E	4/4/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0514467	N/A	N/A	N/A	N/A	N/A	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	00	06000	34.02749142	-118.486063	Los Angeles County
326078	Ordering, Referring, Prescribing	N/A	1255731402	0	0	WAGNER, JEFFREY P LPCC	7/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	11955	N/A	N/A	N/A	N/A	N/A	3491 KURTZ ST	None	SAN DIEGO	CA	92110	4430	00	06000	32.7557948	-117.209639	San Diego County
326115	Ordering, Referring, Prescribing	N/A	1255804175	0	0	WINTER, KAREN E PSYD	5/27/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32635	N/A	N/A	N/A	N/A	N/A	1480 LINCOLN AVE.	None	SAN RAFAEL	CA	94901	2084	00	06000	37.98053839	-122.5224871	Marin County
326152	Ordering, Referring, Prescribing	N/A	1255862553	0	0	WEIL, ELIZABETH C NP	12/17/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005892	N/A	N/A	N/A	N/A	N/A	1920 MEMORIAL DR	None	CERES	CA	95307	1827	00	06000	37.600146	-120.961042	Stanislaus County
326170	Ordering, Referring, Prescribing	N/A	1255883435	0	0	WEDDERBURN, BRIAN MSW LCSW	6/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW102042	N/A	N/A	N/A	N/A	N/A	7165 BURTON AVE	None	ROHNERT PARK	CA	94928	3316	00	06000	38.33819105	-122.6990157	Sonoma County
326183	Ordering, Referring, Prescribing	N/A	1255896551	0	0	WARD, DAVID A PA-C	7/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61427	N/A	N/A	N/A	N/A	N/A	400 WEST PUEBLO	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
326187	Ordering, Referring, Prescribing	N/A	1255908265	0	0	WALL, POOJA PA-C	12/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59398	N/A	N/A	N/A	N/A	N/A	743 PISMO STREET	None	SAN LUIS OBISPO	CA	93401	1000	00	06000	35.27698063	-120.6618385	San Luis Obispo County
326314	Ordering, Referring, Prescribing	N/A	1265211049	0	0	WITTE, AMANDA NP	8/7/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95026527	N/A	N/A	N/A	N/A	N/A	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
326331	Ordering, Referring, Prescribing	N/A	1265426852	0	0	WILCOX, JULIE M MD	6/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C52128	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	275	BAKERSFIELD	CA	93309	2656	00	06000	35.35413152	-119.058471	Kern County
326337	Ordering, Referring, Prescribing	N/A	1265487524	0	0	WANG, ANDREW C MD	1/14/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G41734	N/A	N/A	N/A	N/A	N/A	15350 SHERMAN WAY	STE 200	VAN NUYS	CA	91406	4203	00	06000	34.20109649	-118.467432	Los Angeles County
326338	Ordering, Referring, Prescribing	N/A	1265456636	0	0	WINKLER, HEIDI A MD	10/16/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A50311	N/A	N/A	N/A	N/A	N/A	10210 ORR AND DAY RD	SUITE A	SANTA FE SPRINGS	CA	90670	3581	00	06000	33.94432489	-118.090377	Los Angeles County
326357	Ordering, Referring, Prescribing	N/A	1265535108	0	0	WOOLCOTT, JOHN P LMFT	2/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38302	N/A	N/A	N/A	N/A	N/A	2750 SUTTERVILLE RD	None	SACRAMENTO	CA	95820	1024	00	06000	38.540124	-121.4786745	Sacramento County
326411	Ordering, Referring, Prescribing	N/A	1265660385	0	0	WOLFE, MAUREEN A CNM	8/14/2017	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	371863	N/A	N/A	N/A	N/A	N/A	1691 THE ALAMEDA	None	SAN JOSE	CA	95126	2203	00	06000	37.3373761	-121.9192532	Santa Clara County
326469	Ordering, Referring, Prescribing	N/A	1265741003	0	0	WILLIAMS, VICKIE LMFT	12/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	82445	N/A	N/A	N/A	N/A	N/A	1119 E MONTE VISTA AVE	None	VACAVILLE	CA	95688	3009	00	06000	38.36024633	-121.9763983	Solano County
326541	Ordering, Referring, Prescribing	N/A	1265860720	0	0	WONG, CHARLYN PHARMD	5/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69943	N/A	N/A	N/A	N/A	N/A	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	00	06000	37.66312028	-122.4631592	San Mateo County
326542	Ordering, Referring, Prescribing	N/A	1265860035	0	0	WEST, ERIN A	11/12/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0789064	N/A	N/A	N/A	N/A	N/A	400 W 30TH STREET	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
326547	Ordering, Referring, Prescribing	N/A	1265871032	0	0	WANG, MICHAEL	12/11/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C200328	N/A	N/A	N/A	N/A	N/A	444 BRUCE STREET	None	YREKA	CA	96097	3450	00	06000	41.71863548	-122.6458755	Siskiyou County
326563	Ordering, Referring, Prescribing	N/A	1265894067	0	0	WEI, ANDREW L MD	6/5/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C196683	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	3615	00	06000	32.70162897	-117.1465065	San Diego County
326592	Ordering, Referring, Prescribing	N/A	1265939466	0	0	WANG, CASSANDRA MD	1/11/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164874	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	MS #54	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
326619	Ordering, Referring, Prescribing	N/A	1265991335	0	0	WALLACE, PAUL M MD	6/13/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL912	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
326626	Ordering, Referring, Prescribing	N/A	1265986590	0	0	WAH, CARMEN PHARMD	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74520	N/A	N/A	N/A	N/A	N/A	570 N SHORELINE BLVD	None	MOUNTAIN VIEW	CA	94043	3103	00	06000	37.40276459	-122.0782742	Santa Clara County
326654	Ordering, Referring, Prescribing	N/A	1275071771	0	0	WILKINSON, MALLORY LMFT	8/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120945	N/A	N/A	N/A	N/A	N/A	555 N PERRIS BLVD	None	PERRIS	CA	92571	2811	00	06000	33.79131	-117.226053	Riverside County
326688	Ordering, Referring, Prescribing	N/A	1275113326	0	0	WILSON, ANNALISA V MD	1/9/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192619	N/A	N/A	N/A	N/A	N/A	1731 E 120TH ST	None	LOS ANGELES	CA	90059	3051	00	06000	33.92461329	-118.2426436	Los Angeles County
326719	Ordering, Referring, Prescribing	N/A	1275190761	0	0	WEGNER, BENJAMIN PSYD	1/17/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33965	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	90230	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
326731	Ordering, Referring, Prescribing	N/A	1275200495	0	0	WANG, JOE DMD MSD	7/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	106516	N/A	N/A	N/A	N/A	N/A	242 LA PALA DR	A, B	SAN JOSE	CA	95127	2103	00	06000	37.37740177	-121.8284956	Santa Clara County
326733	Ordering, Referring, Prescribing	N/A	1275237182	0	0	WHITE, KELTY MD	3/13/2025	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A201711	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD ROAD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
326738	Ordering, Referring, Prescribing	N/A	1275230153	0	0	WILLNER, CELIA R PHARMD	10/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87192	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER DR	MS SEC2-B	IDAHO CITY	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
326770	Ordering, Referring, Prescribing	N/A	1275589640	0	0	WEE, LEON L MD	7/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A62838	N/A	N/A	N/A	N/A	N/A	3055 W ORANGE AVE	None	ANAHEIM	CA	92804	3159	00	06000	33.8247435	-117.99621	Orange County
326797	Ordering, Referring, Prescribing	N/A	1275646184	0	0	WEBER, LINDA J LMFT	1/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFT21970	N/A	N/A	N/A	N/A	N/A	68 COOMBS ST	A-6	NAPA	CA	94559	3901	00	06000	38.28705321	-122.2871753	Napa County
326812	Ordering, Referring, Prescribing	N/A	1275662082	0	0	WEICHOLD, LILIANA LMFT	7/27/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98123	N/A	N/A	N/A	N/A	N/A	37926 47TH ST E	None	PALMDALE	CA	93552	3272	00	06000	34.57140358	-118.0449908	Los Angeles County
326819	Ordering, Referring, Prescribing	N/A	1275671919	0	0	WALSH, MARY L LMFT	4/25/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40018	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
326823	Ordering, Referring, Prescribing	N/A	1275669400	0	0	WALKER, DAWN LMFT	2/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116390	N/A	N/A	N/A	N/A	N/A	7001-A EAST PARKWAY	300	SACRAMENTO	CA	95823	2501	00	06000	38.497689	-121.4498385	Sacramento County
326832	Ordering, Referring, Prescribing	N/A	1275695645	0	0	WILLIAMS, BELEN LCSW	5/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26108	N/A	N/A	N/A	N/A	N/A	150 W. 7TH. STREET	None	SAN PEDRO	CA	90731	3320	00	06000	33.73786341	-118.2810362	Los Angeles County
326875	Ordering, Referring, Prescribing	N/A	1275788952	0	0	WU, EMILY OD	11/2/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	13676	N/A	N/A	N/A	N/A	N/A	1206 E 17TH STREET, SUIT	None	SANTA ANA	CA	92701	2641	00	06000	33.75983651	-117.8539425	Orange County
326877	Ordering, Referring, Prescribing	N/A	1275812232	0	0	WEI, DESIREE PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63153	N/A	N/A	N/A	N/A	N/A	100 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1900	00	06000	38.01968283	-122.5339655	Marin County
326914	Ordering, Referring, Prescribing	N/A	1275881237	0	0	WONG, KEVIN PHARMD	4/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	67355	N/A	N/A	N/A	N/A	N/A	1051 HUME WAY	None	VACAVILLE	CA	95687	5558	00	06000	38.35007337	-121.9807606	Solano County
326958	Ordering, Referring, Prescribing	N/A	1275927725	0	0	WHEELER, NAKIA NP	3/11/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016917	N/A	N/A	N/A	N/A	N/A	743 PISMO ST	None	SAN LUIS OBISPO	CA	93401	3921	00	06000	35.27698063	-120.6618385	San Luis Obispo County
327035	Ordering, Referring, Prescribing	N/A	1285030189	0	0	WANG, LORRAINE C PA	11/9/2017	Taxonomy not applicable	NA	n/a	000	Unknown	PA52930	N/A	N/A	N/A	N/A	N/A	1550 N GAREY AVE	None	POMONA	CA	91767	3826	00	06000	34.07356342	-117.7522392	Los Angeles County
327047	Ordering, Referring, Prescribing	N/A	1285052860	0	0	WINOGRAD, PAUL MD	5/23/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A141274	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2308	00	06000	38.555181	-121.4566785	Sacramento County
327070	Ordering, Referring, Prescribing	N/A	1285079582	0	0	WALDMAN, DANIEL MD	10/3/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176346	N/A	N/A	N/A	N/A	N/A	137 N VIRGIL AVE	None	LOS ANGELES	CA	90004	4811	00	06000	34.07457287	-118.2868414	Los Angeles County
327103	Ordering, Referring, Prescribing	N/A	1285130724	0	0	WILES, CONNOR L MD	3/10/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174969	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
327182	Ordering, Referring, Prescribing	N/A	1285260216	0	0	WILSON, CHRISTINE R MD	4/21/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL3343	N/A	N/A	N/A	N/A	N/A	3745 W CHAPMAN AVE	None	ORANGE	CA	92868	1605	00	06000	33.78905002	-117.8934844	Orange County
327350	Ordering, Referring, Prescribing	N/A	1285898072	0	0	WILLIAMSON, LAURIE R LMFT	1/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77133	N/A	N/A	N/A	N/A	N/A	8616 LA TIJERA BLVD	200	LOS ANGELES	CA	90045	0000	00	06000	33.95943215	-118.3918599	Los Angeles County
327353	Ordering, Referring, Prescribing	N/A	1285887604	0	0	WOLDU, RAHEL PHARMD	3/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59181	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PARKWAY	625	SAN JOSE	CA	95119	1101	00	06000	37.23951066	-121.8013511	Santa Clara County
327368	Ordering, Referring, Prescribing	N/A	1285922419	0	0	WONG, SHELLY S LCSW	11/10/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW73372	N/A	N/A	N/A	N/A	N/A	2933 EL NIDO DR	None	ALTADENA	CA	91001	4529	00	06000	34.19549106	-118.1655134	Los Angeles County
327386	Ordering, Referring, Prescribing	N/A	1285940668	0	0	WALLACE, FABIOLA E LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90196	N/A	N/A	N/A	N/A	N/A	320 E TULARE AVE	None	VISALIA	CA	93292	3629	00	06000	36.3201513	-119.2896191	Tulare County
327436	Ordering, Referring, Prescribing	N/A	1295043503	0	0	WONG, TIFFANY C PHARMD	3/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64104	N/A	N/A	N/A	N/A	N/A	4900 RIVERGRADE ROAD	C-110	IRWINDALE	CA	91706	1458	00	06000	34.10201565	-117.9802967	Los Angeles County
327466	Ordering, Referring, Prescribing	N/A	1295106177	0	0	WENSIL, STUART J PHARMD	3/18/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH42846	N/A	N/A	N/A	N/A	N/A	189 NIBLICK RD	None	PASO ROBLES	CA	93446	4845	00	06000	35.61505753	-120.6811935	San Luis Obispo County
327520	Ordering, Referring, Prescribing	N/A	1295200665	0	0	WILSON, ALICIA K LMFT	6/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139885	N/A	N/A	N/A	N/A	N/A	3301 E 12TH ST	259	OAKLAND	CA	94601	3424	00	06000	37.77617499	-122.2247899	Alameda County
327533	Ordering, Referring, Prescribing	N/A	1295224848	0	0	WEEKS, SANDY K LPCC	12/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	12853	N/A	N/A	N/A	N/A	N/A	226 W OJAI AVE	101-180	OJAI	CA	93023	3277	00	06000	34.44760276	-119.2488095	Ventura County
327563	Ordering, Referring, Prescribing	N/A	1295270783	0	0	WONG, STACEY M PA	3/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	54094	N/A	N/A	N/A	N/A	N/A	1550 N GAREY AVE	None	POMONA	CA	91767	3826	00	06000	34.07356342	-117.7522392	Los Angeles County
327594	Ordering, Referring, Prescribing	N/A	1295323079	0	0	WHITE, BETHANIE B	1/11/2023	Taxonomy not applicable	NA	n/a	000	Unknown	LEP3041	N/A	N/A	N/A	N/A	N/A	567 W SHAW AVE	STE A-1	FRESNO	CA	93704	2500	00	06000	36.80833	-119.8035403	Fresno County
327600	Ordering, Referring, Prescribing	N/A	1295326056	0	0	WHITE, BRIANNA NP	8/11/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016565	N/A	N/A	N/A	N/A	N/A	726 4TH ST	None	MARYSVILLE	CA	95901	5656	00	06000	39.13872267	-121.5944372	Yuba County
327606	Ordering, Referring, Prescribing	N/A	1295351757	0	0	WILD, MATTHEW NP	4/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024881	N/A	N/A	N/A	N/A	N/A	954 N VERMONT AVE	None	LOS ANGELES	CA	90029	3529	00	06000	34.08896256	-118.2917211	Los Angeles County
327613	Ordering, Referring, Prescribing	N/A	1295360634	0	0	WEBB, LORRAINE B LMFT	3/11/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131717	N/A	N/A	N/A	N/A	N/A	251 HACKETT RD	None	MODESTO	CA	95358	9800	00	06000	37.58764784	-120.9907809	Stanislaus County
327641	Ordering, Referring, Prescribing	N/A	1295482552	0	0	WOODSON, KASSANDRA H LCSW	8/25/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110139	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
327642	Ordering, Referring, Prescribing	N/A	1295494870	0	0	WU, ALVIN S PHARMD	3/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	85617	N/A	N/A	N/A	N/A	N/A	1051 HUME WAY	None	VACAVILLE	CA	95687	5558	00	06000	38.35007337	-121.9807606	Solano County
327682	Ordering, Referring, Prescribing	N/A	1295781359	0	0	WILSON, CHARLES A DO	6/14/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A7682	N/A	N/A	N/A	N/A	N/A	5580 CALLE REAL	None	GOLETA	CA	93111	1646	00	06000	34.44131559	-119.8184752	Santa Barbara County
327692	Ordering, Referring, Prescribing	N/A	1295810497	0	0	WU, LINDA T PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	46623	N/A	N/A	N/A	N/A	N/A	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	00	06000	37.55102172	-121.9759026	Alameda County
327721	Ordering, Referring, Prescribing	N/A	1295878858	0	0	WOLKENHAUER, DIANNE K PHD	6/10/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY14858	N/A	N/A	N/A	N/A	N/A	658 E BRIER DR	150	SAN BERNARDINO	CA	92408	2880	00	06000	34.07137738	-117.2702805	San Bernardino County
327732	Ordering, Referring, Prescribing	N/A	1295919090	0	0	WU, CECILIA D PHARMD	3/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57383	N/A	N/A	N/A	N/A	N/A	4448 YORK BLVD	None	LOS ANGELES	CA	90041	3328	00	06000	34.12374025	-118.2188529	Los Angeles County
327740	Ordering, Referring, Prescribing	N/A	1295933380	0	0	WHITE MADSEN, KRISTEN LCSW	2/22/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW81734	N/A	N/A	N/A	N/A	N/A	1140 MAIN STREET	None	LIVINGSTON	CA	95334	1257	00	06000	37.37992056	-120.7234222	Merced County
327754	Ordering, Referring, Prescribing	N/A	1295965135	0	0	WOODS, RONKEISHA K LCSW	2/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81182	N/A	N/A	N/A	N/A	N/A	6051 N FRESNO ST	201	FRESNO	CA	93710	5280	00	06000	36.823905	-119.781436	Fresno County
327766	Ordering, Referring, Prescribing	N/A	1295990992	0	0	WILSON, BENJAMIN J PSYD	5/10/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25427	N/A	N/A	N/A	N/A	N/A	3125 MYERS ST	None	RIVERSIDE	CA	92503	5527	00	06000	33.90932558	-117.4428095	Riverside County
327826	Ordering, Referring, Prescribing	N/A	1306121090	0	0	WOLK, POONAM J LCSW	3/31/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82164	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS ROAD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
327842	Ordering, Referring, Prescribing	N/A	1306138300	0	0	WELLS, ALLYSON MD	11/3/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124352	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
327910	Ordering, Referring, Prescribing	N/A	1306236195	0	0	WEGENER, JOYE LMFT	12/10/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	44710	N/A	N/A	N/A	N/A	N/A	1889 LAWRENCE ROAD	None	SANTA CLARA	CA	95052	0397	00	06000	37.35761102	-121.9947195	Santa Clara County
327913	Ordering, Referring, Prescribing	N/A	1306231840	0	0	WYATT, TYNAN MD	6/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146408	N/A	N/A	N/A	N/A	N/A	950 S. EUCLID AVENUS	None	SAN DIEGO	CA	92114	6201	00	06000	32.696181	-117.085139	San Diego County
327927	Ordering, Referring, Prescribing	N/A	1306260930	0	0	WEBER, QUYNHNGA PHARMD	8/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH52590	N/A	N/A	N/A	N/A	N/A	8052 WESTMINSTER BLVD.	None	WESTMINSTER	CA	92683	0000	00	06000	33.75925468	-117.988843	Orange County
327994	Ordering, Referring, Prescribing	N/A	1306386156	0	0	WANG, YUCHEN PHARMD	2/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75208	N/A	N/A	N/A	N/A	N/A	4441 E KINGS CANYON RD	None	FRESNO	CA	93702	3604	00	06000	36.738144	-119.753361	Fresno County
327995	Ordering, Referring, Prescribing	N/A	1306403860	0	0	WHITE, LAUREN N OD	3/26/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34506	N/A	N/A	N/A	N/A	N/A	7217 RESEDA BLVD	None	RESEDA	CA	91335	3046	00	06000	34.201791	-118.5360655	Los Angeles County
328037	Ordering, Referring, Prescribing	N/A	1306494950	0	0	WEGNER, CORALIE A	4/15/2019	Taxonomy not applicable	NA	n/a	000	Unknown	2804	N/A	N/A	N/A	N/A	N/A	1850 WILDCAT BLVD	None	ROCKLIN	CA	95765	5471	00	06000	38.822166	-121.285188	Placer County
328054	Ordering, Referring, Prescribing	N/A	1306511555	0	0	WILEY, KIMBERLY DMD	9/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	106809	N/A	N/A	N/A	N/A	N/A	610 WEST 3RD STREET	None	DORRIS	CA	96023	0170	00	06000	41.9642673	-121.9241778	Siskiyou County
328067	Ordering, Referring, Prescribing	N/A	1306569207	0	0	WU, JIA H PHARMD	9/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86845	N/A	N/A	N/A	N/A	N/A	6310 COLLEGE AVE	None	OAKLAND	CA	94618	1332	00	06000	37.85071196	-122.2523909	Alameda County
328098	Ordering, Referring, Prescribing	N/A	1306856356	0	0	WILLINGHAM, JON Y	5/2/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	100042	N/A	N/A	N/A	N/A	N/A	2500 ALHAMBRA AVE	None	MARTINEZ	CA	94553	3156	00	06000	38.00658519	-122.1309063	Contra Costa County
328120	Ordering, Referring, Prescribing	N/A	1306919584	0	0	WILLIAMS, MARK T MD	12/21/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A74958	N/A	N/A	N/A	N/A	N/A	3569 LEXINGTON AVENUE	None	EL MONTE	CA	91731	2607	00	06000	34.0744277	-118.039296	Los Angeles County
328134	Ordering, Referring, Prescribing	N/A	1306952692	0	0	WARD DIXON, JENNIFER LCSW	4/16/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26549	N/A	N/A	N/A	N/A	N/A	13000 NEW AIRPORT RD	None	AUBURN	CA	95603	9596	00	06000	38.94036707	-121.0798907	Placer County
328137	Ordering, Referring, Prescribing	N/A	1306952940	0	0	WINKLER, CHRISTINE LMFT	9/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	9011	N/A	N/A	N/A	N/A	N/A	529 VIA ALMAR	None	PALOS VERDES PENI	CA	90274	1229	00	06000	33.79920585	-118.4013697	Los Angeles County
328146	Ordering, Referring, Prescribing	N/A	1306978150	0	0	WEST, AMY J LCSW	8/11/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	62234	N/A	N/A	N/A	N/A	N/A	3580 WILSHIRE BLVD., 8TH	800	LOS ANGELES	CA	90010	2151	00	06000	34.06170677	-118.302787	Los Angeles County
328156	Ordering, Referring, Prescribing	N/A	1306998927	0	0	WONG, KENNETH PHARMD	4/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH38753	N/A	N/A	N/A	N/A	N/A	4950 SUNSET BLVD.	None	LOS ANGELES	CA	90027	5821	00	06000	34.09812092	-118.2980246	Los Angeles County
328179	Ordering, Referring, Prescribing	N/A	1316041767	0	0	WHITNEY, ERIC D LMFT	6/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42208	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	None	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
328183	Ordering, Referring, Prescribing	N/A	1316058407	0	0	WISHART BARNES, TRACIE LMFT	9/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	39429	N/A	N/A	N/A	N/A	N/A	2225 CHALLENGER WAY	None	SANTA ROSA	CA	95407	5441	00	06000	38.425482	-122.75262	Sonoma County
328249	Ordering, Referring, Prescribing	N/A	1316204225	0	0	WAITE, AMELIA C LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111472	N/A	N/A	N/A	N/A	N/A	3787 S VERMONT AVE	None	LOS ANGELES	CA	90007	4203	00	06000	34.01739	-118.291567	Los Angeles County
328301	Ordering, Referring, Prescribing	N/A	1316304389	0	0	WHITTEN, JUSTINE N LMFT	1/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111347	N/A	N/A	N/A	N/A	N/A	1809 19TH STREET	None	SACRAMENTO	CA	95811	6745	00	06000	38.567835	-121.4849475	Sacramento County
328339	Ordering, Referring, Prescribing	N/A	1316356884	0	0	WELDEGHIORGIS, NAZRET G OD	11/21/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT15024	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
328387	Ordering, Referring, Prescribing	N/A	1316422793	0	0	WHITLOCK, JULIE R RN	10/30/2017	Taxonomy not applicable	NA	n/a	000	Unknown	362556	N/A	N/A	N/A	N/A	N/A	5000 W CYPRESS	None	VISALIA	CA	93277	8300	00	06000	36.324207	-119.3463225	Tulare County
328514	Ordering, Referring, Prescribing	N/A	1316655996	0	0	WONG, MICHELLE PA	3/5/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA62308	N/A	N/A	N/A	N/A	N/A	1245 WILSHIRE BLVD	775	LOS ANGELES	CA	90017	1449	00	06000	34.05362775	-118.2661889	Los Angeles County
328525	Ordering, Referring, Prescribing	N/A	1316693179	0	0	WALDEN, SARAH G PHARMD	4/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72872	N/A	N/A	N/A	N/A	N/A	6715 HILLMONT DR	None	OAKLAND	CA	94605	2248	00	06000	37.77526958	-122.1701726	Alameda County
328573	Ordering, Referring, Prescribing	N/A	1326090804	0	0	WELL, JAMES D MD	6/16/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G78059	N/A	N/A	N/A	N/A	N/A	2108 STILLMAN ST	None	SELMA	CA	93662	3026	00	06000	36.57250949	-119.6127495	Fresno County
328606	Ordering, Referring, Prescribing	N/A	1326157389	0	0	WEINTRAUB, CARY MD	12/31/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70252	N/A	N/A	N/A	N/A	N/A	650 HOWE AVE	BDG 400-B	SACRAMENTO	CA	95825	4731	00	06000	38.577294	-121.4146395	Sacramento County
328616	Ordering, Referring, Prescribing	N/A	1326168113	0	0	WHALLEY, TALI M LCSW	8/29/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23957	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
328618	Ordering, Referring, Prescribing	N/A	1326170432	0	0	WONG, YUE KWAN IRENE PHARMD	3/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49792	N/A	N/A	N/A	N/A	N/A	30116 EIGENBRODT WAY	None	UNION CITY	CA	94587	1225	00	06000	37.60846354	-122.0715526	Alameda County
328633	Ordering, Referring, Prescribing	N/A	1326181199	0	0	WANTLAND, CHERYL R LCSW	9/19/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20517	N/A	N/A	N/A	N/A	N/A	333 LAWS AVE	None	UKIAH	CA	95482	6540	00	06000	39.12772164	-123.2111168	Mendocino County
328663	Ordering, Referring, Prescribing	N/A	1326243221	0	0	WALLIN, SHANE R	5/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28659	N/A	N/A	N/A	N/A	N/A	2513 24TH STREET	None	SAN FRANCISCO	CA	94110	3556	00	06000	37.75308592	-122.4047531	San Francisco County
328665	Ordering, Referring, Prescribing	N/A	1326252602	0	0	WADDELL, SHAYLA M	9/21/2015	Taxonomy not applicable	NA	n/a	000	Unknown	230	N/A	N/A	N/A	N/A	N/A	111 MAIDEN LANE	SUITE 700	SAN FRANCISCO	CA	94108	5307	00	06000	37.78814761	-122.4055072	San Francisco County
328751	Ordering, Referring, Prescribing	N/A	1326363581	0	0	WOLF, KIMBERLY J DO MD	3/26/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16000	N/A	N/A	N/A	N/A	N/A	2201 COURAGE DR	None	FAIRFIELD	CA	94533	6733	00	06000	38.23727106	-122.0692856	Solano County
328770	Ordering, Referring, Prescribing	N/A	1326387556	0	0	WILKERSON, KRISTIN J NP	12/8/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95000211	N/A	N/A	N/A	N/A	N/A	1722 S LEWIS RD	None	CAMARILLO	CA	93012	8520	00	06000	34.18921316	-119.0340743	Ventura County
328788	Ordering, Referring, Prescribing	N/A	1326425547	0	0	WARD, KRISTEN PHARMD	3/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71609	N/A	N/A	N/A	N/A	N/A	501 J ST	6TH FLOOR PHARMACY	SACRAMENTO	CA	95814	2325	00	06000	38.582118	-121.499325	Sacramento County
328817	Ordering, Referring, Prescribing	N/A	1326471160	0	0	WATTS, JEREMIAH LMFT	8/9/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117424	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	210	SANTA ROSA	CA	95407	5478	00	06000	38.425266	-122.749875	Sonoma County
328822	Ordering, Referring, Prescribing	N/A	1326476326	0	0	WHANG, LINDSEY	1/30/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23836	N/A	N/A	N/A	N/A	N/A	7107 REMMET AVE	None	CANOGA PARK	CA	91303	2016	00	06000	34.199406	-118.6003185	Los Angeles County
328876	Ordering, Referring, Prescribing	N/A	1326575226	0	0	WANG, NATHAN MD	11/25/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159815	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE# A	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
328894	Ordering, Referring, Prescribing	N/A	1326601139	0	0	WANG, XIAOXI PHARMD	1/22/2025	Taxonomy not applicable	NA	n/a	000	Unknown	11524	N/A	N/A	N/A	N/A	N/A	3110 CHINO AVE	STE 100	CHINO HILLS	CA	91709	1294	00	06000	34.01077341	-117.738406	San Bernardino County
328896	Ordering, Referring, Prescribing	N/A	1326602889	0	0	WARD, DEIDRA J LCSW	3/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW107213	N/A	N/A	N/A	N/A	N/A	2640 BRESLAUER WAY	None	REDDING	CA	96001	4246	00	06000	40.5496754	-122.3791396	Shasta County
328916	Ordering, Referring, Prescribing	N/A	1326626797	0	0	WILLIAMS, MATTHEW C MD	7/15/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A186478	N/A	N/A	N/A	N/A	N/A	1801 VICENTE ST	None	SAN FRANCISCO	CA	94116	2923	00	06000	37.7388459	-122.4861544	San Francisco County
328931	Ordering, Referring, Prescribing	N/A	1326684796	0	0	WABBEL, JILL NP	11/28/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023445	N/A	N/A	N/A	N/A	N/A	20833 LONG BRANCH DR	None	COTTONWOOD	CA	96022	8701	00	06000	40.39391709	-122.2799142	Shasta County
328944	Ordering, Referring, Prescribing	N/A	1326700477	0	0	WENDIMU, MICHAEL S	3/20/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018710	N/A	N/A	N/A	N/A	N/A	177 N HUDSON AVE UNIT 51	None	PASADENA	CA	91101	2297	00	06000	34.14914648	-118.1339138	Los Angeles County
328955	Ordering, Referring, Prescribing	N/A	1326719907	0	0	WONG, MICHAEL OD FAAO	10/12/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT34957	N/A	N/A	N/A	N/A	N/A	5460 E LA PALMA AVE	None	ANAHEIM	CA	92807	2023	00	06000	33.85983003	-117.7966383	Orange County
329011	Ordering, Referring, Prescribing	N/A	1336227321	0	0	WILLIAMS, ANA T CNM	1/17/2022	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	1183	N/A	N/A	N/A	N/A	N/A	2051 JOHN JONES RD	None	DAVIS	CA	95616	9701	00	06000	38.56371578	-121.7691963	Yolo County
329078	Ordering, Referring, Prescribing	N/A	1336367267	0	0	WAGER, PAUL P LMFT	5/16/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT38677	N/A	N/A	N/A	N/A	N/A	1188 N.EUCLID, ANAHEIM,	None	ANAHEIM	CA	92801	0011	00	06000	33.850314	-117.9416115	Orange County
329155	Ordering, Referring, Prescribing	N/A	1336504273	0	0	WEBER, SARA NP	10/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004709	N/A	N/A	N/A	N/A	N/A	1685 E MAIN ST	301	EL CAJON	CA	92021	5225	00	06000	32.81132509	-116.9192044	San Diego County
329197	Ordering, Referring, Prescribing	N/A	1336551480	0	0	WILSON, KENDRA M LMFT	10/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	141842	N/A	N/A	N/A	N/A	N/A	43520 DIVISION ST	None	LANCASTER	CA	93535	4089	00	06000	34.673445	-118.130143	Los Angeles County
329199	Ordering, Referring, Prescribing	N/A	1336551084	0	0	WILLARD, BRENT MD	3/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A142234	N/A	N/A	N/A	N/A	N/A	820 E GILBERT ST	None	SAN BERNARDINO	CA	92415	0928	00	06000	34.1268333	-117.2687417	San Bernardino County
329243	Ordering, Referring, Prescribing	N/A	1336624980	0	0	WANG, JOHN T PHARMD	4/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	79444	N/A	N/A	N/A	N/A	N/A	28505 HESPERIAN BLVD	None	HAYWARD	CA	94545	5008	00	06000	37.61653109	-122.0880046	Alameda County
329262	Ordering, Referring, Prescribing	N/A	1336651801	0	0	WARD, LINDSAY L LPCC	6/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	11699	N/A	N/A	N/A	N/A	N/A	1045 NINTH AVE	None	SAN DIEGO	CA	92101	1000	00	06000	32.71607643	-117.1564968	San Diego County
329309	Ordering, Referring, Prescribing	N/A	1336728559	0	0	WEYGANDT, GREGORY D DO	1/15/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20464	N/A	N/A	N/A	N/A	N/A	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
329389	Ordering, Referring, Prescribing	N/A	1346201126	0	0	WILLIAMS, ANASTASIA L MD	8/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	C174451	N/A	N/A	N/A	N/A	N/A	732 MOTT ST	100-110	SAN FERNANDO	CA	91340	3247	00	06000	34.27661761	-118.4442372	Los Angeles County
329429	Ordering, Referring, Prescribing	N/A	1346345485	0	0	WYDRO, JENNIFER PSYD	1/18/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY22254	N/A	N/A	N/A	N/A	N/A	1521 UNIVERSITY AVE	None	BERKELEY	CA	94703	1422	00	06000	37.87060038	-122.2812128	Alameda County
329456	Ordering, Referring, Prescribing	N/A	1346385788	0	0	WU, JOHN C PSYD	2/22/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY20034	N/A	N/A	N/A	N/A	N/A	9353 VALLEY BLVD.	SUITE C	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
329457	Ordering, Referring, Prescribing	N/A	1346390374	0	0	WEBSTER ROBINSON, LINDA L PHD	8/15/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY12187	N/A	N/A	N/A	N/A	N/A	509 W. 10TH STREET	None	ANTIOCH	CA	94509	1653	00	06000	38.01116769	-121.8130914	Contra Costa County
329475	Ordering, Referring, Prescribing	N/A	1346431772	0	0	WEISS, RIVKA L NP	1/7/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	12123	N/A	N/A	N/A	N/A	N/A	263 N VILLA AVE	None	WILLOWS	CA	95988	2607	00	06000	39.52254122	-122.2089532	Glenn County
329484	Ordering, Referring, Prescribing	N/A	1346454816	0	0	WILLETT, LARRY P LCSW	2/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW25811	N/A	N/A	N/A	N/A	N/A	520 E. TULARE AVE	None	VISALIA	CA	93292	2912	00	06000	36.320679	-119.2870845	Tulare County
329505	Ordering, Referring, Prescribing	N/A	1346485448	0	0	WU, ESTHER M LCSW	2/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25221	N/A	N/A	N/A	N/A	N/A	3727 W 6TH ST	320	LOS ANGELES	CA	90020	5105	00	06000	34.06358655	-118.3037656	Los Angeles County
329553	Ordering, Referring, Prescribing	N/A	1346571387	0	0	WONG, ESTHER LCSW	5/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81813	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	BLDG 5, UNIT 6B	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
329568	Ordering, Referring, Prescribing	N/A	1346597218	0	0	WANG, JINGYI	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67351	N/A	N/A	N/A	N/A	N/A	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	00	06000	36.84133078	-119.7824983	Fresno County
329586	Ordering, Referring, Prescribing	N/A	1346626843	0	0	WATSON, LESLIE LCSW	4/18/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW122072	N/A	N/A	N/A	N/A	N/A	13585 SAN PABLO AVE	FIRST FLOOR	SAN PABLO	CA	94806	3863	00	06000	37.95651393	-122.3371491	Contra Costa County
329601	Ordering, Referring, Prescribing	N/A	1346647559	0	0	WUNNER, VESTA LCSW	1/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28928	N/A	N/A	N/A	N/A	N/A	720 WOOD STREET	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
329682	Ordering, Referring, Prescribing	N/A	1346770526	0	0	WHITMEE, JENNIFER LMFT	9/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121688	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVE	100	GILROY	CA	95020	3673	00	06000	37.03080985	-121.5741639	Santa Clara County
329699	Ordering, Referring, Prescribing	N/A	1346786613	0	0	WILL, JULIE C LMFT	5/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49336	N/A	N/A	N/A	N/A	N/A	931 CAVALLO ROAD	None	ANTIOCH	CA	94501	1979	00	06000	38.01093967	-121.7966585	Contra Costa County
329744	Ordering, Referring, Prescribing	N/A	1346903077	0	0	WOHALI, SANDRA D LCSW	5/15/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	122530	N/A	N/A	N/A	N/A	N/A	1420 WILLOW PASS ROAD	200	CONCORD	CA	94520	5223	00	06000	37.96956948	-122.0507563	Contra Costa County
329865	Ordering, Referring, Prescribing	N/A	1356482962	0	0	WILLIAMS, GENCIA M LMFT	6/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50283	N/A	N/A	N/A	N/A	N/A	10801 SIXTH STREET	120	RANCHO CUCAMONGA	CA	91729	4319	00	06000	34.08237	-117.5693715	San Bernardino County
329874	Ordering, Referring, Prescribing	N/A	1356506679	0	0	WRIGHT, MEGAN	4/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW114847	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	STE. 210	OXNARD	CA	93036	0617	00	06000	34.219566	-119.1539365	Ventura County
329895	Ordering, Referring, Prescribing	N/A	1356554307	0	0	WATTERS, TRICIA D LCSW	11/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW21763	N/A	N/A	N/A	N/A	N/A	3331 POWER INN RD.	STE 140	SACRAMENTO	CA	95826	3889	00	06000	38.543391	-121.4077095	Sacramento County
329916	Ordering, Referring, Prescribing	N/A	1356600746	0	0	WALSH, JAMES P LMFT	1/10/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFC21963	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PARK	None	SANTA CLARITA	CA	91350	0000	00	06000	34.41078438	-118.510775	Los Angeles County
329941	Ordering, Referring, Prescribing	N/A	1356626741	0	0	WOODRUFF, JOLANA R PA	10/11/2017	Taxonomy not applicable	NA	n/a	000	Unknown	21839	N/A	N/A	N/A	N/A	N/A	6107 NORTH FIRST ST	STE 103	FRESNO	CA	93710	5406	00	06000	36.8252391	-119.7723926	Fresno County
329971	Ordering, Referring, Prescribing	N/A	1356691265	0	0	WEST, ANNA R LMFT	11/24/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100347	N/A	N/A	N/A	N/A	N/A	1540 E COLORADO ST	None	GLENDALE	CA	91205	1514	00	06000	34.1427285	-118.230039	Los Angeles County
329976	Ordering, Referring, Prescribing	N/A	1356700165	0	0	WEISZ, ASHLEE N LMFT	3/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	95071	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	SUITE 401	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
329986	Ordering, Referring, Prescribing	N/A	1356710685	0	0	WALSHAW, LAURA L LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111781	N/A	N/A	N/A	N/A	N/A	8912 VOLUNTEER LN	None	SACRAMENTO	CA	95826	3221	00	06000	38.55438	-121.3756965	Sacramento County
330080	Ordering, Referring, Prescribing	N/A	1356853386	0	0	WEST, JARON PA-C	5/4/2020	Taxonomy not applicable	NA	n/a	000	Unknown	55093	N/A	N/A	N/A	N/A	N/A	2101 COURAGE DR	None	FAIRFIELD	CA	94533	6717	00	06000	38.23737478	-122.0676832	Solano County
330192	Ordering, Referring, Prescribing	N/A	1366081986	0	0	WILSON, JENNIFER L LMFT	4/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125685	N/A	N/A	N/A	N/A	N/A	226 W OJAI AVE.	101-180	OJAI	CA	93023	3277	00	06000	34.44760276	-119.2488095	Ventura County
330224	Ordering, Referring, Prescribing	N/A	1366175994	0	0	WHITNEY, MEGHAN T CCC-SLP	7/3/2021	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	20250	N/A	N/A	N/A	N/A	N/A	84 E J ST	None	CHULA VISTA	CA	91910	6115	00	06000	32.6320024	-117.0582826	San Diego County
330368	Ordering, Referring, Prescribing	N/A	1366753071	0	0	WAUSON, TARRAH LMFT	7/27/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84549	N/A	N/A	N/A	N/A	N/A	170 S SPRUCE AVE	SUITE 200	SOUTH SAN FRANCIS	CA	94080	4557	00	06000	37.64883531	-122.4187311	San Mateo County
330377	Ordering, Referring, Prescribing	N/A	1366771222	0	0	WANG, WEN H PHARMD	3/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62521	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	8TH FL	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
330450	Ordering, Referring, Prescribing	N/A	1366876682	0	0	WEBB, LAURA E LMFT	1/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111862	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
330458	Ordering, Referring, Prescribing	N/A	1366885931	0	0	WU, STACEY Y PHARMD	1/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	67996	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	MS SEC2-B	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
330515	Ordering, Referring, Prescribing	N/A	1366986127	0	0	WOODS, ALANISHA	3/26/2018	Taxonomy not applicable	NA	n/a	000	Unknown	76031	N/A	N/A	N/A	N/A	N/A	1520 BRUNDAGE LN	None	BAKERSFIELD	CA	93304	2949	00	06000	35.355456	-119.0196225	Kern County
330566	Ordering, Referring, Prescribing	N/A	1376071183	0	0	WILENSKY, WILLIAM LCSW	2/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW70725	N/A	N/A	N/A	N/A	N/A	1950 MARKET ST	None	RIVERSIDE	CA	92501	1720	00	06000	34.00316496	-117.3767967	Riverside County
330610	Ordering, Referring, Prescribing	N/A	1376165787	0	0	WEIDIG, HILARY LCSW	4/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW114845	N/A	N/A	N/A	N/A	N/A	1045 9TH AVE	None	SAN DIEGO	CA	92101	5504	00	06000	32.71607643	-117.1564968	San Diego County
330645	Ordering, Referring, Prescribing	N/A	1376296103	0	0	WHITACRE, CARYN PSYD	5/26/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32271	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
330649	Ordering, Referring, Prescribing	N/A	1376327015	0	0	WELLS, ASHLEY NP	8/22/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95026812	N/A	N/A	N/A	N/A	N/A	1560 MESA RD	STE 100	NIPOMO	CA	93444	6709	00	06000	35.02977199	-120.5498922	San Luis Obispo County
330668	Ordering, Referring, Prescribing	N/A	1376554162	0	0	WENGER, MILDRED S	5/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A48053	N/A	N/A	N/A	N/A	N/A	1031 W 34TH ST	None	LOS ANGELES	CA	90089	3602	00	06000	34.024005	-118.2895875	Los Angeles County
330723	Ordering, Referring, Prescribing	N/A	1376687848	0	0	WILKINSON, SINDY A LMFT	6/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFT28816	N/A	N/A	N/A	N/A	N/A	2045 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	0188	00	06000	37.709892	-122.118966	Alameda County
330727	Ordering, Referring, Prescribing	N/A	1376694802	0	0	WOOTEN, WILMA J MD	5/16/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A46474	N/A	N/A	N/A	N/A	N/A	3851 ROSECRANS ST	None	SAN DIEGO	CA	92110	3115	00	06000	32.75343795	-117.2028528	San Diego County
330772	Ordering, Referring, Prescribing	N/A	1376813865	0	0	WONG, CARMEN PHARMD	3/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66353	N/A	N/A	N/A	N/A	N/A	1011 SNEATH LN	None	SAN BRUNO	CA	94066	2311	00	06000	37.63437084	-122.4264474	San Mateo County
330830	Ordering, Referring, Prescribing	N/A	1376911222	0	0	WU, AI-TING LMFT	10/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122274	N/A	N/A	N/A	N/A	N/A	905 E 8TH ST	None	LOS ANGELES	CA	90021	1848	00	06000	34.03639545	-118.2465917	Los Angeles County
330877	Ordering, Referring, Prescribing	N/A	1376979849	0	0	WANG, HAIYAN MD	11/29/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A138796	N/A	N/A	N/A	N/A	N/A	4553 GLENCOE AVE	315	MARINA DEL REY	CA	90292	7933	00	06000	33.98427168	-118.4328564	Los Angeles County
330902	Ordering, Referring, Prescribing	N/A	1386010353	0	0	WILLIAMS, CRYSTAL LCSW	10/23/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW91136	N/A	N/A	N/A	N/A	N/A	1816 S FIGUEROA ST	6TH FL	LOS ANGELES	CA	90015	3422	00	06000	34.03542929	-118.2713663	Los Angeles County
330925	Ordering, Referring, Prescribing	N/A	1386044725	0	0	WARD, MANDI LCSW	11/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98544	N/A	N/A	N/A	N/A	N/A	3500 W. MINERAL KING AVE	None	VISALIA	CA	93291	5635	00	06000	36.32778	-119.3297805	Tulare County
330936	Ordering, Referring, Prescribing	N/A	1386055036	0	0	WILLIAMS, EBONY LMFT	7/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113831	N/A	N/A	N/A	N/A	N/A	335 E AVENUE I	None	LANCASTER	CA	93535	1916	00	06000	34.7041113	-118.1247548	Los Angeles County
330987	Ordering, Referring, Prescribing	N/A	1386148302	0	0	WU, MENGYOU MD	4/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166175	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FLOOR SUITE. 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
331023	Ordering, Referring, Prescribing	N/A	1386177129	0	0	WADZANI, DENIS CNP	7/27/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006189	N/A	N/A	N/A	N/A	N/A	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
331026	Ordering, Referring, Prescribing	N/A	1386184109	0	0	WANG, YU DC	3/31/2017	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	33790	N/A	N/A	N/A	N/A	N/A	210 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1746	00	06000	34.064181	-118.122834	Los Angeles County
331062	Ordering, Referring, Prescribing	N/A	1386273027	0	0	WATSON, AARON J MD	11/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL4543	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE	None	LOS ANGELES	CA	90018	1353	00	06000	34.037415	-118.3176815	Los Angeles County
331127	Ordering, Referring, Prescribing	N/A	1386466407	0	0	WEIDNER, JILLIAN PA	10/29/2024	Taxonomy not applicable	NA	n/a	000	Unknown	65346	N/A	N/A	N/A	N/A	N/A	1325 E CHUR	STE 202	SANTA MARIA	CA	93454	5909	00	06000	34.93830382	-120.4738822	Santa Barbara County
331135	Ordering, Referring, Prescribing	N/A	1386626562	0	0	WEBER, KEVIN MD	6/17/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G196960	N/A	N/A	N/A	N/A	N/A	1133W. SYCAMORE STREET	None	WILLOWS	CA	95988	2601	00	06000	39.5205105	-122.2082775	Glenn County
331139	Ordering, Referring, Prescribing	N/A	1386645117	0	0	WANG, YINGFUH A MD	9/27/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77698	N/A	N/A	N/A	N/A	N/A	420 SOUTH GLENDORA AVE	None	WEST COVINA	CA	91790	3001	00	06000	34.06750236	-117.925203	Los Angeles County
331168	Ordering, Referring, Prescribing	N/A	1386757433	0	0	WILLIAMS, BRUCE E	4/26/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D21417	N/A	N/A	N/A	N/A	N/A	122 E SAN ANTONIO DR	None	KING CITY	CA	93930	2518	00	06000	36.22193886	-121.1268537	Monterey County
331228	Ordering, Referring, Prescribing	N/A	1386829240	0	0	WILKINSON, GENEVIEVE LMFT	12/15/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	83788	N/A	N/A	N/A	N/A	N/A	115 S LA CUMBRE LN	None	SANTA BARBARA	CA	93105	5102	00	06000	34.43809964	-119.7511604	Santa Barbara County
331245	Ordering, Referring, Prescribing	N/A	1386864908	0	0	WANNIGMAN, PETER J	10/26/2016	Taxonomy not applicable	NA	n/a	000	Unknown	13	N/A	N/A	N/A	N/A	N/A	4110 SORRENTO VALLEY BLV	None	SAN DIEGO	CA	92121	1429	00	06000	32.90375674	-117.2170258	San Diego County
331260	Ordering, Referring, Prescribing	N/A	1386918761	0	0	WARMBIER-SPINA, SUSAN M LMFT	12/9/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50655	N/A	N/A	N/A	N/A	N/A	530 W BADILLO ST	None	COVINA	CA	91722	3787	00	06000	34.08625283	-117.8999625	Los Angeles County
331282	Ordering, Referring, Prescribing	N/A	1386956407	0	0	WONG, CARRIE K	3/11/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D60667	N/A	N/A	N/A	N/A	N/A	5205 MELROSE AVE	None	LOS ANGELES	CA	90038	3144	00	06000	34.08354051	-118.314009	Los Angeles County
331317	Ordering, Referring, Prescribing	N/A	1396012670	0	0	WETZLER, MIKI	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56432	N/A	N/A	N/A	N/A	N/A	4170 EL CAMINO REAL	None	PALO ALTO	CA	94306	4008	00	06000	37.41148135	-122.1243315	Santa Clara County
331319	Ordering, Referring, Prescribing	N/A	1396020996	0	0	WALKER, SHERRY R PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57301	N/A	N/A	N/A	N/A	N/A	6570 LONE TREE WAY	None	BRENTWOOD	CA	94513	5257	00	06000	37.96174626	-121.7318398	Contra Costa County
331320	Ordering, Referring, Prescribing	N/A	1396021085	0	0	WONG, KIRSTI PHARMD	8/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	CA41934	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
331380	Ordering, Referring, Prescribing	N/A	1396129219	0	0	WONG, MELINDA C L	7/11/2016	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	70806	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	RM 0762	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
331381	Ordering, Referring, Prescribing	N/A	1396130142	0	0	WAN, JENNY	3/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73542	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
331402	Ordering, Referring, Prescribing	N/A	1396159679	0	0	WILLIAMS, CHRISTINA S MD	11/16/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159010	N/A	N/A	N/A	N/A	N/A	2225 CHALLENGER WAY	None	SANTA ROSA	CA	95407	5418	00	06000	38.425482	-122.75262	Sonoma County
331406	Ordering, Referring, Prescribing	N/A	1396170015	0	0	WAHL, LISA OD FAAO	3/7/2024	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	14724TLG	N/A	N/A	N/A	N/A	N/A	3916 S. BROADWAY	None	LOS ANGELES	CA	90037	1307	00	06000	34.0120423	-118.2782584	Los Angeles County
331412	Ordering, Referring, Prescribing	N/A	1396171419	0	0	WHITE, KRISTIN OD	9/21/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	33577	N/A	N/A	N/A	N/A	N/A	12140 NEW YORK RANCH ROA	None	JACKSON	CA	95642	0000	00	06000	38.38465694	-120.739897	Amador County
331442	Ordering, Referring, Prescribing	N/A	1396206165	0	0	WALSTON, BARBARA E CNP	8/10/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95008281	N/A	N/A	N/A	N/A	N/A	15810 S HARLAN RD	None	LATHROP	CA	95330	8719	00	06000	37.81877638	-121.292417	San Joaquin County
331449	Ordering, Referring, Prescribing	N/A	1396224671	0	0	WILLIAMS, ALYCIA LCSW	12/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99178	N/A	N/A	N/A	N/A	N/A	214 CACHE CT.	None	AUBURN	CA	95603	3172	00	06000	38.92765657	-121.0611922	Placer County
331471	Ordering, Referring, Prescribing	N/A	1396266110	0	0	WATKINS, KENNETH LCSW	3/16/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW77078	N/A	N/A	N/A	N/A	N/A	8788 ELK GROVE BLVD.	None	ELK GROVE	CA	95624	1766	00	06000	38.408382	-121.3770645	Sacramento County
331481	Ordering, Referring, Prescribing	N/A	1396276614	0	0	WAGGONER, EMILY CCC-SLP	3/13/2024	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	36926	N/A	N/A	N/A	N/A	N/A	511 S ORCHARD AVE	None	UKIAH	CA	95482	5022	00	06000	39.14729048	-123.1987868	Mendocino County
331493	Ordering, Referring, Prescribing	N/A	1396298667	0	0	WONG, LISA S LMFT	12/5/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110120	N/A	N/A	N/A	N/A	N/A	447 N EL MOLINO AVE	None	PASADENA	CA	91101	1403	00	06000	34.15365596	-118.1370318	Los Angeles County
331541	Ordering, Referring, Prescribing	N/A	1396380705	0	0	WEINSTOCK, BRANDON C NP	6/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013215	N/A	N/A	N/A	N/A	N/A	2640 BRESLAUER WAY	None	REDDING	CA	96001	4246	00	06000	40.5496754	-122.3791396	Shasta County
331561	Ordering, Referring, Prescribing	N/A	1396414603	0	0	WHITE, AMANDA M LCSW	2/17/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW128704	N/A	N/A	N/A	N/A	N/A	4343 BUCKSKIN DR ANTIOCH	None	ANTIOCH	CA	94531	7470	00	06000	37.97309775	-121.7780451	Contra Costa County
331574	Ordering, Referring, Prescribing	N/A	1396467320	0	0	WIN, CHO NP	11/28/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021280	N/A	N/A	N/A	N/A	N/A	276 W COLLEGE ST	None	COVINA	CA	91723	1902	00	06000	34.08747441	-117.8941951	Los Angeles County
331685	Ordering, Referring, Prescribing	N/A	1396907127	0	0	WILKIE, JOHN E LCSW	5/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27828	N/A	N/A	N/A	N/A	N/A	1963 4TH AVE	None	SAN DIEGO	CA	92101	2394	00	06000	32.72572745	-117.1608615	San Diego County
331705	Ordering, Referring, Prescribing	N/A	1396959201	0	0	WILSON, KELLY	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0562218	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
331735	Ordering, Referring, Prescribing	N/A	1407015076	0	0	WINSLOW, JELANI E	3/31/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D56557	N/A	N/A	N/A	N/A	N/A	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	00	06000	34.06750236	-117.925203	Los Angeles County
331804	Ordering, Referring, Prescribing	N/A	1407198385	0	0	WASHINGTON, GERRI LCSW	11/23/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81242	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
331815	Ordering, Referring, Prescribing	N/A	1407208499	0	0	WILSON, TYLER DO	5/10/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21080	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
331820	Ordering, Referring, Prescribing	N/A	1407216112	0	0	WEISBURST, SHAUNA NP	4/30/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021497	N/A	N/A	N/A	N/A	N/A	1522 BUSH ST	None	SAN FRANCISCO	CA	94109	5420	00	06000	37.78842019	-122.4225944	San Francisco County
331864	Ordering, Referring, Prescribing	N/A	1407298086	0	0	WELCH, MARIA LMFT	12/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114543	N/A	N/A	N/A	N/A	N/A	23311 DRACAEA AVE	None	MORENO VALLEY	CA	92553	3201	00	06000	33.92807348	-117.258489	Riverside County
331894	Ordering, Referring, Prescribing	N/A	1407334733	0	0	WAAS, ROSHANI P NP	9/12/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	2018008175	N/A	N/A	N/A	N/A	N/A	400 WEST 30TH STREET	None	LOS ANGELES	CA	90007	0000	00	06000	34.0239409	-118.2755606	Los Angeles County
331923	Ordering, Referring, Prescribing	N/A	1407362528	0	0	WONG, DAVID T PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH76835	N/A	N/A	N/A	N/A	N/A	1414 EL CAMINO REAL	None	SAN CARLOS	CA	94070	0000	00	06000	37.49716574	-122.2485578	San Mateo County
331983	Ordering, Referring, Prescribing	N/A	1407520653	0	0	WADE, KERRI S LMFT	9/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116146	N/A	N/A	N/A	N/A	N/A	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
332054	Ordering, Referring, Prescribing	N/A	1407942634	0	0	WU, XIPU J MD	12/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A69486	N/A	N/A	N/A	N/A	N/A	19115 COLIMA RD	#202	ROWLAND HEIGHTS	CA	91748	3002	00	06000	33.987359	-117.8863645	Los Angeles County
332085	Ordering, Referring, Prescribing	N/A	1417004268	0	0	WINCH, LISA M	6/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW22704	N/A	N/A	N/A	N/A	N/A	1626 32ND AVE	None	SAN FRANCISCO	CA	94122	3141	00	06000	37.75680987	-122.4905982	San Francisco County
332191	Ordering, Referring, Prescribing	N/A	1417213711	0	0	WOOLFREY, JOHN R MD	10/31/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A128588	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPRESSWAY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
332195	Ordering, Referring, Prescribing	N/A	1417216144	0	0	WINDHAM, RHONDA OT	2/18/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT13283	N/A	N/A	N/A	N/A	N/A	19401 S VERMONT AVENUE	L102	TORRANCE	CA	90502	1029	00	06000	33.85486409	-118.2905603	Los Angeles County
332244	Ordering, Referring, Prescribing	N/A	1417320946	0	0	WEE, MEGHAN L LPCC	12/30/2019	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC3657	N/A	N/A	N/A	N/A	N/A	1360 S. ANAHEIM BLVD.	SUITE 101	ANAHEIM	CA	92805	6205	00	06000	33.8143261	-117.9066647	Orange County
332250	Ordering, Referring, Prescribing	N/A	1417321753	0	0	WU, ELVIE PHARMD	2/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71114	N/A	N/A	N/A	N/A	N/A	3948 N PECK ROAD	A1-A2	EL MONTE	CA	91732	2255	00	06000	34.07745077	-118.0210415	Los Angeles County
332252	Ordering, Referring, Prescribing	N/A	1417325051	0	0	WETTACH-FARIAS, NICOLE MSW LCSW	10/30/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127045	N/A	N/A	N/A	N/A	N/A	4820 BUSINESS CENTER DR	None	FAIRFIELD	CA	94534	1696	00	06000	38.22055392	-122.1386622	Solano County
332255	Ordering, Referring, Prescribing	N/A	1417303207	0	0	WAHEED, OSMOND DO	6/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16598	N/A	N/A	N/A	N/A	N/A	9990 COUNTY FARM ROAD, S	4	RIVERSIDE	CA	92503	3542	00	06000	33.9201112	-117.4577963	Riverside County
332272	Ordering, Referring, Prescribing	N/A	1417342957	0	0	WALKER, CHARLES E LMFT	10/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111585	N/A	N/A	N/A	N/A	N/A	1665 PRECISION PARK LN	None	SAN YSIDRO	CA	92173	1348	00	06000	32.56615193	-117.0594773	San Diego County
332309	Ordering, Referring, Prescribing	N/A	1417406158	0	0	WALKER, LISA LMFT	7/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT120518	N/A	N/A	N/A	N/A	N/A	1236 CHAPALA STREET	None	SANTA BARBARA	CA	93101	3116	00	06000	34.42310529	-119.7066629	Santa Barbara County
332320	Ordering, Referring, Prescribing	N/A	1417423864	0	0	WILLIAMS, KRISTI P RN	2/6/2018	Taxonomy not applicable	NA	n/a	000	Unknown	667991	N/A	N/A	N/A	N/A	N/A	1300 BAKER ST	None	BAKERSFIELD	CA	93305	4326	00	06000	35.38256022	-118.990868	Kern County
332327	Ordering, Referring, Prescribing	N/A	1417441478	0	0	WILSON, MADISON E LMFT	4/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125390	N/A	N/A	N/A	N/A	N/A	5150 E. PACIFIC COAST HW	SUITE 100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
332328	Ordering, Referring, Prescribing	N/A	1417444001	0	0	WAHLEN, LAUREN A LCSW	11/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98588	N/A	N/A	N/A	N/A	N/A	155 N OCCIDENTAL BLVD	None	LOS ANGELES	CA	90026	4641	00	06000	34.07178779	-118.2787879	Los Angeles County
332340	Ordering, Referring, Prescribing	N/A	1417471459	0	0	WOOD, KEEGAN NP	9/2/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006887	N/A	N/A	N/A	N/A	N/A	4283 EL CAJON BLVD	UNIT 110	SAN DIEGO	CA	92105	1289	00	06000	32.7550405	-117.102186	San Diego County
332341	Ordering, Referring, Prescribing	N/A	1417473059	0	0	WEST, RECHELLE LCSW	4/28/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101289	N/A	N/A	N/A	N/A	N/A	555 TECHNOLOGY CT	None	RIVERSIDE	CA	92507	2155	00	06000	34.00024862	-117.32403	Riverside County
332342	Ordering, Referring, Prescribing	N/A	1417473224	0	0	WATSON, SUZETTE M CNP	12/7/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022861	N/A	N/A	N/A	N/A	N/A	2201 COURAGE DR	None	FAIRFIELD	CA	94533	6733	00	06000	38.23727106	-122.0692856	Solano County
332346	Ordering, Referring, Prescribing	N/A	1417474768	0	0	WONG, ALICIA A PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76866	N/A	N/A	N/A	N/A	N/A	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	00	06000	33.9040752	-118.1328995	Los Angeles County
332352	Ordering, Referring, Prescribing	N/A	1417480690	0	0	WATERS, REBECCA MD	10/28/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166144	N/A	N/A	N/A	N/A	N/A	2630 TUOLUMNE ST	None	FRESNO	CA	93721	1227	00	06000	36.74274957	-119.7876577	Fresno County
332368	Ordering, Referring, Prescribing	N/A	1417490376	0	0	WONG, PAUL PHARMD	1/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	41877	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	MS SEC2-B	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
332400	Ordering, Referring, Prescribing	N/A	1417571845	0	0	WOO, YOUNHI	8/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73400	N/A	N/A	N/A	N/A	N/A	2995 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3535	00	06000	37.92663556	-122.0164121	Contra Costa County
332408	Ordering, Referring, Prescribing	N/A	1417585597	0	0	WALDER, ZACHARY DO	8/31/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21369	N/A	N/A	N/A	N/A	N/A	4212 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6269	00	06000	38.706228	-120.834891	El Dorado County
332484	Ordering, Referring, Prescribing	N/A	1427029883	0	0	WAKIM, SARAH K MD	6/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	A94411	N/A	N/A	N/A	N/A	N/A	18800 DELAWARE ST	100	HUNTINGTON BEACH	CA	92648	6082	00	06000	33.68911733	-117.9931535	Orange County
332492	Ordering, Referring, Prescribing	N/A	1427061183	0	0	WALIN, SUSAN L PA-C	7/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA13606	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	None	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
332494	Ordering, Referring, Prescribing	N/A	1427103365	0	0	WILKINSON, MARY ANN MD	5/27/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G67652	N/A	N/A	N/A	N/A	N/A	23521 PASEO DE VALENCIA	STE 200	LAGUNA HILLS	CA	92653	3101	00	06000	33.61113028	-117.7126684	Orange County
332504	Ordering, Referring, Prescribing	N/A	1427120468	0	0	WORK, JOEL C MSW LCSW	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	15631	N/A	N/A	N/A	N/A	N/A	251 LLEWELLYN AVE	None	CAMPBELL	CA	95008	1940	00	06000	37.29173129	-121.9584335	Santa Clara County
332519	Ordering, Referring, Prescribing	N/A	1427135623	0	0	WALKER, MACHON R	12/19/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D65236	N/A	N/A	N/A	N/A	N/A	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	00	06000	38.653245	-121.3836075	Sacramento County
332547	Ordering, Referring, Prescribing	N/A	1427198621	0	0	WINLOCK, KAI L	3/22/2013	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN0510736	N/A	N/A	N/A	N/A	N/A	200 UCLA MEDICAL PLAZA	STE 430	LOS ANGELES	CA	90095	6928	00	06000	34.065126	-118.446237	Los Angeles County
332548	Ordering, Referring, Prescribing	N/A	1427199157	0	0	WALLACE-BURKE, PATRICIA F PHD	6/29/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	16726	N/A	N/A	N/A	N/A	N/A	2008 N. GARY AVE.	None	POMONA	CA	91767	3032	00	06000	34.08295003	-117.7528173	Los Angeles County
332572	Ordering, Referring, Prescribing	N/A	1427251222	0	0	WANG, SUSAN J	10/22/2002	Taxonomy not applicable	NA	n/a	099	DENTIST	D50015	N/A	N/A	N/A	N/A	N/A	501 S IDAHO ST	STE 190	LA HABRA	CA	90631	6047	00	06000	33.927525	-117.959216	Orange County
332592	Ordering, Referring, Prescribing	N/A	1427302199	0	0	WOOD, FRANK C PHARMD	4/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	39991	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
332632	Ordering, Referring, Prescribing	N/A	1427370733	0	0	WILLE, MAYA E MD	1/18/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124078	N/A	N/A	N/A	N/A	N/A	4455 W 117TH ST	300	HAWTHORNE	CA	90250	2241	00	06000	33.92825048	-118.3539285	Los Angeles County
332653	Ordering, Referring, Prescribing	N/A	1427424464	0	0	WRAY, LINDSAY L PSYD	2/5/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	30954	N/A	N/A	N/A	N/A	N/A	3200 MOTOR AVE	None	CULVER CITY	CA	90034	3710	00	06000	34.03321301	-118.4109122	Los Angeles County
332665	Ordering, Referring, Prescribing	N/A	1427435379	0	0	WIN, EMILY F MD	2/9/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A154136	N/A	N/A	N/A	N/A	N/A	3700 MALL VIEW RD	None	BAKERSFIELD	CA	93306	3050	00	06000	35.39462173	-118.9518506	Kern County
332716	Ordering, Referring, Prescribing	N/A	1427517150	0	0	WERBY, JASPER MD	2/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A193827	N/A	N/A	N/A	N/A	N/A	1001 PORTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
332873	Ordering, Referring, Prescribing	N/A	1437208758	0	0	WHITE, GARY M MD	5/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G64333	N/A	N/A	N/A	N/A	N/A	4725 MARKET ST	None	SAN DIEGO	CA	92102	4715	00	06000	32.71127386	-117.0929781	San Diego County
332894	Ordering, Referring, Prescribing	N/A	1437238953	0	0	WARDEN, KIMBERLY NP	1/31/2018	Taxonomy not applicable	NA	n/a	000	Unknown	650976	N/A	N/A	N/A	N/A	N/A	500 B JEFFERSON BOULEVAR	180 & 195	WEST SACRAMENTO	CA	95605	2394	00	06000	38.58758543	-121.5270475	Yolo County
332931	Ordering, Referring, Prescribing	N/A	1437309796	0	0	WHITE, NANCY A LMFT	7/28/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT40492	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
332933	Ordering, Referring, Prescribing	N/A	1437315967	0	0	WONG, DONOVAN A MD	11/24/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A103766	N/A	N/A	N/A	N/A	N/A	4760 S. SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
332985	Ordering, Referring, Prescribing	N/A	1437415247	0	0	WEBSTER, VENUS CATHERINE M PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65724	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
332987	Ordering, Referring, Prescribing	N/A	1437415957	0	0	WOO, VICTORIA G H MD	5/9/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A128309	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
332991	Ordering, Referring, Prescribing	N/A	1437418878	0	0	WU, MARTIN W MD	12/8/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A128132	N/A	N/A	N/A	N/A	N/A	1119 E MONTE VISTA AVE	None	VACAVILLE	CA	95688	3009	00	06000	38.36024633	-121.9763983	Solano County
333025	Ordering, Referring, Prescribing	N/A	1437455367	0	0	WILLIAMS, NANCY J LMFT	3/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52762	N/A	N/A	N/A	N/A	N/A	2335 COUNTRY HILLS DR	None	ANTIOCH	CA	94509	7315	00	06000	37.97021462	-121.7841321	Contra Costa County
333039	Ordering, Referring, Prescribing	N/A	1437491966	0	0	WHALEN, KATRINA M	6/13/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0641919	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
333040	Ordering, Referring, Prescribing	N/A	1437499654	0	0	WALTHERS, MARY V LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92435	N/A	N/A	N/A	N/A	N/A	780 E GILBERT ST	None	SAN BERNARDINO	CA	92415	1003	00	06000	34.1268333	-117.2705634	San Bernardino County
333052	Ordering, Referring, Prescribing	N/A	1437509650	0	0	WALI, JAZMIN LMFT	5/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119082	N/A	N/A	N/A	N/A	N/A	1031 25TH ST	None	SAN DIEGO	CA	92102	2102	00	06000	32.716404	-117.1402635	San Diego County
333055	Ordering, Referring, Prescribing	N/A	1437520715	0	0	WALLS, CANDACE S LMFT	4/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138953	N/A	N/A	N/A	N/A	N/A	8233 E. STOCKTON BLVD	STE D	SACRAMENTO	CA	95828	8203	00	06000	38.459628	-121.4095815	Sacramento County
333074	Ordering, Referring, Prescribing	N/A	1437545217	0	0	WILLIAMS, CAMILE D NP	7/30/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95052437	N/A	N/A	N/A	N/A	N/A	925 G ST	None	REEDLEY	CA	93654	2626	00	06000	36.59806483	-119.4526979	Fresno County
333108	Ordering, Referring, Prescribing	N/A	1437590312	0	0	WONGPRASERT, HANSA MD	2/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A141533	N/A	N/A	N/A	N/A	N/A	847 W CHILDS AVE	None	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
333153	Ordering, Referring, Prescribing	N/A	1437642352	0	0	WALIA, ARMAN S MD	12/8/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165052	N/A	N/A	N/A	N/A	N/A	1873 COMMERCENTER W	None	SAN BERNARDINO	CA	92408	3303	00	06000	34.067781	-117.286122	San Bernardino County
333154	Ordering, Referring, Prescribing	N/A	1437656980	0	0	WONG, GORDON X MD	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164070	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
333165	Ordering, Referring, Prescribing	N/A	1437667383	0	0	WILSON, MARISSA LMFT	11/17/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129324	N/A	N/A	N/A	N/A	N/A	1255 KENDALL RD	None	SAN LUIS OBISPO	CA	93401	8750	00	06000	35.2372881	-120.6292313	San Luis Obispo County
333203	Ordering, Referring, Prescribing	N/A	1437736394	0	0	WILSON, MADISON R MD	1/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192711	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	1M	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
333320	Ordering, Referring, Prescribing	N/A	1447300413	0	0	WOO, MARGIE M PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH41336	N/A	N/A	N/A	N/A	N/A	10325 NORTHVALE RD	None	LOS ANGELES	CA	90064	4330	00	06000	34.03324864	-118.4119291	Los Angeles County
333340	Ordering, Referring, Prescribing	N/A	1447356795	0	0	WU, DAVY MD	1/3/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70449	N/A	N/A	N/A	N/A	N/A	211 EASTMOOR AVE	None	DALY CITY	CA	94015	2036	00	06000	37.6847337	-122.4787562	San Mateo County
333374	Ordering, Referring, Prescribing	N/A	1447424031	0	0	WIRTH, JEFFREY LMFT	7/16/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	30166	N/A	N/A	N/A	N/A	N/A	25910 ACERO	160	MISSION VIEJO	CA	92691	2790	00	06000	33.61712389	-117.6780482	Orange County
333392	Ordering, Referring, Prescribing	N/A	1447476288	0	0	WOOD, ALISA M LCSW	2/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27981	N/A	N/A	N/A	N/A	N/A	714 W. MAIN STREET	None	GRASS VALLEY	CA	95945	6140	00	06000	39.22048887	-121.0678757	Nevada County
333407	Ordering, Referring, Prescribing	N/A	1447513817	0	0	WONG, KAM	9/17/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RPH47751	N/A	N/A	N/A	N/A	N/A	500 TULLY RD	None	SAN JOSE	CA	95111	0000	00	06000	37.30579894	-121.8506333	Santa Clara County
333417	Ordering, Referring, Prescribing	N/A	1447522529	0	0	WIRTH, SHANNON NP	12/18/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	21560	N/A	N/A	N/A	N/A	N/A	134 GOLDEN GATE AVE	None	SAN FRANCISCO	CA	94102	3810	00	06000	37.78204768	-122.4129337	San Francisco County
333433	Ordering, Referring, Prescribing	N/A	1447551775	0	0	WONG, BARNETT PHARMD	12/16/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48817	N/A	N/A	N/A	N/A	N/A	2220 SUNSET BLVD	None	ROCKLIN	CA	95765	4270	00	06000	38.802915	-121.2743205	Placer County
333482	Ordering, Referring, Prescribing	N/A	1447653886	0	0	WERNER, THOMAS LPCC	6/9/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC4787	N/A	N/A	N/A	N/A	N/A	1904 RICHLAND AVE	None	CERES	CA	95307	4562	00	06000	37.60031128	-120.9658226	Stanislaus County
333497	Ordering, Referring, Prescribing	N/A	1447677141	0	0	WALKER, ERIN PA-C	3/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	23189	N/A	N/A	N/A	N/A	N/A	10978 DONNER PASS RD	None	TRUCKEE	CA	96161	0433	00	06000	39.32616692	-120.2026317	Nevada County
333557	Ordering, Referring, Prescribing	N/A	1447772124	0	0	WILSON, KIMBERLY D RDHAP	8/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	24554	N/A	N/A	N/A	N/A	N/A	15301 TYLER FOOTE RD	None	NEVADA CITY	CA	95959	9318	00	06000	39.36622661	-121.0368658	Nevada County
333570	Ordering, Referring, Prescribing	N/A	1447782438	0	0	WU, SANG LMFT	11/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115370	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
333587	Ordering, Referring, Prescribing	N/A	1447815410	0	0	WONG, KAREN MD	11/30/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A183495	N/A	N/A	N/A	N/A	N/A	1685 EAST HOME AVENUE	None	FRESNO	CA	93728	2027	00	06000	36.76325049	-119.7908582	Fresno County
333591	Ordering, Referring, Prescribing	N/A	1447818380	0	0	WONG, SOO Y PHARMD	5/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67155	N/A	N/A	N/A	N/A	N/A	6843 MISSION ST	None	DALY CITY	CA	94014	2006	00	06000	37.69800563	-122.4641796	San Mateo County
333617	Ordering, Referring, Prescribing	N/A	1447887914	0	0	WANG, PHILIP PHARMD	1/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79785	N/A	N/A	N/A	N/A	N/A	43543 20TH ST W	None	LANCASTER	CA	93534	5961	00	06000	34.67416843	-118.1658212	Los Angeles County
333634	Ordering, Referring, Prescribing	N/A	1447930540	0	0	WARREN, KAREN NP	7/19/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95026167	N/A	N/A	N/A	N/A	N/A	801 S GRAND AVENUE	STE 475	LOS ANGELES	CA	90017	4622	00	06000	34.04532806	-118.258462	Los Angeles County
333663	Ordering, Referring, Prescribing	N/A	1457068892	0	0	WONG, RYAN T PHD	9/4/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	35309	N/A	N/A	N/A	N/A	N/A	11980 MOUNT VERNON AVE	None	GRAND TERRACE	CA	92313	5172	00	06000	34.036353	-117.3136565	San Bernardino County
333701	Ordering, Referring, Prescribing	N/A	1457390197	0	0	WANG, FU NAN MD	10/3/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A93089	N/A	N/A	N/A	N/A	N/A	1201 S HACIENDA BLVD	None	HACIENDA HEIGHTS	CA	91745	4844	00	06000	34.00888119	-117.9637514	Los Angeles County
333709	Ordering, Referring, Prescribing	N/A	1457418766	0	0	WEBSTER, WILLIAM E MSW LCSW	5/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23875	N/A	N/A	N/A	N/A	N/A	1 SAINT VINCENTS DR	None	SAN RAFAEL	CA	94903	1504	00	06000	38.034216	-122.525199	Marin County
333714	Ordering, Referring, Prescribing	N/A	1457434300	0	0	WU HSIEH, JULIE T MD	11/18/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A82652	N/A	N/A	N/A	N/A	N/A	330 E LIVE OAK AVE	None	ARCADIA	CA	91006	5617	00	06000	34.10850998	-118.0219204	Los Angeles County
333715	Ordering, Referring, Prescribing	N/A	1457405433	0	0	WALTERS, CYNTHIA L LMFT	1/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT41667	N/A	N/A	N/A	N/A	N/A	2751 NAPA VALLEY CORPORA	None	NAPA	CA	94558	6216	00	06000	38.24829023	-122.2745626	Napa County
333727	Ordering, Referring, Prescribing	N/A	1457475832	0	0	WILLIAMS, CHYRL L LCSW	5/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24455	N/A	N/A	N/A	N/A	N/A	1870 N. MAIN STREET	None	SALINAS	CA	93906	2042	00	06000	36.71784314	-121.6554107	Monterey County
333733	Ordering, Referring, Prescribing	N/A	1457484537	0	0	WAHAB, NAZO PSYD	6/19/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY21604	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
333738	Ordering, Referring, Prescribing	N/A	1457492837	0	0	WHITTAKER, DARRIN M LMFT	1/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	39236	N/A	N/A	N/A	N/A	N/A	809 PLUMAS STREET	None	YUBA CITY	CA	95991	4437	00	06000	39.13989097	-121.6173645	Sutter County
333750	Ordering, Referring, Prescribing	N/A	1457500944	0	0	WARD, CRYSTAL LMFT	11/16/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99113	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
333761	Ordering, Referring, Prescribing	N/A	1457535825	0	0	WALLMAN, BENJAMIN LMFT	8/9/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	148757	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	210	OXNARD	CA	93036	0617	00	06000	34.219566	-119.1539365	Ventura County
333789	Ordering, Referring, Prescribing	N/A	1457597247	0	0	WHITE, NATASHA MD	3/6/2025	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A106271	N/A	N/A	N/A	N/A	N/A	23772 NEWHALL AVE	None	SANTA CLARITA	CA	91321	3125	00	06000	34.37160007	-118.5160227	Los Angeles County
333849	Ordering, Referring, Prescribing	N/A	1457697963	0	0	WILSON, DIANA C LCSW	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28156	N/A	N/A	N/A	N/A	N/A	452 S 1ST ST	None	SAN JOSE	CA	95113	2815	00	06000	37.32939426	-121.8854867	Santa Clara County
333855	Ordering, Referring, Prescribing	N/A	1457721441	0	0	WONG, NATHAN C PHARMD	11/8/2017	Taxonomy not applicable	NA	n/a	000	Unknown	71981	N/A	N/A	N/A	N/A	N/A	650 HOWE AVE STE 600	None	SACRAMENTO	CA	95258	4797	00	06000	38.577123	-121.413924	Sacramento County
333871	Ordering, Referring, Prescribing	N/A	1457746695	0	0	WARAPRATEEP, SANDY M NP	4/20/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002212	N/A	N/A	N/A	N/A	N/A	4024 NORTH DURFEE AVENUE	None	EL MONTE	CA	91732	0000	00	06000	34.07329983	-118.0065548	Los Angeles County
334025	Ordering, Referring, Prescribing	N/A	1457966178	0	0	WOO, MICHELLE C CNP	9/8/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015397	N/A	N/A	N/A	N/A	N/A	2425 ALHAMBRA BLVD	None	SACRAMENTO	CA	95817	1110	00	06000	38.55627	-121.471875	Sacramento County
334037	Ordering, Referring, Prescribing	N/A	1457984239	0	0	WIGGINS, KATHERINE N NP	12/16/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016259	N/A	N/A	N/A	N/A	N/A	72724 TWENTYNINE PALMS H	SUITE 103	TWENTYNINE PALMS	CA	92277	2459	00	06000	34.13547448	-116.076159	San Bernardino County
334080	Ordering, Referring, Prescribing	N/A	1467082131	0	0	WHITTAKER DAVIS, AMANDA M	9/12/2019	Taxonomy not applicable	NA	n/a	000	Unknown	LEP3959	N/A	N/A	N/A	N/A	N/A	4167 AVENIDA DE LA PLATA	106	OCEANSIDE	CA	92056	6032	00	06000	33.21287482	-117.2892109	San Diego County
334106	Ordering, Referring, Prescribing	N/A	1467156547	0	0	WANG, JESSICA J MD	5/29/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A196560	N/A	N/A	N/A	N/A	N/A	2051 MARENGO ST	None	LOS ANGELES	CA	90033	1352	00	06000	34.05627579	-118.2064774	Los Angeles County
334210	Ordering, Referring, Prescribing	N/A	1467655720	0	0	WILLIAMS, CLAUDIA M LCSW	1/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW62941	N/A	N/A	N/A	N/A	N/A	7007 WASHINGTON AVE.	SUITE 211	WHITTIER	CA	90602	3616	00	06000	33.9788072	-118.0350497	Los Angeles County
334281	Ordering, Referring, Prescribing	N/A	1467780916	0	0	WANG, ABRAHAM PA-C	10/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA20605	N/A	N/A	N/A	N/A	N/A	4126 N. MAINE AVENUE	None	BALDWIN PARK	CA	91706	3304	00	06000	34.08740223	-117.9603532	Los Angeles County
334295	Ordering, Referring, Prescribing	N/A	1467792051	0	0	WARREN, JANET A NP	11/8/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22425	N/A	N/A	N/A	N/A	N/A	18077 HIGHWAY18	SUITE 100	APPLE VALLEY	CA	92307	1000	00	06000	34.54021616	-117.2696677	San Bernardino County
334432	Ordering, Referring, Prescribing	N/A	1467994806	0	0	WARREN, ALLISON LMFT	11/5/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104845	N/A	N/A	N/A	N/A	N/A	1000 SUNSET BLVD	140	ROCKLIN	CA	95765	3791	00	06000	38.81665958	-121.2884287	Placer County
334447	Ordering, Referring, Prescribing	N/A	1477021764	0	0	WARBURTON, ROBERT F NP	10/1/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95012975	N/A	N/A	N/A	N/A	N/A	451 W. LINCOLN AVE	100	ANAHEIM	CA	92805	0204	00	06000	33.83445082	-117.9189372	Orange County
334456	Ordering, Referring, Prescribing	N/A	1477042141	0	0	WILSON, ANNEKE MD	11/10/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A175467	N/A	N/A	N/A	N/A	N/A	1043 ELM AVE	SUITE 310	LOS ANGELES	CA	90813	3295	00	06000	33.779655	-118.1880065	Los Angeles
334536	Ordering, Referring, Prescribing	N/A	1477196079	0	0	WONG, ADRIANNE PA	6/19/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58243	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
334555	Ordering, Referring, Prescribing	N/A	1477269637	0	0	WALKER, RAYNA PA	1/26/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62251	N/A	N/A	N/A	N/A	N/A	303 W LINCOLN AVE	#105	ANAHEIM	CA	92805	2936	00	06000	33.83508976	-117.9177981	Orange County
334572	Ordering, Referring, Prescribing	N/A	1477373629	0	0	WANG-ROCKWELL, ANDREA T LMFT	10/10/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	150506	N/A	N/A	N/A	N/A	N/A	300 BRADFORD STREET	None	REDWOOD CITY	CA	94063	1530	00	06000	37.48767403	-122.2323005	San Mateo County
334580	Ordering, Referring, Prescribing	N/A	1477537736	0	0	WILLIAMS, STEPHEN C PA-C	3/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	16501	N/A	N/A	N/A	N/A	N/A	37491 ENTERPRISE DR	None	BURNEY	CA	96013	4379	00	06000	40.88784451	-121.6526265	Shasta County
334656	Ordering, Referring, Prescribing	N/A	1477697688	0	0	WILEY, KARLY LMFT	10/2/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53495	N/A	N/A	N/A	N/A	N/A	240 EDMONDS RD.	None	REDWOOD CITY	CA	94062	3813	00	06000	37.47334689	-122.2854712	San Mateo County
334695	Ordering, Referring, Prescribing	N/A	1477799930	0	0	WALTON, BETH LMFT	9/24/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	33467	N/A	N/A	N/A	N/A	N/A	1330 LINCOLN AVE	201	SAN RAFAEL	CA	94901	2120	00	06000	37.97629089	-122.5226851	Marin County
334703	Ordering, Referring, Prescribing	N/A	1477806842	0	0	WATERS-CARRICO, ZIESHA LCSW	4/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100916	N/A	N/A	N/A	N/A	N/A	12450 VAN NUYS BLVD	200	PACOIMA	CA	91331	1393	00	06000	34.27894489	-118.4044363	Los Angeles County
334716	Ordering, Referring, Prescribing	N/A	1477821668	0	0	WONG, JEANNA	3/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65672	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	362	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
334746	Ordering, Referring, Prescribing	N/A	1477860773	0	0	WU, KRYSTLE CHER P PHARMD	2/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62671	N/A	N/A	N/A	N/A	N/A	1515 N VERMONT AVE	237	LOS ANGELES	CA	90027	5337	00	06000	34.09851639	-118.2918012	Los Angeles County
334764	Ordering, Referring, Prescribing	N/A	1477907491	0	0	WEBER, TRAVIS	8/31/2018	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5493	N/A	N/A	N/A	N/A	N/A	9436 E SLAUSON AVE	None	PICO RIVERA	CA	90660	0000	00	06000	33.96800305	-118.0956362	Los Angeles County
334778	Ordering, Referring, Prescribing	N/A	1477924579	0	0	WEIL, KARENA S LMFT	10/1/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90890	N/A	N/A	N/A	N/A	N/A	7165 BURTON AVENUE	None	ROHNERT PARK	CA	94928	3316	00	06000	38.33819105	-122.6990157	Sonoma County
334788	Ordering, Referring, Prescribing	N/A	1477944783	0	0	WOODSON, DOUGLAS LMFT	9/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT121818	N/A	N/A	N/A	N/A	N/A	2275 ARLINGTON DR	None	SAN LEANDRO	CA	94578	1132	00	06000	37.70851907	-122.1117036	Alameda County
334819	Ordering, Referring, Prescribing	N/A	1477986594	0	0	WANDAG, EVERLYN RUTH	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68013	N/A	N/A	N/A	N/A	N/A	617 W 7TH ST	None	LOS ANGELES	CA	90017	3830	00	06000	34.04779593	-118.2573368	Los Angeles County
334828	Ordering, Referring, Prescribing	N/A	1487004602	0	0	WILLIAMS, KATLYN LMFT	12/29/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFT101056	N/A	N/A	N/A	N/A	N/A	23832 ROCKFIELD BLVD	120	LAKE FOREST	CA	92630	2805	00	06000	33.6263651	-117.7142932	Orange County
334881	Ordering, Referring, Prescribing	N/A	1487060927	0	0	WHEELER, MELISSA A PHARMD	10/10/2018	Taxonomy not applicable	NA	n/a	000	Unknown	70192	N/A	N/A	N/A	N/A	N/A	976 LENZEN AVE	1400	SAN JOSE	CA	95126	2737	00	06000	37.33463902	-121.9121497	Santa Clara County
334905	Ordering, Referring, Prescribing	N/A	1487095261	0	0	WARD, LINDSEY NP	6/26/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030802	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
334911	Ordering, Referring, Prescribing	N/A	1487111217	0	0	WATSON, ASHLEIGH T PA	3/1/2019	Taxonomy not applicable	NA	n/a	000	Unknown	PA56622	N/A	N/A	N/A	N/A	N/A	71777 SAN JACINTO DR	STE. 202	RANCHO MIRAGE	CA	92270	4457	00	06000	33.74394755	-116.4124572	Riverside County
334951	Ordering, Referring, Prescribing	N/A	1487159737	0	0	WANG, JORDAN MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165803	N/A	N/A	N/A	N/A	N/A	4860 Y ST	1700	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
334952	Ordering, Referring, Prescribing	N/A	1487161618	0	0	WARA-GOSS, RUBY LCSW	5/24/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101630	N/A	N/A	N/A	N/A	N/A	2222 9TH AVE	None	OAKLAND	CA	94606	2614	00	06000	37.79841816	-122.2425535	Alameda County
334960	Ordering, Referring, Prescribing	N/A	1487171468	0	0	WATKINS, RACHEL PSYD	2/28/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31126	N/A	N/A	N/A	N/A	N/A	3301 E. 12TH ST	SUITE 259	OAKLAND	CA	94601	2940	00	06000	37.77617499	-122.2247899	Alameda County
334963	Ordering, Referring, Prescribing	N/A	1487174777	0	0	WHEATON, BRITTANEE L LCSW	12/18/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	119856	N/A	N/A	N/A	N/A	N/A	3800 FLORIN ROAD	None	SACRAMENTO	CA	95838	4464	00	06000	38.495052	-121.463874	Sacramento County
335037	Ordering, Referring, Prescribing	N/A	1487308821	0	0	WALOEWANDJA, NINA I NP	7/30/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017946	N/A	N/A	N/A	N/A	N/A	1066 S WHITE RD	STE 170	SAN JOSE	CA	95127	3812	00	06000	37.35676387	-121.8196933	Santa Clara County
335040	Ordering, Referring, Prescribing	N/A	1487323770	0	0	WEAVER, ALLISON LMFT	10/23/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT150838	N/A	N/A	N/A	N/A	N/A	6615 VALLEY HI DRIVE	SUITE A	SACRAMENTO	CA	95823	7076	00	06000	38.470986	-121.4276985	Sacramento County
335044	Ordering, Referring, Prescribing	N/A	1487357604	0	0	WEBB RAMOS, DIANA A MD	7/1/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197370	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
335086	Ordering, Referring, Prescribing	N/A	1487689725	0	0	WARD, ELIZABETH T LMFT	8/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFC29328	N/A	N/A	N/A	N/A	N/A	2292 FARADAY AVE	100	CARLSBAD	CA	92008	7238	00	06000	33.13490794	-117.2765569	San Diego County
335096	Ordering, Referring, Prescribing	N/A	1487716858	0	0	WEARY, CYNTHIA L LMFT	12/14/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96703	N/A	N/A	N/A	N/A	N/A	2101 COURAGE DR	MS 10-270	FAIRFIELD	CA	94533	6717	00	06000	38.23737478	-122.0676832	Solano County
335132	Ordering, Referring, Prescribing	N/A	1487779047	0	0	WONG, ANNIE P O MD	4/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G33575	N/A	N/A	N/A	N/A	N/A	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	00	06000	36.33611794	-119.6460191	Kings County
335155	Ordering, Referring, Prescribing	N/A	1487803623	0	0	WIMETT, MARIE C NP	5/16/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP18375	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL STREET	None	SAN FRANCISCO	CA	94110	1323	00	06000	37.76460716	-122.416335	San Francisco County
335171	Ordering, Referring, Prescribing	N/A	1487857066	0	0	WELLS, ANDREA LMFT	4/9/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT33997	N/A	N/A	N/A	N/A	N/A	740 FRONT STREET	340	SANTA CRUZ	CA	95060	4267	00	06000	36.97547419	-122.0254852	Santa Cruz County
335191	Ordering, Referring, Prescribing	N/A	1487920385	0	0	WARM, HEATHER A MD	5/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A126922	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	7M8	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
335261	Ordering, Referring, Prescribing	N/A	1497025217	0	0	WILSON, NICOLE K LPCC	5/19/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC2387	N/A	N/A	N/A	N/A	N/A	1963 4TH AVE	None	SAN DIEGO	CA	92101	2394	00	06000	32.72572745	-117.1608615	San Diego County
335286	Ordering, Referring, Prescribing	N/A	1497059604	0	0	WONG, LISA PHARMD	7/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64115	N/A	N/A	N/A	N/A	N/A	498 CASTRO STREET	None	SAN FRANCISCO	CA	94114	1234	00	06000	37.76111969	-122.4350504	San Francisco County
335301	Ordering, Referring, Prescribing	N/A	1497094304	0	0	WEEKLY, CHARITA A CNP	12/2/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016514	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
335327	Ordering, Referring, Prescribing	N/A	1497137749	0	0	WARDEN, COLETTE NP	3/23/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004983	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVE	None	OAKLAND	CA	94602	3311	00	06000	37.8007257	-122.2064578	Alameda County
335356	Ordering, Referring, Prescribing	N/A	1497176903	0	0	WILSON, JONATHAN P LMFT	8/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86228	N/A	N/A	N/A	N/A	N/A	303 E VANDERBILT WAY	None	SAN BERNARDINO	CA	92415	0026	00	06000	34.06872265	-117.2775832	San Bernardino County
335381	Ordering, Referring, Prescribing	N/A	1497209837	0	0	WEINER, JEFFREY PHARMD	11/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	43625	N/A	N/A	N/A	N/A	N/A	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	00	06000	34.07607952	-118.373418	Los Angeles County
335422	Ordering, Referring, Prescribing	N/A	1497276406	0	0	WONG, FLORA PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73782	N/A	N/A	N/A	N/A	N/A	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	00	06000	37.78368811	-122.4218578	San Francisco County
335433	Ordering, Referring, Prescribing	N/A	1497307763	0	0	WONG, AMANDA	5/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	59545	N/A	N/A	N/A	N/A	N/A	1901 VICTOR AVE	None	REDDING	CA	96002	0412	00	06000	40.578561	-122.338664	Shasta County
335463	Ordering, Referring, Prescribing	N/A	1497377048	0	0	WONG, BRANDON PA-C	5/8/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58085	N/A	N/A	N/A	N/A	N/A	121 BARBOZA ST	None	MENDOTA	CA	93640	1901	00	06000	36.76619136	-120.3839072	Fresno County
335492	Ordering, Referring, Prescribing	N/A	1497426217	0	0	WU, SABRINA PHARMD	8/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84904	N/A	N/A	N/A	N/A	N/A	3400 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	00	06000	34.02767826	-118.2008037	Los Angeles County
335498	Ordering, Referring, Prescribing	N/A	1497435713	0	0	WONG, BETHANY DMD	9/19/2023	Taxonomy not applicable	NA	n/a	000	Unknown	DDS108930	N/A	N/A	N/A	N/A	N/A	1450 E. HOLT AVENUE	None	POMONA	CA	91767	5822	00	06000	34.06299829	-117.7215562	Los Angeles County
335546	Ordering, Referring, Prescribing	N/A	1497827471	0	0	WONG, LAUREEN S PHD	5/17/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY18789	N/A	N/A	N/A	N/A	N/A	747 52ND STREET	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
335568	Ordering, Referring, Prescribing	N/A	1497879720	0	0	WAXMAN, TYLER D PSYD	3/23/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY18571	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD.	MS #53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
335601	Ordering, Referring, Prescribing	N/A	1497940191	0	0	WANG, HENGBING MD	5/11/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A134988	N/A	N/A	N/A	N/A	N/A	260 HOSPITAL DR	STE 207	MENDOCINO	CA	95482	4568	00	06000	39.15349918	-123.2039443	Mendocino
335621	Ordering, Referring, Prescribing	N/A	1497988646	0	0	WUERZ, TIMOTHY P DO	11/18/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14028	N/A	N/A	N/A	N/A	N/A	21730 S VERMONT AVE	122	TORRANCE	CA	90502	2196	00	06000	33.830658	-118.290203	Los Angeles County
335639	Ordering, Referring, Prescribing	N/A	1508034992	0	0	WACHNER, KRISTELYN B LAC	8/28/2019	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	11690	N/A	N/A	N/A	N/A	N/A	1309 S MISSION RD	None	FALLBROOK	CA	92028	4167	00	06000	33.36938909	-117.2510954	San Diego County
335696	Ordering, Referring, Prescribing	N/A	1508148560	0	0	WONG, ELIZABETH PHARMD	9/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54049	N/A	N/A	N/A	N/A	N/A	4201 DALE ROAD	None	MODESTO	CA	95356	9767	00	06000	37.700883	-121.0500865	Stanislaus County
335728	Ordering, Referring, Prescribing	N/A	1508200809	0	0	WEGMAN, DONNA M	5/24/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0751354	N/A	N/A	N/A	N/A	N/A	21001 SHERMAN WAY	#9	CANOGA PARK	CA	91303	1760	00	06000	34.20113553	-118.5912126	Los Angeles County
335786	Ordering, Referring, Prescribing	N/A	1508285149	0	0	WEBB, MEREDITH LMFT	7/1/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52874	N/A	N/A	N/A	N/A	N/A	2460 CLAY BANK ROAD	BUILDING #2	FAIRFIELD	CA	94533	1615	00	06000	38.274507	-122.0064875	Solano County
335788	Ordering, Referring, Prescribing	N/A	1508292954	0	0	WRIGHT, ARIELLE P LCSW	1/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99643	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
335833	Ordering, Referring, Prescribing	N/A	1508380700	0	0	WILKEY, SARAH M LMFT	1/16/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	137224	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
335846	Ordering, Referring, Prescribing	N/A	1508392739	0	0	WONG, TIFFANY	8/3/2020	Taxonomy not applicable	NA	n/a	000	Unknown	76413	N/A	N/A	N/A	N/A	N/A	101 THE CITY DR S	PAVILION IV, BLDG 25A, R	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
335931	Ordering, Referring, Prescribing	N/A	1508624297	0	0	WELLER, HEATHER	1/10/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028646	N/A	N/A	N/A	N/A	N/A	925 BEVINS CT	None	LAKEPORT	CA	95453	9754	00	06000	39.03772106	-122.9223338	Lake County
335955	Ordering, Referring, Prescribing	N/A	1508858747	0	0	WILLIAMS, FRANCES NP	5/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	13347	N/A	N/A	N/A	N/A	N/A	300 PROSPERITY BLVD	None	CHOWCHILLA	CA	93610	8498	00	06000	37.12533191	-120.2539247	Madera County
335956	Ordering, Referring, Prescribing	N/A	1508852013	0	0	WALL, DANIEL MD	2/11/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A74764	N/A	N/A	N/A	N/A	N/A	1127 WILSHIRE BLVD	600	LOS ANGELES	CA	90017	3907	00	06000	34.05270508	-118.2641005	Los Angeles County
335990	Ordering, Referring, Prescribing	N/A	1508949868	0	0	WEINBERG, SARAH LCSW	10/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW14151	N/A	N/A	N/A	N/A	N/A	3933 CANON AVENUE	None	OAKLAND	CA	94602	2223	00	06000	37.80368378	-122.2175471	Alameda County
335992	Ordering, Referring, Prescribing	N/A	1508959594	0	0	WIDENER, MARGUERITE S LCSW	5/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW73336	N/A	N/A	N/A	N/A	N/A	321 CASSIDY ST	None	OCEANSIDE	CA	92054	5314	00	06000	33.17461079	-117.3631765	San Diego County
336005	Ordering, Referring, Prescribing	N/A	1508984980	0	0	WEBB, CHRISTINA P LCSW	4/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28585	N/A	N/A	N/A	N/A	N/A	262 HARBOR BLVD, A	None	BELMONT	CA	94002	4017	00	06000	37.52106623	-122.2673667	San Mateo County
336023	Ordering, Referring, Prescribing	N/A	1518019777	0	0	WALLS-JOHNSON, MILDRED N LMFT	10/9/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT87983	N/A	N/A	N/A	N/A	N/A	84 BROADWAY	None	RICHMOND	CA	94804	1910	00	06000	37.9323378	-122.3469072	Contra Costa County
336053	Ordering, Referring, Prescribing	N/A	1518082155	0	0	WILLIAMS, RICKEY A LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50651	N/A	N/A	N/A	N/A	N/A	8838 W PICO BLVD	None	LOS ANGELES	CA	90035	3302	00	06000	34.05493093	-118.3847461	Los Angeles County
336087	Ordering, Referring, Prescribing	N/A	1518112069	0	0	WALTON, LETICIA D LCSW	5/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75519	N/A	N/A	N/A	N/A	N/A	9033 BASELINE RD. SUITE	STE A	RANCHO CUCAMONGA	CA	91730	1255	00	06000	34.12151248	-117.6080805	San Bernardino County
336089	Ordering, Referring, Prescribing	N/A	1518132216	0	0	WARD, CORI L CNP	4/4/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	AP61050214	N/A	N/A	N/A	N/A	N/A	12715 E MISSION AVE	None	SPOKANE VALLEY	WA	99216	1027	00	06000	47.67169523	-117.2331815	Spokane County
336135	Ordering, Referring, Prescribing	N/A	1518236728	0	0	WONG, EUGENE K PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	53479	N/A	N/A	N/A	N/A	N/A	1344 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3356	00	06000	33.89151984	-118.299757	Los Angeles County
336211	Ordering, Referring, Prescribing	N/A	1518368059	0	0	WILLIAMS, KENA S NP	4/25/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000196	N/A	N/A	N/A	N/A	N/A	14550 HAYNES ST	None	VAN NUYS	CA	91411	1613	00	06000	34.18967817	-118.4506446	Los Angeles County
336237	Ordering, Referring, Prescribing	N/A	1518403849	0	0	WELCH, MICHELLE CNP	7/5/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004718	N/A	N/A	N/A	N/A	N/A	42135 10TH STREET WEST	SUITE 201	LANCASTER	CA	93534	6093	00	06000	34.648533	-118.1477975	Los Angeles County
336244	Ordering, Referring, Prescribing	N/A	1518412345	0	0	WILMARTH, ALEXA D NP	5/19/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009707	N/A	N/A	N/A	N/A	N/A	650 CLARK WAY	None	PALO ALTO	CA	94304	2300	00	06000	37.43949537	-122.1784133	Santa Clara County
336280	Ordering, Referring, Prescribing	N/A	1518477108	0	0	WU, WENDY Z	2/26/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	102888	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
336285	Ordering, Referring, Prescribing	N/A	1518481878	0	0	WONG, KIMBERLY A PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76563	N/A	N/A	N/A	N/A	N/A	216 WESTLAKE CENTER	None	DALY CITY	CA	94015	1430	00	06000	37.70123591	-122.4833751	San Mateo County
336291	Ordering, Referring, Prescribing	N/A	1518496124	0	0	WENDEROTH, CHRISTINE R LPCC	5/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC9667	N/A	N/A	N/A	N/A	N/A	2621 OSWELL ST	None	BAKERSFIELD	CA	93306	3172	00	06000	35.393283	-118.9496505	Kern County
336292	Ordering, Referring, Prescribing	N/A	1518496462	0	0	WALTERS, RANDI C	7/30/2019	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	293068	N/A	N/A	N/A	N/A	N/A	1901 N RICE AVE	170-180	OXNARD	CA	93030	7912	00	06000	34.21960355	-119.1421345	Ventura County
336308	Ordering, Referring, Prescribing	N/A	1518545771	0	0	WANG, RYAN DO	11/1/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22238	N/A	N/A	N/A	N/A	N/A	20 E HUNTINGTON DR	None	ARCADIA	CA	91006	3269	00	06000	34.14002799	-118.030359	Los Angeles County
336416	Ordering, Referring, Prescribing	N/A	1528142015	0	0	WERNER, MANDANA I LCSW	11/4/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23253	N/A	N/A	N/A	N/A	N/A	19231 VICTORY BLVD	SUITE 110	RESEDA	CA	91335	6300	00	06000	34.18659852	-118.552221	Los Angeles County
336428	Ordering, Referring, Prescribing	N/A	1528186269	0	0	WAY, FRANCINE M LMFT	11/24/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	94354	N/A	N/A	N/A	N/A	N/A	830 ATLANTIC AVE	None	LONG BEACH	CA	90813	4513	00	06000	33.77718	-118.185023	Los Angeles County
336457	Ordering, Referring, Prescribing	N/A	1528241502	0	0	WONG, TERESA Y PHARMD	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	53159	N/A	N/A	N/A	N/A	N/A	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	00	06000	37.89189148	-122.057999	Contra Costa County
336470	Ordering, Referring, Prescribing	N/A	1528276474	0	0	WOODS, SHALEAH A LCSW	8/9/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	85069	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
336474	Ordering, Referring, Prescribing	N/A	1528285632	0	0	WU, YU-JING MSW LCSW	6/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25231	N/A	N/A	N/A	N/A	N/A	1266 14TH ST	None	OAKLAND	CA	94607	2247	00	06000	37.81022696	-122.2887619	Alameda County
336504	Ordering, Referring, Prescribing	N/A	1528340288	0	0	WEI, DONNA	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49985	N/A	N/A	N/A	N/A	N/A	260 EL CAMINO REAL	None	BURLINGAME	CA	94010	5120	00	06000	37.5763288	-122.3496381	San Mateo County
336539	Ordering, Referring, Prescribing	N/A	1528377553	0	0	WHITE, CHRISTOPHER L MD	3/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A126600	N/A	N/A	N/A	N/A	N/A	720 WOOD ST	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
336546	Ordering, Referring, Prescribing	N/A	1528418159	0	0	WEISS, MAIA LCSW	4/28/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101324	N/A	N/A	N/A	N/A	N/A	2484 SHATTUCK AVE	SUITE 210	BERKELEY	CA	94704	1209	00	06000	37.8641716	-122.2676092	Alameda County
336609	Ordering, Referring, Prescribing	N/A	1528504198	0	0	WU, JULIE MD	3/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164338	N/A	N/A	N/A	N/A	N/A	2150 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1337	00	06000	38.557287	-121.461444	Sacramento County
336626	Ordering, Referring, Prescribing	N/A	1528533403	0	0	WAGGONER, ALLISON NP	9/27/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95010160	N/A	N/A	N/A	N/A	N/A	1650 VALENCIA ST	None	SAN FRANCISCO	CA	94110	5013	00	06000	37.74617273	-122.4201514	San Francisco County
336630	Ordering, Referring, Prescribing	N/A	1528540382	0	0	WILLIS, MICHAEL D LMFT	1/18/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	140007	N/A	N/A	N/A	N/A	N/A	11901 AVALON BLVD	None	LOS ANGELES	CA	90061	2836	00	06000	33.9245228	-118.2652609	Los Angeles County
336680	Ordering, Referring, Prescribing	N/A	1528619590	0	0	WARD, VERONICA L PA-C	6/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57723	N/A	N/A	N/A	N/A	N/A	533 E PALMDALE BLVD	533-A1	PALMDALE	CA	93550	2374	00	06000	34.5796702	-118.1198284	Los Angeles County
336681	Ordering, Referring, Prescribing	N/A	1528611860	0	0	WILLIAMS, BITHIAH K LCSW	3/4/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	121385	N/A	N/A	N/A	N/A	N/A	3417 MARTIN LUTHER KING	None	SACRAMENTO	CA	95817	3648	00	06000	38.5436141	-121.4646557	Sacramento County
336725	Ordering, Referring, Prescribing	N/A	1528719424	0	0	WEISSKOPF, CLAIRE K PA	11/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60188	N/A	N/A	N/A	N/A	N/A	220 EUCLID AVE	STE 30	SAN DIEGO	CA	92114	3644	00	06000	32.706387	-117.085098	San Diego County
336736	Ordering, Referring, Prescribing	N/A	1528749579	0	0	WANG, FRANCE LCSW	10/4/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW105446	N/A	N/A	N/A	N/A	N/A	3665 KEARNY VILLA RD	SUITE 101	SAN DIEGO	CA	92123	1953	00	06000	32.80816826	-117.1510112	San Diego County
336749	Ordering, Referring, Prescribing	N/A	1528796828	0	0	WONG, TIFFANY W PHARMD	4/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86057	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	9373	00	06000	38.36981229	-120.8002806	Amador County
336760	Ordering, Referring, Prescribing	N/A	1538121272	0	0	WOOD, CHRISTOPHER K MD	11/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A85569	N/A	N/A	N/A	N/A	N/A	1904 RICHLAND AVE	None	CERES	CA	95307	4562	00	06000	37.60031128	-120.9658226	Stanislaus County
336775	Ordering, Referring, Prescribing	N/A	1538189683	0	0	WHEADON, SCOTT C	3/19/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D34440	N/A	N/A	N/A	N/A	N/A	13975 MONO WAY	STE I	SONORA	CA	95370	2824	00	06000	37.97831488	-120.3396851	Tuolumne County
336805	Ordering, Referring, Prescribing	N/A	1538230453	0	0	WILHELMI, JULIE A	6/21/2002	Taxonomy not applicable	NA	n/a	099	DENTIST	D44447	N/A	N/A	N/A	N/A	N/A	363 S MAIN ST	STE 204	ORANGE	CA	92868	3833	00	06000	33.782787	-117.8672715	Orange County
336809	Ordering, Referring, Prescribing	N/A	1538241773	0	0	WEBB, LEWIS V PHD	6/13/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY9619	N/A	N/A	N/A	N/A	N/A	2900 S HARBOR BLVD	100	SANTA ANA	CA	92704	6418	00	06000	33.70816839	-117.9197655	Orange County
336817	Ordering, Referring, Prescribing	N/A	1538282058	0	0	WOZNIAK, STEVEN T MD	1/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77273	N/A	N/A	N/A	N/A	N/A	760 HARRISON ST	None	SAN FRANCISCO	CA	94107	1235	00	06000	37.78155484	-122.3987081	San Francisco County
336835	Ordering, Referring, Prescribing	N/A	1538302781	0	0	WINCZNER, APRIL D LCSW	12/9/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25445	N/A	N/A	N/A	N/A	N/A	3600 POWER INN RD	None	SACRAMENTO	CA	95826	3826	00	06000	38.541726	-121.4096355	Sacramento County
336836	Ordering, Referring, Prescribing	N/A	1538307897	0	0	WHITE, JUSTIN R NP	10/6/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012483	N/A	N/A	N/A	N/A	N/A	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	00	06000	33.12123297	-117.1199417	San Diego County
336864	Ordering, Referring, Prescribing	N/A	1538350004	0	0	WALKER, DAVID A LCSW	9/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96919	N/A	N/A	N/A	N/A	N/A	137 N COTTONWOOD ST	None	WOODLAND	CA	95695	6646	00	06000	38.68538399	-121.7933582	Yolo County
336876	Ordering, Referring, Prescribing	N/A	1538378484	0	0	WISER, JOHN E LMFT	3/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	36743	N/A	N/A	N/A	N/A	N/A	544 S MAIN ST	None	FORT BRAGG	CA	95437	5107	00	06000	39.4355271	-123.8060174	Mendocino County
336931	Ordering, Referring, Prescribing	N/A	1538482039	0	0	WILLIAMS, BRITTANY N LMFT	11/19/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT86506	N/A	N/A	N/A	N/A	N/A	10155 COLIMA RD	None	WHITTIER	CA	90603	2042	00	06000	33.94349601	-118.0106968	Los Angeles County
336960	Ordering, Referring, Prescribing	N/A	1538534193	0	0	WAT, BALDRIC KWONG SHEK PHARMD	8/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74016	N/A	N/A	N/A	N/A	N/A	1050 REDWOOD STREET	None	VALLEJO	CA	94590	2295	00	06000	38.12243542	-122.2500918	Solano County
336980	Ordering, Referring, Prescribing	N/A	1538546734	0	0	WOODSIDE, RACHEL MD	1/15/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A144416	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
337000	Ordering, Referring, Prescribing	N/A	1538562939	0	0	WILLIAMS, ANGELA T NP	8/11/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	496199	N/A	N/A	N/A	N/A	N/A	5245 PACIFIC CONCOURSE	STE 100	LOS ANGELES	CA	90045	6905	00	06000	33.92774061	-118.3727154	Los Angeles County
337042	Ordering, Referring, Prescribing	N/A	1538645635	0	0	WILLIAMSON, DANIELLE E LCSW	2/8/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99938	N/A	N/A	N/A	N/A	N/A	24077 STATE HIGHWAY 49	None	NEVADA CITY	CA	95959	8519	00	06000	39.321882	-121.0992075	Nevada County
337073	Ordering, Referring, Prescribing	N/A	1538685508	0	0	WHEELER, QUINSHA	6/12/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112561	N/A	N/A	N/A	N/A	N/A	1720 E. 120TH	SUITE 1119	LOS ANGELES	CA	90059	9998	00	06000	33.92455929	-118.2423557	Los Angeles County
337120	Ordering, Referring, Prescribing	N/A	1538850847	0	0	WANG, TIANYU OD	5/16/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35430	N/A	N/A	N/A	N/A	N/A	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	00	06000	36.332757	-119.288682	Tulare County
337215	Ordering, Referring, Prescribing	N/A	1548356074	0	0	WALDECK, NANCY	11/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	6310	N/A	N/A	N/A	N/A	N/A	68 COOMBS ST	STE A-4	NAPA	CA	94559	3901	00	06000	38.28705321	-122.2871753	Napa County
337233	Ordering, Referring, Prescribing	N/A	1548394810	0	0	WEISS-TARLOW, MICHELE C LCSW	6/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW21315	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
337252	Ordering, Referring, Prescribing	N/A	1548438971	0	0	WALTERS, JENNIFER L LMFT	1/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52661	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
337358	Ordering, Referring, Prescribing	N/A	1548644313	0	0	WU, CASEY J	1/1/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D64660	N/A	N/A	N/A	N/A	N/A	1031 WATERLOO RD	None	STOCKTON	CA	95205	4256	00	06000	37.96732496	-121.2723543	San Joaquin County
337389	Ordering, Referring, Prescribing	N/A	1548707615	0	0	WYANT, BILLIE J LCSW	3/24/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100703	N/A	N/A	N/A	N/A	N/A	631 S ORCHARD STREET	None	UKIAH	CA	95482	5011	00	06000	39.14619517	-123.1986323	Mendocino County
337398	Ordering, Referring, Prescribing	N/A	1548713605	0	0	WELLS, SARAH LCSW	6/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101788	N/A	N/A	N/A	N/A	N/A	RIVER OAK CENTER FOR CHI	5445 LAUREL HILLS DRIVE	SACRAMENTO	CA	95841	3105	00	06000	38.6014015	-121.3301537	Sacramento
337409	Ordering, Referring, Prescribing	N/A	1548742083	0	0	WHITSETT, DAVID PSYD	2/23/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31318	N/A	N/A	N/A	N/A	N/A	18350 MOUNT LANGLEY ST	220	FOUNTAIN VALLEY	CA	92708	6900	00	06000	33.69633523	-117.9420534	Orange County
337421	Ordering, Referring, Prescribing	N/A	1548760606	0	0	WALTON, MARY NP	2/15/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008617	N/A	N/A	N/A	N/A	N/A	1578 COLORADO BLVD	None	LOS ANGELES	CA	90041	1451	00	06000	34.13947661	-118.2009328	Los Angeles County
337437	Ordering, Referring, Prescribing	N/A	1548772551	0	0	WANG, FONGCHUN	6/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58435	N/A	N/A	N/A	N/A	N/A	114 S PARK VICTORIA DRIV	None	MILPITAS	CA	95035	5724	00	06000	37.43384159	-121.8836388	Santa Clara County
337464	Ordering, Referring, Prescribing	N/A	1548845845	0	0	WHITE, ERICA LCSW	2/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82234	N/A	N/A	N/A	N/A	N/A	4368 SPYRES WAY	None	MODESTO	CA	95356	9259	00	06000	37.702611	-120.998372	Stanislaus County
337480	Ordering, Referring, Prescribing	N/A	1548897614	0	0	WRIGHT, HILARY MD MPH	10/23/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A190532	N/A	N/A	N/A	N/A	N/A	20151 NORDHOFF ST	None	CHATSWORTH	CA	91311	6215	00	06000	34.23182352	-118.572948	Los Angeles County
337551	Ordering, Referring, Prescribing	N/A	1558323741	0	0	WANG, HUEYJANE	4/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	40160	N/A	N/A	N/A	N/A	N/A	1601 COLEMAN AVE	None	SANTA CLARA	CA	95050	3122	00	06000	37.35814451	-121.93908	Santa Clara County
337605	Ordering, Referring, Prescribing	N/A	1558492645	0	0	WILLIS, JEPHRIE E LCSW	4/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21228	N/A	N/A	N/A	N/A	N/A	9645 ARROW ROUTE	BLDG. 5, SUITE A	RANCHO CUCAMONGA	CA	91730	4544	00	06000	34.0992835	-117.595287	San Bernardino County
337624	Ordering, Referring, Prescribing	N/A	1558536987	0	0	WHALEY, HEATHER M MD	1/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	47470	N/A	N/A	N/A	N/A	N/A	10820 PARKSIDE DR	None	KNOXVILLE	TN	37934	1956	00	06000	35.90003918	-84.14416556	Knox County
337628	Ordering, Referring, Prescribing	N/A	1558557660	0	0	WESTIN, TOM LMFT	12/17/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50413	N/A	N/A	N/A	N/A	N/A	2424 DWIGHT WAY	#3	BERKELEY	CA	94704	2365	00	06000	37.86494873	-122.2595558	Alameda County
337664	Ordering, Referring, Prescribing	N/A	1558637439	0	0	WU, SUZANNA T PHARMD	3/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	51101	N/A	N/A	N/A	N/A	N/A	2207 W COMMONWEALTH AVE	None	ALHAMBRA	CA	91803	1302	00	06000	34.08785952	-118.1488918	Los Angeles County
337680	Ordering, Referring, Prescribing	N/A	1558647735	0	0	WELSH, JESSICA LMFT	6/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT82949	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
337698	Ordering, Referring, Prescribing	N/A	1558700179	0	0	WILLIAMS, EMILY N MD	5/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A138947	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
337808	Ordering, Referring, Prescribing	N/A	1558874362	0	0	WONG, KIMBERLY J	7/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77113	N/A	N/A	N/A	N/A	N/A	1630 OCEAN AVE	None	SAN FRANCISCO	CA	94112	1718	00	06000	37.7246634	-122.4596848	San Francisco County
337825	Ordering, Referring, Prescribing	N/A	1558907725	0	0	WANG, SUZANNE	10/19/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011574	N/A	N/A	N/A	N/A	N/A	1425 MONTGOMERY RD	None	RED BLUFF	CA	96080	4605	00	06000	40.157883	-122.2250685	Tehama County
337830	Ordering, Referring, Prescribing	N/A	1558911594	0	0	WILLS, MEAGAN LCSW	10/4/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	118407	N/A	N/A	N/A	N/A	N/A	345 SAN PEDRO ST	None	LOS ANGELES	CA	90013	9998	00	06000	34.04602976	-118.2429461	Los Angeles County
337851	Ordering, Referring, Prescribing	N/A	1558967489	0	0	WATSON, CARMEN H NP	12/16/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016267	N/A	N/A	N/A	N/A	N/A	847 W CHILDS AVE	None	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
337859	Ordering, Referring, Prescribing	N/A	1558988295	0	0	WHITEHEAD, AURELIA NP	7/23/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014717	N/A	N/A	N/A	N/A	N/A	12813 AVALON BLVD	None	LOS ANGELES	CA	90061	2731	00	06000	33.915897	-118.2653295	Los Angeles County
337876	Ordering, Referring, Prescribing	N/A	1568022663	0	0	WOLDEMICHAEL, BISRAT	9/4/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A198867	N/A	N/A	N/A	N/A	N/A	1275 THARP RD	None	YUBA CITY	CA	95993	2645	00	06000	39.14572609	-121.6484225	Sutter County
337951	Ordering, Referring, Prescribing	N/A	1568223451	0	0	WORTLEY, CHRISTINE R NP	1/10/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028654	N/A	N/A	N/A	N/A	N/A	820 W BROADWAY ST	None	NEEDLES	CA	92363	2729	00	06000	34.83897407	-114.6052958	San Bernardino County
337964	Ordering, Referring, Prescribing	N/A	1568478527	0	0	WICKS, STEPHANI A NP	3/12/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	339119	N/A	N/A	N/A	N/A	N/A	1820 J ST	None	SACRAMENTO	CA	95811	3010	00	06000	38.57688	-121.4816625	Sacramento County
338086	Ordering, Referring, Prescribing	N/A	1568735496	0	0	WATSON, NYREE N LMFT	8/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121217	N/A	N/A	N/A	N/A	N/A	15095 ARMAGOSA ROAD	None	VICTORVILLE	CA	92394	0500	00	06000	0	0	None
338088	Ordering, Referring, Prescribing	N/A	1568739290	0	0	WU, KATIE	8/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56581	N/A	N/A	N/A	N/A	N/A	2799 S WHITE RD	None	SAN JOSE	CA	95148	2093	00	06000	37.32572871	-121.7973412	Santa Clara County
338141	Ordering, Referring, Prescribing	N/A	1568816163	0	0	WONG, SHUNDE T	3/23/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151943	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
338156	Ordering, Referring, Prescribing	N/A	1568832426	0	0	WALLACE, KATHLEEN PT	2/22/2022	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	294253	N/A	N/A	N/A	N/A	N/A	1441 LIBERTY STREET	None	REDDING	CA	96001	1441	00	06000	40.5857177	-122.3870781	Shasta County
338159	Ordering, Referring, Prescribing	N/A	1568843787	0	0	WU, LITA	9/20/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	15272	N/A	N/A	N/A	N/A	N/A	386 GELLERT BLVD	None	DALY CITY	CA	94015	2611	00	06000	37.66532592	-122.4690476	San Mateo County
338210	Ordering, Referring, Prescribing	N/A	1568897734	0	0	WILLIAMS, RAQUEL LMFT	12/28/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103242	N/A	N/A	N/A	N/A	N/A	200 PINE AVE.	400	LONG BEACH	CA	90802	3039	00	06000	33.76962	-118.1923435	Los Angeles County
338227	Ordering, Referring, Prescribing	N/A	1568922185	0	0	WEILAND, DAVID MD	5/19/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A186418	N/A	N/A	N/A	N/A	N/A	6640 ALTON PARKWAY	None	IRVINE	CA	92618	8049	00	06000	33.65911992	-117.7737909	Orange County
338296	Ordering, Referring, Prescribing	N/A	1578045654	0	0	WONG, MEN CHUN LMFT	4/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139302	N/A	N/A	N/A	N/A	N/A	1303 SAN CARLOS AVE	None	SAN CARLOS	CA	94070	2317	00	06000	37.50572931	-122.2621879	San Mateo County
338308	Ordering, Referring, Prescribing	N/A	1578070892	0	0	WARNER, SHEREE J LCSW	12/14/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW106432	N/A	N/A	N/A	N/A	N/A	2201 MISSION AVE	None	SAN DIEGO	CA	92116	2839	00	06000	32.76012926	-117.1411896	San Diego County
338319	Ordering, Referring, Prescribing	N/A	1578081931	0	0	WOODARD, KATHERINE A NP	10/25/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	797667	N/A	N/A	N/A	N/A	N/A	1201 W LA VETA AVENUE	None	ORANGE	CA	92868	4203	00	06000	33.78034779	-117.8655767	Orange County
338354	Ordering, Referring, Prescribing	N/A	1578133625	0	0	WATU, VANESSA L	10/12/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	106374	N/A	N/A	N/A	N/A	N/A	31180 ROAD 72	None	VISALIA	CA	93291	9672	00	06000	36.35594779	-119.4124242	Tulare County
338367	Ordering, Referring, Prescribing	N/A	1578179271	0	0	WEBER, DAVID M PSYD	10/23/2019	Taxonomy not applicable	NA	n/a	000	Unknown	LEP2567	N/A	N/A	N/A	N/A	N/A	1680 DAVID E COOK WAY	None	CLOVIS	CA	93611	2505	00	06000	36.83462552	-119.684979	Fresno County
338368	Ordering, Referring, Prescribing	N/A	1578184156	0	0	WONG, VIONE OD	6/10/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34517	N/A	N/A	N/A	N/A	N/A	425 W. BONITA AVE.	SUITE 110B	SAN DIMAS	CA	91773	2543	00	06000	34.10669347	-117.814932	Los Angeles County
338383	Ordering, Referring, Prescribing	N/A	1578220612	0	0	WALKER, ALEXANDRA NP	8/2/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95026439	N/A	N/A	N/A	N/A	N/A	605 CROUCH ST	BLDG C	OCEANSIDE	CA	92054	4415	00	06000	33.19619156	-117.3537219	San Diego County
338417	Ordering, Referring, Prescribing	N/A	1578342705	0	0	WU, CHEYENNE R PHARMD	9/25/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88692	N/A	N/A	N/A	N/A	N/A	2505 SAN RAMON VALLEY BL	None	SAN RAMON	CA	94583	1603	00	06000	37.77418776	-121.9755744	Contra Costa County
338460	Ordering, Referring, Prescribing	N/A	1578657110	0	0	WRIGHT, CARTER R	11/30/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D38150	N/A	N/A	N/A	N/A	N/A	959 MYRTLE AVE	None	EUREKA	CA	95501	1219	00	06000	40.80062789	-124.1497475	Humboldt County
338503	Ordering, Referring, Prescribing	N/A	1578721585	0	0	WHEELER, DARLENE K PSYD	5/17/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	25590	N/A	N/A	N/A	N/A	N/A	4344 LATHAM ST	110	RIVERSIDE	CA	92501	0400	00	06000	34.00198519	-117.3739252	Riverside County
338534	Ordering, Referring, Prescribing	N/A	1578768081	0	0	WEDELL, JAMES R MD	5/11/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G40844	N/A	N/A	N/A	N/A	N/A	3441 MARYSVILLE BLVD	None	SACRAMENTO	CA	95838	4512	00	06000	38.631231	-121.431402	Sacramento County
338537	Ordering, Referring, Prescribing	N/A	1578778643	0	0	WEBER, IHANDE M LCSW	7/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21531	N/A	N/A	N/A	N/A	N/A	3300 CAPITOL AVE	None	FREMONT	CA	94538	1514	00	06000	37.55270431	-121.9826871	Alameda County
338560	Ordering, Referring, Prescribing	N/A	1578816633	0	0	WRIGHT, JENNIFER N	2/11/2014	Taxonomy not applicable	NA	n/a	000	Unknown	PA22468	N/A	N/A	N/A	N/A	N/A	650 N FULTON	None	FRESNO	CA	93728	3404	00	06000	36.75213	-119.800333	Fresno County
338567	Ordering, Referring, Prescribing	N/A	1578832887	0	0	WONG, CECY PHARMD	1/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50891	N/A	N/A	N/A	N/A	N/A	2341 WINCHESTER BLVD	None	CAMPBELL	CA	95008	4001	00	06000	37.279971	-121.949816	Santa Clara County
338599	Ordering, Referring, Prescribing	N/A	1578878617	0	0	WAXHAM, AMY D LCSW	12/14/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83420	N/A	N/A	N/A	N/A	N/A	1955 LONG BEACH BLVD	None	LONG BEACH	CA	90806	5501	00	06000	33.79290697	-118.1895017	Los Angeles County
338661	Ordering, Referring, Prescribing	N/A	1578935854	0	0	WOLFF, JESSICA LMFT	3/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	37831	N/A	N/A	N/A	N/A	N/A	5170 GOLDEN FOOTHILL PAR	None	EL DORADO HILLS	CA	95762	9608	00	06000	38.64013136	-121.0681138	El Dorado County
338672	Ordering, Referring, Prescribing	N/A	1578972808	0	0	WAI, CHRISTINE PSYD	2/11/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY28203	N/A	N/A	N/A	N/A	N/A	3626 BALBOA STREET	None	SAN FRANCISCO	CA	94121	2604	00	06000	37.77571711	-122.4980286	San Francisco County
338701	Ordering, Referring, Prescribing	N/A	1588001622	0	0	WU, DIANA MD	1/12/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133043	N/A	N/A	N/A	N/A	N/A	1357 OAKLAND BOULEVARD	None	WALNUT CREEK	CA	94596	4303	00	06000	37.89795717	-122.0701674	Contra Costa County
338707	Ordering, Referring, Prescribing	N/A	1588007769	0	0	WANG, WEN-HSIN PHARMD	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69151	N/A	N/A	N/A	N/A	N/A	4950 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5822	00	06000	34.09812092	-118.2980246	Los Angeles County
338752	Ordering, Referring, Prescribing	N/A	1588060461	0	0	WADE, KATHERINE E LCSW	11/18/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82702	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
338780	Ordering, Referring, Prescribing	N/A	1588090542	0	0	WALKER, SEAN-PAUL LMFT	4/27/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	146606	N/A	N/A	N/A	N/A	N/A	947 COLE AVE	None	LOS ANGELES	CA	90038	2610	00	06000	34.088499	-118.3299065	Los Angeles County
338786	Ordering, Referring, Prescribing	N/A	1588106124	0	0	WAKE, AMANDA M LCSW	5/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101592	N/A	N/A	N/A	N/A	N/A	5275 CLAREMONT AVE.	None	OAKLAND	CA	94618	1032	00	06000	37.8391822	-122.260841	Alameda County
338790	Ordering, Referring, Prescribing	N/A	1588112502	0	0	WATKINS, JENNIFER J NP	11/14/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	516579	N/A	N/A	N/A	N/A	N/A	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	00	06000	33.78034779	-117.8655767	Orange County
338824	Ordering, Referring, Prescribing	N/A	1588164560	0	0	WALLMAN, MELISSA A NP	7/12/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95060068	N/A	N/A	N/A	N/A	N/A	201 E LAKEVIEW AVE	None	WOODLAKE	CA	93286	1301	00	06000	36.4172997	-119.0975768	Tulare County
338838	Ordering, Referring, Prescribing	N/A	1588187546	0	0	WONG, MATTHEW K RN PNP	2/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008796	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
338868	Ordering, Referring, Prescribing	N/A	1588241863	0	0	WALLACE, NICOLAI MD	3/8/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A194552	N/A	N/A	N/A	N/A	N/A	751 W LEGION RD	None	BRAWLEY	CA	92227	7732	00	06000	32.95996012	-115.5538196	Imperial County
338883	Ordering, Referring, Prescribing	N/A	1588305221	0	0	WADHWANI, KRISHEN D DO	1/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21945	N/A	N/A	N/A	N/A	N/A	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	00	06000	32.55831005	-117.0475102	San Diego County
338890	Ordering, Referring, Prescribing	N/A	1588329197	0	0	WANG, ANDREW PT	11/9/2020	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	296939	N/A	N/A	N/A	N/A	N/A	728 PACIFIC AVE	STE 301	SAN FRANCISCO	CA	94133	4488	00	06000	37.79687859	-122.4074282	San Francisco County
338925	Ordering, Referring, Prescribing	N/A	1588609481	0	0	WOLDUM, LANE A	7/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	53778	N/A	N/A	N/A	N/A	N/A	1607 E PLANTATION RD	None	MOHAVE VALLEY	AZ	86440	8420	00	06000	34.851987	-114.5952675	Mohave County
338928	Ordering, Referring, Prescribing	N/A	1588609614	0	0	WU, SHEILA T PHD	10/14/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY15392	N/A	N/A	N/A	N/A	N/A	520 S. LAFAYETTE PARK PL	#300	LOS ANGELES	CA	90057	1607	00	06000	34.06392003	-118.2826062	Los Angeles County
338935	Ordering, Referring, Prescribing	N/A	1588684880	0	0	WORRLEIN, SHAWN LCSW	5/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW26835	N/A	N/A	N/A	N/A	N/A	4150 UTE DR	None	SAN DIEGO	CA	92117	5853	00	06000	32.80925642	-117.2018921	San Diego County
338966	Ordering, Referring, Prescribing	N/A	1588735088	0	0	WAYT, MARISA PA	7/2/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA17117	N/A	N/A	N/A	N/A	N/A	27800 MEDICAL CENTER RD	109	MISSION VIEJO	CA	92691	6410	00	06000	33.55952733	-117.6645199	Orange County
339000	Ordering, Referring, Prescribing	N/A	1588814305	0	0	WILDER, NAILAH LCSW	9/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96921	N/A	N/A	N/A	N/A	N/A	3787 S VERMONT AVE	None	LOS ANGELES	CA	90007	4203	00	06000	34.01739	-118.291567	Los Angeles County
339040	Ordering, Referring, Prescribing	N/A	1588914022	0	0	WILSON, ROSALIE B LPCC	5/18/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC6561	N/A	N/A	N/A	N/A	N/A	1260 MORENA BLVD	STE 100	SAN DIEGO	CA	92110	3889	00	06000	32.77077343	-117.2018542	San Diego County
339090	Ordering, Referring, Prescribing	N/A	1588978837	0	0	WEEKS, YVETTE LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88208	N/A	N/A	N/A	N/A	N/A	1950 MARKET ST	None	RIVERSIDE	CA	92501	1720	00	06000	34.00316496	-117.3767967	Riverside County
339174	Ordering, Referring, Prescribing	N/A	1598102394	0	0	WAGNER, AISHA MD	8/6/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A135827	N/A	N/A	N/A	N/A	N/A	1711 OCEAN PARK BOULEVAR	None	SANTA MONICA	CA	90405	1414	00	06000	34.0127217	-118.466458	Los Angeles County
339190	Ordering, Referring, Prescribing	N/A	1598130361	0	0	WATTS, HATIRA NP	9/27/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013964	N/A	N/A	N/A	N/A	N/A	2105 FOREST AVE	STE 110	CHICO	CA	95928	7695	00	06000	39.722121	-121.8015035	Butte County
339193	Ordering, Referring, Prescribing	N/A	1598131112	0	0	WUNG, ZHEN HUI DDS	6/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	64789	N/A	N/A	N/A	N/A	N/A	1133 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	00	06000	36.05124618	-119.0425626	Tulare County
339199	Ordering, Referring, Prescribing	N/A	1598137093	0	0	WILLIAMS, MADELINE MSW LCSW	5/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88879	N/A	N/A	N/A	N/A	N/A	2440 TULARE STREET	SUITE 200	FRESNO	CA	93721	2208	00	06000	36.73727495	-119.7852493	Fresno County
339203	Ordering, Referring, Prescribing	N/A	1598139289	0	0	WANG, SI MD	3/30/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177334	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
339230	Ordering, Referring, Prescribing	N/A	1598186181	0	0	WONG, KRISTIN PHARMD	3/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69887	N/A	N/A	N/A	N/A	N/A	3801 HOWE ST	None	OAKLAND	CA	94611	5312	00	06000	37.8242732	-122.2568561	Alameda County
339264	Ordering, Referring, Prescribing	N/A	1598243263	0	0	WILHELM, KELLY	5/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136202	N/A	N/A	N/A	N/A	N/A	950 W JULIAN ST	None	SAN JOSE	CA	95126	2719	00	06000	37.33352455	-121.9089111	Santa Clara County
339266	Ordering, Referring, Prescribing	N/A	1598250219	0	0	WHISLER, EMILY DO	7/18/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19623	N/A	N/A	N/A	N/A	N/A	2001 THE ALAMEDA	None	SAN JOSE	CA	95126	1136	00	06000	37.34293689	-121.9270392	Santa Clara County
339292	Ordering, Referring, Prescribing	N/A	1598306615	0	0	WU, BING LAC	10/4/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	18171	N/A	N/A	N/A	N/A	N/A	2517 STEPHANIE CT. W	None	SANTA ROSA	CA	95407	6781	00	06000	38.421657	-122.7469545	Sonoma County
339305	Ordering, Referring, Prescribing	N/A	1598321838	0	0	WILLIAMS, JULIE A	6/8/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133158	N/A	N/A	N/A	N/A	N/A	1616 ANDROMEDA COURT	None	LATHROP	CA	95330	8358	00	06000	37.80124554	-121.3245945	San Joaquin County
339334	Ordering, Referring, Prescribing	N/A	1598375982	0	0	WONG, KRISTINA L PHARMD	11/9/2022	Taxonomy not applicable	NA	n/a	000	Unknown	82609	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
339339	Ordering, Referring, Prescribing	N/A	1598383663	0	0	WRIGHT, PHILLIP PT	6/30/2020	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	298502	N/A	N/A	N/A	N/A	N/A	4445 EASTGATE MALL	STE 103	SAN DIEGO	CA	92121	1979	00	06000	32.87856225	-117.2103399	San Diego County
339360	Ordering, Referring, Prescribing	N/A	1598431769	0	0	WHITE, TERRA R PHARMD	11/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84803	N/A	N/A	N/A	N/A	N/A	2601 BALLS FERRY RD	None	ANDERSON	CA	96007	3507	00	06000	40.45353398	-122.2893192	Shasta County
339373	Ordering, Referring, Prescribing	N/A	1598533911	0	0	WHITLEY, DESDEMONA B DC	1/16/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	28762	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
339405	Ordering, Referring, Prescribing	N/A	1598804981	0	0	WHITE, VICTORIA S LMFT	4/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT25860	N/A	N/A	N/A	N/A	N/A	3125 MYERS STREET	None	RIVERSIDE	CA	92503	5527	00	06000	33.90932558	-117.4428095	Riverside County
339436	Ordering, Referring, Prescribing	N/A	1598900870	0	0	WRIGHT, SARAH K LMFT	6/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	80513	N/A	N/A	N/A	N/A	N/A	3951 PERFORMANCE DRIVE	SUITE G	SACRAMENTO	CA	95838	3264	00	06000	38.639979	-121.464099	Sacramento County
339442	Ordering, Referring, Prescribing	N/A	1598913865	0	0	WEINSTEIN, ALLISON PSYD	9/22/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27707	N/A	N/A	N/A	N/A	N/A	1400 EMELINE AVE	None	SANTA CRUZ	CA	95060	1976	00	06000	36.99276804	-122.0178271	Santa Cruz County
339487	Ordering, Referring, Prescribing	N/A	1609003565	0	0	WISE, BRIAN LMFT	8/2/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84632	N/A	N/A	N/A	N/A	N/A	1936 CARLOTTA DR	None	CONCORD	CA	94519	1358	00	06000	37.98614491	-122.0061167	Contra Costa County
339503	Ordering, Referring, Prescribing	N/A	1609039387	0	0	WOO, BRADFORD L PSYD	4/24/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY15627	N/A	N/A	N/A	N/A	N/A	1038 POST STREET	None	SAN FRANCISCO	CA	94109	5603	00	06000	37.78697013	-122.4190434	San Francisco County
339507	Ordering, Referring, Prescribing	N/A	1609049071	0	0	WEISS, NICHOLAS T MD	2/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80148	N/A	N/A	N/A	N/A	N/A	2130 N VENTURA RD	None	OXNARD	CA	93036	2246	00	06000	34.22414993	-119.1944701	Ventura County
339519	Ordering, Referring, Prescribing	N/A	1609084763	0	0	WHIDBY, WAMAITHA LCSW	10/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW65927	N/A	N/A	N/A	N/A	N/A	1904 RICHLAND AVE	C2	CERES	CA	95307	4562	00	06000	37.60031128	-120.9658226	Stanislaus County
339527	Ordering, Referring, Prescribing	N/A	1609095041	0	0	WALKER, LORI A MD	5/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G66060	N/A	N/A	N/A	N/A	N/A	1031 W 34TH ST	None	LOS ANGELES	CA	90089	3602	00	06000	34.024005	-118.2895875	Los Angeles County
339533	Ordering, Referring, Prescribing	N/A	1609113935	0	0	WATKINS, LINDSEY LMFT	7/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT101768	N/A	N/A	N/A	N/A	N/A	3628 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2153	00	06000	35.35426453	-119.045007	Kern County
339564	Ordering, Referring, Prescribing	N/A	1609153584	0	0	WALKER, BRITTNEY L LCSW	8/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	95009	N/A	N/A	N/A	N/A	N/A	1433 S ROBERTSON BLVD	None	LOS ANGELES	CA	90035	3414	00	06000	34.05373818	-118.3839685	Los Angeles County
339619	Ordering, Referring, Prescribing	N/A	1609246651	0	0	WILSON, AMY M NP	10/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003158	N/A	N/A	N/A	N/A	N/A	1708 S. VICTORIA	SUITE D	VENTURA	CA	93003	6594	00	06000	34.25957804	-119.2110778	Ventura County
339693	Ordering, Referring, Prescribing	N/A	1609363548	0	0	WHITAKER, TAYLOR R MD	9/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164957	N/A	N/A	N/A	N/A	N/A	1000 W. CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
339719	Ordering, Referring, Prescribing	N/A	1609407410	0	0	WU, KUAN PEI PHARMD	8/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81958	N/A	N/A	N/A	N/A	N/A	1615 MERIDIAN AVE	None	SAN JOSE	CA	95125	5532	00	06000	37.293957	-121.9135775	Santa Clara County
339763	Ordering, Referring, Prescribing	N/A	1609497916	0	0	WILLIAMS, GABRIELLE S MD	3/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184844	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	FLOOR 2	ANAHEIM	CA	92806	1111	00	06000	33.81812448	-117.8880075	Orange County
339777	Ordering, Referring, Prescribing	N/A	1609557149	0	0	WINKELHAUS, MELISSA NP	7/17/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026050	N/A	N/A	N/A	N/A	N/A	3569 ROUND BARN CIR	None	SANTA ROSA	CA	95403	5781	00	06000	38.479743	-122.729625	Sonoma County
339778	Ordering, Referring, Prescribing	N/A	1609558428	0	0	WELLS, NIKKIA NP	8/30/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026956	N/A	N/A	N/A	N/A	N/A	8950 VILLA LA JOLLA DR	SUITE C217	LA JOLLA	CA	92037	1714	00	06000	32.870934	-117.2338765	San Diego County
339800	Ordering, Referring, Prescribing	N/A	1609807049	0	0	WOZNIAK, SHANNON NP	10/17/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001853	N/A	N/A	N/A	N/A	N/A	630 DRAKE AVE	None	SAUSALITO	CA	94965	1107	00	06000	37.87340883	-122.515085	Marin County
339821	Ordering, Referring, Prescribing	N/A	1609918663	0	0	WICKHAM, THOMAS A PHD	7/1/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY6128	N/A	N/A	N/A	N/A	N/A	26967 BEAUMONT AVE.	None	REDLANDS	CA	92373	4360	00	06000	34.03741027	-117.2157872	San Bernardino County
339864	Ordering, Referring, Prescribing	N/A	1609990647	0	0	WILEY, JOAN LCSW	3/31/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19593	N/A	N/A	N/A	N/A	N/A	4545 N. WEST AVE	None	FRESNO	CA	93705	0946	00	06000	36.799623	-119.8264355	Fresno County
339871	Ordering, Referring, Prescribing	N/A	1619004173	0	0	WILLIAMS, KAREN P	3/5/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY12198	N/A	N/A	N/A	N/A	N/A	10737 LAUREL ST. ,	SUITE 230	RANCHO CUCAMONGA	CA	91730	3837	00	06000	34.10515337	-117.570867	San Bernardino County
339890	Ordering, Referring, Prescribing	N/A	1619036449	0	0	WALKER, JAMESE B	12/16/2014	Taxonomy not applicable	NA	n/a	099	DENTIST	D53966	N/A	N/A	N/A	N/A	N/A	1031 WATERLOO RD	None	STOCKTON	CA	95205	4256	00	06000	37.96732496	-121.2723543	San Joaquin County
339910	Ordering, Referring, Prescribing	N/A	1619064797	0	0	WEN, SHIRLEY S	4/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47508	N/A	N/A	N/A	N/A	N/A	5601 DE SOTO AVE	#4891	WOODLAND HILLS	CA	91367	6701	00	06000	34.17030266	-118.5881699	Los Angeles County
339948	Ordering, Referring, Prescribing	N/A	1619167046	0	0	WOGAN, JAMES C LCSW	1/27/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	22756	N/A	N/A	N/A	N/A	N/A	1936 CARLOTTA DR	None	CONCORD	CA	94519	1358	00	06000	37.98614491	-122.0061167	Contra Costa County
339969	Ordering, Referring, Prescribing	N/A	1619194743	0	0	WEISSMAN, BARBARA Y MD	1/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72285	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
340021	Ordering, Referring, Prescribing	N/A	1619287067	0	0	WHITFIELD, ALYESE	8/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111971	N/A	N/A	N/A	N/A	N/A	25910 ACERO	SUITE 160	MISSION VIEJO	CA	92691	2790	00	06000	33.61712389	-117.6780482	Orange County
340064	Ordering, Referring, Prescribing	N/A	1619357761	0	0	WANG, DAWEI DO	12/17/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17496	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
340079	Ordering, Referring, Prescribing	N/A	1619378155	0	0	WRIGHT, AIMEE LCSW	6/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84426	N/A	N/A	N/A	N/A	N/A	290 IOOF AVENUE	None	GILROY	CA	95020	5204	00	06000	37.01377513	-121.5685719	Santa Clara County
340107	Ordering, Referring, Prescribing	N/A	1619418407	0	0	WANG, KAI CHEN PHARMD	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH76008	N/A	N/A	N/A	N/A	N/A	14102 RAMONA BLVD	None	BALDWIN PARK	CA	91706	3138	00	06000	34.08514059	-117.965948	Los Angeles County
340111	Ordering, Referring, Prescribing	N/A	1619426442	0	0	WAGNER, ROBERT LCSW	12/8/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW112493	N/A	N/A	N/A	N/A	N/A	650 CLARK WAY	None	PALO ALTO	CA	94304	2300	00	06000	37.43949537	-122.1784133	Santa Clara County
340120	Ordering, Referring, Prescribing	N/A	1619428729	0	0	WILBANKS, NICHOLAS	9/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	75655	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
340189	Ordering, Referring, Prescribing	N/A	1619569258	0	0	WILKEY, MELISSA NP	3/5/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95016601	N/A	N/A	N/A	N/A	N/A	147 N BRENT ST	None	VENTURA	CA	93003	2809	00	06000	34.2746295	-119.2573399	Ventura County
340208	Ordering, Referring, Prescribing	N/A	1619621307	0	0	WILSON, ALAN LMFT	11/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	27605	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
340252	Ordering, Referring, Prescribing	N/A	1619997897	0	0	WOODWARD, LISA S NP	5/24/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	413942	N/A	N/A	N/A	N/A	N/A	5420 N. FIGUEROA ST.	None	LOS ANGELES	CA	90042	4118	00	06000	34.10779213	-118.196385	Los Angeles County
340261	Ordering, Referring, Prescribing	N/A	1629067111	0	0	WHELCHEL, ELIZABETH A	8/12/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY14389	N/A	N/A	N/A	N/A	N/A	1515 FUNSTON AVE	None	SAN FRANCISCO	CA	94122	3530	00	06000	37.75976055	-122.4703458	San Francisco County
340273	Ordering, Referring, Prescribing	N/A	1629106414	0	0	WOOD, SUSAN J LMFT	10/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	39261	N/A	N/A	N/A	N/A	N/A	1910 MAGNOLIA AVENUE	None	LOS ANGELES	CA	90007	1220	00	06000	34.039638	-118.2864045	Los Angeles County
340328	Ordering, Referring, Prescribing	N/A	1629210695	0	0	WRIGHT, RENEE LMFT	7/29/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT127210	N/A	N/A	N/A	N/A	N/A	232 E CANON PERDIDO ST	None	SANTA BARBARA	CA	93101	2242	00	06000	34.42349188	-119.6973758	Santa Barbara County
340350	Ordering, Referring, Prescribing	N/A	1629273180	0	0	WOLF, ABIGAIL NP	3/6/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009947	N/A	N/A	N/A	N/A	N/A	1212 BROADWAY	1200	OAKLAND	CA	94612	1814	00	06000	37.80315112	-122.2718722	Alameda County
340368	Ordering, Referring, Prescribing	N/A	1629311378	0	0	WILSON, MALLORY LCSW	11/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW98202	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE.	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
340381	Ordering, Referring, Prescribing	N/A	1629338835	0	0	WHITE, ASHLIE MD	10/10/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A162704	N/A	N/A	N/A	N/A	N/A	444 BRUCE ST	None	YREKA	CA	96097	3450	00	06000	41.71863548	-122.6458755	Siskiyou County
340389	Ordering, Referring, Prescribing	N/A	1629346275	0	0	WALLACE, ALESSIA C LMFT	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102310	N/A	N/A	N/A	N/A	N/A	5575 HOSPITAL DRIVE	None	ATASCADERO	CA	93422	4264	00	06000	35.49162766	-120.6627516	San Luis Obispo County
340396	Ordering, Referring, Prescribing	N/A	1629352802	0	0	WONG, WAI-YIP PHARMD	5/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH46315	N/A	N/A	N/A	N/A	N/A	3150 FOSTORIA WAY	None	DANVILLE	CA	94526	5553	00	06000	37.78145555	-121.9725562	Contra Costa County
340397	Ordering, Referring, Prescribing	N/A	1629351333	0	0	WADHAVA, RAJESH H PHARMD	7/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63763	N/A	N/A	N/A	N/A	N/A	855 COLUSA AVE	None	YUBA CITY	CA	95991	3717	00	06000	39.1418138	-121.6288755	Sutter County
340404	Ordering, Referring, Prescribing	N/A	1629357546	0	0	WONG, WILLIAM W PHARMD	4/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60837	N/A	N/A	N/A	N/A	N/A	7095 MARKET PLACE DR	None	GOLETA	CA	93117	5905	00	06000	34.42799696	-119.873532	Santa Barbara County
340418	Ordering, Referring, Prescribing	N/A	1629378609	0	0	WAHLSTROM, KENNETH PHARMD	7/21/2022	Taxonomy not applicable	NA	n/a	000	Unknown	51053	N/A	N/A	N/A	N/A	N/A	32401 CAMINO CAPISTRANO	None	SAN JUAN CAPISTRA	CA	92675	4517	00	06000	33.49262774	-117.6627855	Orange County
340447	Ordering, Referring, Prescribing	N/A	1629429287	0	0	WOOLBRIGHT-HUTCHINS, STEPHANIE LMFT	11/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111913	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DRIVE	None	SACRAMENTO	CA	95841	3105	00	06000	38.662227	-121.3378965	Sacramento County
340465	Ordering, Referring, Prescribing	N/A	1629478821	0	0	WONG, TIFFANY G PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70677	N/A	N/A	N/A	N/A	N/A	615 BROADWAY	None	MILLBRAE	CA	94030	1909	00	06000	37.60368974	-122.3954957	San Mateo County
340522	Ordering, Referring, Prescribing	N/A	1629566245	0	0	WANG, I-TING LMFT	8/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120971	N/A	N/A	N/A	N/A	N/A	3551 CAMINO MIRA COSTA	SUITE T	SAN CLEMENTE	CA	92672	3508	00	06000	33.45549271	-117.6566925	Orange County
340528	Ordering, Referring, Prescribing	N/A	1629570221	0	0	WOOD, KERRIE LCSW	3/24/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW100268	N/A	N/A	N/A	N/A	N/A	976 LENZEN AVE. 3RD FLOO	None	SAN JOSE	CA	95126	2737	00	06000	37.33463902	-121.9121497	Santa Clara County
340582	Ordering, Referring, Prescribing	N/A	1629643234	0	0	WEBB, ANDREA F LMFT	4/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138979	N/A	N/A	N/A	N/A	N/A	10075 LEVONE AVE CKEE,	None	TRUCKEE	CA	96161	6162	00	06000	39.32516768	-120.2000777	Nevada County
340587	Ordering, Referring, Prescribing	N/A	1629655444	0	0	WILSON, ALEXIS LMFT	12/9/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	143568	N/A	N/A	N/A	N/A	N/A	226 W OJAI AVE	None	OJAI	CA	93023	3277	00	06000	34.44760276	-119.2488095	Ventura County
340644	Ordering, Referring, Prescribing	N/A	1639137490	0	0	WHITE, KEVIN M MD	11/26/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A92052	N/A	N/A	N/A	N/A	N/A	3000 COLBY ST	202	BERKELEY	CA	94705	2058	00	06000	37.85473248	-122.2575793	Alameda County
340650	Ordering, Referring, Prescribing	N/A	1639180193	0	0	WILSON, ROY C MD	12/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C170911	N/A	N/A	N/A	N/A	N/A	2025 EAST 7TH ST.	None	LONG BEACH	CA	90804	4590	00	06000	33.77538146	-118.167057	Los Angeles County
340652	Ordering, Referring, Prescribing	N/A	1639200769	0	0	WILSON, BENJAMIN LMFT	12/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	46444	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
340665	Ordering, Referring, Prescribing	N/A	1639214802	0	0	WALTON, MARC A LMFT	11/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49176	N/A	N/A	N/A	N/A	N/A	100 W WALNUT ST	375	PASADENA	CA	91124	0001	00	06000	34.14963648	-118.1522925	Los Angeles County
340862	Ordering, Referring, Prescribing	N/A	1639572969	0	0	WARDLEY, ERMA J	7/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW8525	N/A	N/A	N/A	N/A	N/A	2311 LOVERIDGE RD	None	PITTSBURG	CA	94565	5117	00	06000	38.00694767	-121.8712439	Contra Costa County
340891	Ordering, Referring, Prescribing	N/A	1639620396	0	0	WALLACE, MORGAN A LMFT	1/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	109698	N/A	N/A	N/A	N/A	N/A	11600 ELDRIDGE AVE	None	LAKE VIEW TERRACE	CA	91342	6506	00	06000	34.28038404	-118.3838708	Los Angeles County
340914	Ordering, Referring, Prescribing	N/A	1639650526	0	0	WINGOOD, JENNIFER PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77972	N/A	N/A	N/A	N/A	N/A	14250 PRAIRIE AVE	None	HAWTHORNE	CA	90250	7908	00	06000	33.90229852	-118.3438368	Los Angeles County
340979	Ordering, Referring, Prescribing	N/A	1639782063	0	0	WU, YINXI LCSW	6/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95013	N/A	N/A	N/A	N/A	N/A	23520 CACTUS AVE	None	MORENO VALLEY	CA	92553	8906	00	06000	33.91028375	-117.2519375	Riverside County
341019	Ordering, Referring, Prescribing	N/A	1639846140	0	0	WILLIAMS, BRITANE D NP	9/19/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018147	N/A	N/A	N/A	N/A	N/A	18077 HIGHWAY18, SUITE 1	100	APPLE VALLEY	CA	92307	1000	00	06000	34.54021616	-117.2696677	San Bernardino County
341021	Ordering, Referring, Prescribing	N/A	1639939671	0	0	WANG, HAO MD	7/28/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL15043	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
341023	Ordering, Referring, Prescribing	N/A	1639952500	0	0	WOOD, KATIE RDH	1/8/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RDH19245	N/A	N/A	N/A	N/A	N/A	1400 MARKET ST	None	REDDING	CA	96001	1052	00	06000	40.58499451	-122.3911682	Shasta County
341072	Ordering, Referring, Prescribing	N/A	1649307950	0	0	WEHN, LINDSEY A LMFT	6/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51782	N/A	N/A	N/A	N/A	N/A	776 S STATE ST.	SUITE 107	UKIAH	CA	95482	5847	00	06000	39.13987386	-123.2059844	Mendocino County
341087	Ordering, Referring, Prescribing	N/A	1649345240	0	0	WILLETT, TONYA S LMFT	4/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49441	N/A	N/A	N/A	N/A	N/A	151 W DANA ST	201	NIPOMO	CA	93444	9131	00	06000	35.04141911	-120.4760034	San Luis Obispo County
341101	Ordering, Referring, Prescribing	N/A	1649364068	0	0	WATT, AMY T PHD	5/8/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY15386	N/A	N/A	N/A	N/A	N/A	3996 MISSION ST	None	SAN FRANCISCO	CA	94112	1050	00	06000	37.73371617	-122.4264284	San Francisco County
341153	Ordering, Referring, Prescribing	N/A	1649494063	0	0	WILKINS, CHARLES LMFT	9/23/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49846	N/A	N/A	N/A	N/A	N/A	6001 BUTLER LANE	208	SANTA CRUZ	CA	95066	3550	00	06000	37.06102724	-122.0059753	Santa Cruz County
341169	Ordering, Referring, Prescribing	N/A	1649522400	0	0	WALLACE, AYESHA D LCSW	11/19/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	79411	N/A	N/A	N/A	N/A	N/A	1203 N CHERRY ST	None	TULARE	CA	93274	2233	00	06000	36.224964	-119.336946	Tulare County
341177	Ordering, Referring, Prescribing	N/A	1649541269	0	0	WONG, SIMON	8/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66641	N/A	N/A	N/A	N/A	N/A	2010 ALAMO DR	None	VACAVILLE	CA	95687	6289	00	06000	38.33537552	-121.9692825	Solano County
341178	Ordering, Referring, Prescribing	N/A	1649544339	0	0	WARD, SHEREEN N PHARMD	5/14/2019	Taxonomy not applicable	NA	n/a	000	Unknown	66823	N/A	N/A	N/A	N/A	N/A	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
341217	Ordering, Referring, Prescribing	N/A	1649605288	0	0	WEBER, TRACY LCSW	4/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW77016	N/A	N/A	N/A	N/A	N/A	100 MASONIC AVENUE	None	SAN FRANCISCO	CA	94118	4415	00	06000	37.78055387	-122.4474128	San Francisco County
341224	Ordering, Referring, Prescribing	N/A	1649613563	0	0	WILLIAMS, ANTHONY J LMFT	10/30/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102945	N/A	N/A	N/A	N/A	N/A	2145 5TH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
341237	Ordering, Referring, Prescribing	N/A	1649624867	0	0	WANG, CRAIG DO	12/23/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A23714	N/A	N/A	N/A	N/A	N/A	10414 VACCO ST.	None	SOUTH EL MONTE	CA	91733	0000	00	06000	34.04731781	-118.0443923	Los Angeles County
341285	Ordering, Referring, Prescribing	N/A	1649708504	0	0	WESTHOFF, SHANNON	5/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT98987	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	None	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
341295	Ordering, Referring, Prescribing	N/A	1649720335	0	0	WANG, MICHELLE PHARMD	4/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61491	N/A	N/A	N/A	N/A	N/A	6230 ELLENVIEW AVE	None	WEST HILLS	CA	91307	2711	00	06000	34.18493738	-118.6600479	Los Angeles County
341333	Ordering, Referring, Prescribing	N/A	1649790874	0	0	WALKER, MONIECIA LCSW	9/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	97210	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
341344	Ordering, Referring, Prescribing	N/A	1649809625	0	0	WEINERT, DANE MD	10/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182711	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
341514	Ordering, Referring, Prescribing	N/A	1659448918	0	0	WHITE, KATHRYN C MD	11/21/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A67922	N/A	N/A	N/A	N/A	N/A	1625 E 4TH ST	None	LOS ANGELES	CA	90033	4201	00	06000	34.04297786	-118.2220181	Los Angeles County
341570	Ordering, Referring, Prescribing	N/A	1659581833	0	0	WILDE, ALIZA M	9/18/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80551	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
341607	Ordering, Referring, Prescribing	N/A	1659652808	0	0	WONG, CINDY Y PHARMD	2/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH53568	N/A	N/A	N/A	N/A	N/A	4131 GEARY BLVD	B25	SAN FRANCISCO	CA	94118	3101	00	06000	37.78096053	-122.4637512	San Francisco County
341737	Ordering, Referring, Prescribing	N/A	1659832186	0	0	WEIL, DOUGLAS	2/7/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW113585	N/A	N/A	N/A	N/A	N/A	131B STONY CIRCLE	1200	SANTA ROSA	CA	95401	6024	00	06000	38.43966826	-122.7451256	Sonoma County
341748	Ordering, Referring, Prescribing	N/A	1659852788	0	0	WILKERSON, ERIN S LMFT	10/31/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135603	N/A	N/A	N/A	N/A	N/A	9713 SANTA MONICA BLVD.	SUITE 201	BEVERLY HILLS	CA	90210	4236	00	06000	34.06835061	-118.4076858	Los Angeles County
341759	Ordering, Referring, Prescribing	N/A	1659875672	0	0	WANG, BELINDA MD	6/6/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164278	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
341775	Ordering, Referring, Prescribing	N/A	1659904365	0	0	WATSON, REGAN CNM	11/21/2019	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236085	N/A	N/A	N/A	N/A	N/A	2051 JOHN JONES RD	None	DAVIS	CA	95616	9701	00	06000	38.56371578	-121.7691963	Yolo County
341858	Ordering, Referring, Prescribing	N/A	1669141560	0	0	WEN, CINDY PHARMD	8/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH84970	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	9373	00	06000	38.36981229	-120.8002806	Amador County
341861	Ordering, Referring, Prescribing	N/A	1669137287	0	0	WHITMORE, LISA R	3/10/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87433	N/A	N/A	N/A	N/A	N/A	3100 DE LA CRUZ BLVD, SU	None	SANTA CLARA	CA	95054	9505	00	06000	37.37984068	-121.9398579	Santa Clara County
341882	Ordering, Referring, Prescribing	N/A	1669185336	0	0	WATERHOUSE, REBECCA	2/9/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	103630	N/A	N/A	N/A	N/A	N/A	611 S KINGSLEY DR.	None	LOS ANGELES	CA	90005	2319	00	06000	34.06305793	-118.3028813	Los Angeles County
341901	Ordering, Referring, Prescribing	N/A	1669425765	0	0	WARE, PAUL F MD	6/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A73645	N/A	N/A	N/A	N/A	N/A	21507 E CLIFF DR	None	SANTA CRUZ	CA	95062	4844	00	06000	36.96330203	-121.9900666	Santa Cruz County
341909	Ordering, Referring, Prescribing	N/A	1669497004	0	0	WYNNE, ROBERT L PHD	6/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	27612	N/A	N/A	N/A	N/A	N/A	2142 SUTTER STREET	None	SAN FRANCISCO	CA	94115	3120	00	06000	37.78581888	-122.4356608	San Francisco County
341950	Ordering, Referring, Prescribing	N/A	1669587382	0	0	WANZO, JOHN E	7/7/2009	Taxonomy not applicable	NA	n/a	099	DENTIST	D30137	N/A	N/A	N/A	N/A	N/A	725 W I ST	None	LOS BANOS	CA	93635	3478	00	06000	37.06257631	-120.8618873	Merced County
341968	Ordering, Referring, Prescribing	N/A	1669629531	0	0	WILLIAMS, TAVARES K MD	11/5/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C199854	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE #A, B, C	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
342044	Ordering, Referring, Prescribing	N/A	1669805305	0	0	WATSON, KELLY J	11/27/2018	Taxonomy not applicable	NA	n/a	000	Unknown	23137	N/A	N/A	N/A	N/A	N/A	700 S TUSTIN STREET	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
342046	Ordering, Referring, Prescribing	N/A	1669808028	0	0	WIECHERT, KAITLIN I LMFT	9/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT121912	N/A	N/A	N/A	N/A	N/A	1841 E MAIN ST	None	BARSTOW	CA	92311	3234	00	06000	34.8901829	-116.9978731	San Bernardino County
342065	Ordering, Referring, Prescribing	N/A	1669847786	0	0	WILLIAMS, EBONI S LPCC	11/17/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC8819	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
342090	Ordering, Referring, Prescribing	N/A	1669897898	0	0	WHITE, ALENA LCSW	12/15/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87712	N/A	N/A	N/A	N/A	N/A	1234 EMPIRE ST	None	FAIRFIELD	CA	94533	5711	00	06000	38.25037548	-122.049045	Solano County
342101	Ordering, Referring, Prescribing	N/A	1669906897	0	0	WORD, SABRINA N LCSW	12/12/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	119719	N/A	N/A	N/A	N/A	N/A	480 CHADBOURNE RD	None	FAIRFIELD	CA	94534	9639	00	06000	38.23538389	-122.0821428	Solano County
342161	Ordering, Referring, Prescribing	N/A	1679005581	0	0	WISE, LICIA E	6/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90769	N/A	N/A	N/A	N/A	N/A	21151 S WESTERN AVE	255	TORRANCE	CA	90501	1724	00	06000	33.83695304	-118.3092655	Los Angeles County
342173	Ordering, Referring, Prescribing	N/A	1679035828	0	0	WINQUIST, GRACE K	8/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	10197	N/A	N/A	N/A	N/A	N/A	3636 CAMINO DEL RIO N	None	SAN DIEGO	CA	92108	1703	00	06000	32.778982	-117.1164717	San Diego County
342185	Ordering, Referring, Prescribing	N/A	1679048813	0	0	WATSON, MIRIAM	6/2/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108335	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	1496	00	06000	34.48058899	-117.2907353	San Bernardino County
342218	Ordering, Referring, Prescribing	N/A	1679094007	0	0	WOMACK, STENSON E	3/8/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	101457	N/A	N/A	N/A	N/A	N/A	8233 E STOCKTON BLVD	STE C	SACRAMENTO	CA	95828	8203	00	06000	38.459628	-121.4095815	Sacramento County
342236	Ordering, Referring, Prescribing	N/A	1679126106	0	0	WONG, TARYN LCSW	10/10/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	118555	N/A	N/A	N/A	N/A	N/A	3545 LONG BEACH BLVD	None	LONG BEACH	CA	90807	3941	00	06000	33.82086796	-118.18938	Los Angeles County
342254	Ordering, Referring, Prescribing	N/A	1679157531	0	0	WOLFE, MICHAEL K MD	9/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	A181496	N/A	N/A	N/A	N/A	N/A	2204 NATIONAL AVE	None	SAN DIEGO	CA	92113	3615	00	06000	32.69715769	-117.1399272	San Diego County
342290	Ordering, Referring, Prescribing	N/A	1679262067	0	0	WAYNE, ANNIE PA-C	7/24/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63098	N/A	N/A	N/A	N/A	N/A	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	00	06000	34.062852	-117.9446658	Los Angeles County
342335	Ordering, Referring, Prescribing	N/A	1679635221	0	0	WILLIAMS, ANGELA K MD	7/1/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	19898	N/A	N/A	N/A	N/A	N/A	39990 FAURE RD	None	HEMET	CA	92544	9108	00	06000	33.54540303	-116.8982524	Riverside County
342336	Ordering, Referring, Prescribing	N/A	1679638852	0	0	WONG, KAM PHARMD	4/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	44298	N/A	N/A	N/A	N/A	N/A	910 MARSHALL ST	# 118	REDWOOD CITY	CA	94063	2033	00	06000	37.4876781	-122.2249265	San Mateo County
342349	Ordering, Referring, Prescribing	N/A	1679663439	0	0	WELDON, CHERYL A LMFT	2/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT34780	N/A	N/A	N/A	N/A	N/A	1055 W HENDERSON AVE	STE 2	PORTERVILLE	CA	93257	1490	00	06000	36.08036906	-119.0410926	Tulare County
342364	Ordering, Referring, Prescribing	N/A	1679704571	0	0	WATERS, MICHELLE LMFT	1/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47449	N/A	N/A	N/A	N/A	N/A	1401 L ST	None	BAKERSFIELD	CA	93301	4522	00	06000	35.37071435	-119.0164657	Kern County
342365	Ordering, Referring, Prescribing	N/A	1679705255	0	0	WHITESIDE, WENDY J LMFT	4/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	97096	N/A	N/A	N/A	N/A	N/A	777 DAVIS ST	None	SAN LEANDRO	CA	94577	6923	00	06000	37.72317409	-122.162925	Alameda County
342375	Ordering, Referring, Prescribing	N/A	1679721609	0	0	WIGGINS, KENDRA L MD	8/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A126601	N/A	N/A	N/A	N/A	N/A	5580 CALLE REAL	None	GOLETA	CA	93111	1646	00	06000	34.44131559	-119.8184752	Santa Barbara County
342406	Ordering, Referring, Prescribing	N/A	1679792170	0	0	WONG, MAGDALENE Y LMFT	4/16/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47349	N/A	N/A	N/A	N/A	N/A	13201 SAN PABLO AVE	None	SAN PABLO	CA	94806	3965	00	06000	37.95165516	-122.3328786	Contra Costa County
342408	Ordering, Referring, Prescribing	N/A	1679788160	0	0	WARREN, PAUL	8/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT37285	N/A	N/A	N/A	N/A	N/A	1305 E VINE ST	None	LODI	CA	95240	3148	00	06000	38.12334848	-121.249194	San Joaquin County
342493	Ordering, Referring, Prescribing	N/A	1679950026	0	0	WEST, SEKEIA M LMFT	3/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115224	N/A	N/A	N/A	N/A	N/A	1330 E COOLEY DR	None	COLTON	CA	92324	3905	00	06000	34.0544745	-117.305721	San Bernardino County
342528	Ordering, Referring, Prescribing	N/A	1689006793	0	0	WATSON, EBONY LCSW	10/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112959	N/A	N/A	N/A	N/A	N/A	7065 INDIANA AVE	SUITE 110	RIVERSIDE	CA	92506	4167	00	06000	33.94000037	-117.3961722	Riverside County
342541	Ordering, Referring, Prescribing	N/A	1689024176	0	0	WIN, CAROL	9/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	12315	N/A	N/A	N/A	N/A	N/A	6221 GEARY BLVD	None	SAN FRANCISCO	CA	94121	1887	00	06000	37.77994312	-122.4862014	San Francisco County
342547	Ordering, Referring, Prescribing	N/A	1689038457	0	0	WIMER, ALEXIS R LMFT	5/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT115213	N/A	N/A	N/A	N/A	N/A	1260 MORENA BLVD	STE 200	SAN DIEGO	CA	92110	3889	00	06000	32.77077343	-117.2018542	San Diego County
342595	Ordering, Referring, Prescribing	N/A	1689117400	0	0	WELCH, MEGAN K LMFT	3/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113763	N/A	N/A	N/A	N/A	N/A	2535 CAMINO DEL RIO S	STE. 160	SAN DIEGO	CA	92108	3754	00	06000	32.76923898	-117.1376556	San Diego County
342649	Ordering, Referring, Prescribing	N/A	1689197857	0	0	WALKER, TIMOTHY LMFT	5/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126108	N/A	N/A	N/A	N/A	N/A	3727 MARCONI AVE	None	SACRAMENTO	CA	95821	5303	00	06000	38.618118	-121.376988	Sacramento County
342694	Ordering, Referring, Prescribing	N/A	1689285769	0	0	WONG, CHRISTINE PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH82983	N/A	N/A	N/A	N/A	N/A	39 HARMONY	None	IRVINE	CA	92602	0921	00	06000	33.73384368	-117.7667886	Orange County
342722	Ordering, Referring, Prescribing	N/A	1689349490	0	0	WEBBER, JAMES D LAC	11/6/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	19203	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE.	None	SAN DIEGO	CA	92106	1839	00	06000	32.750523	-117.100927	San Diego County
342744	Ordering, Referring, Prescribing	N/A	1689607749	0	0	WATTS, NICODEMUS M MD	3/15/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A88041	N/A	N/A	N/A	N/A	N/A	4309 3RD AVE	None	SAN DIEGO	CA	92103	1407	00	06000	32.75638577	-117.162084	San Diego County
342782	Ordering, Referring, Prescribing	N/A	1689749483	0	0	WAGNER, HEIDI	1/22/2024	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34705	N/A	N/A	N/A	N/A	N/A	5460 E LA PALMA AVE	None	ANAHEIM	CA	92807	2023	00	06000	33.85983003	-117.7966383	Orange County
342783	Ordering, Referring, Prescribing	N/A	1689711202	0	0	WILLIAMS, MARIAN E PHD	3/5/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY12787	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD, MS#53	None	LOS ANGELES	CA	90027	6060	00	06000	34.09813032	-118.2901794	Los Angeles County
342785	Ordering, Referring, Prescribing	N/A	1689750325	0	0	WAYNE, JEFFREY MD	12/28/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G65909	N/A	N/A	N/A	N/A	N/A	160 GATEWAY DRIVE	STE110	LINCOLN	CA	95648	3319	00	06000	38.88434593	-121.2914128	Placer County
342800	Ordering, Referring, Prescribing	N/A	1689821753	0	0	WHITCHER, JUDITH A LPCC	4/9/2020	Taxonomy not applicable	NA	n/a	000	Unknown	7722	N/A	N/A	N/A	N/A	N/A	8755 AERO DR	306	SAN DIEGO	CA	92123	1776	00	06000	32.80965252	-117.139383	San Diego County
342820	Ordering, Referring, Prescribing	N/A	1689858607	0	0	WARD, ROMY T LMFT	11/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53497	N/A	N/A	N/A	N/A	N/A	1436 GOODRICH BLVD	None	COMMERCE	CA	90022	5111	00	06000	34.01117577	-118.1585527	Los Angeles County
342872	Ordering, Referring, Prescribing	N/A	1689952236	0	0	WOODBURY, JOSHUA LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116983	N/A	N/A	N/A	N/A	N/A	2180 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	4558	00	06000	35.27488974	-120.6468257	San Luis Obispo County
342897	Ordering, Referring, Prescribing	N/A	1689993016	0	0	WHEELER, BRIAN J MD	4/18/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	50118	N/A	N/A	N/A	N/A	N/A	1265 UNION AVE	None	MEMPHIS	TN	38104	3415	00	06000	35.13704372	-90.01875401	Shelby County
342901	Ordering, Referring, Prescribing	N/A	1699008540	0	0	WERONSKI, LAURA Q LMFT	3/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53324	N/A	N/A	N/A	N/A	N/A	2180 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	4558	00	06000	35.27488974	-120.6468257	San Luis Obispo County
342912	Ordering, Referring, Prescribing	N/A	1699042457	0	0	WILLIAMSON, MARY	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0229405	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
342915	Ordering, Referring, Prescribing	N/A	1699042580	0	0	WU, JEANNIE C PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59663	N/A	N/A	N/A	N/A	N/A	150 S GRAND AVE	None	COVINA	CA	91724	3236	00	06000	34.0852152	-117.8724188	Los Angeles County
342961	Ordering, Referring, Prescribing	N/A	1699099382	0	0	WEIL, ALEXANDER M LMFT	5/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88232	N/A	N/A	N/A	N/A	N/A	982 MISSION STREET	None	SAN FRANCISCO	CA	94103	0902	00	06000	37.7813638	-122.4082438	San Francisco County
342983	Ordering, Referring, Prescribing	N/A	1699138891	0	0	WILSON, MATTHEW D	7/8/2020	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5700	N/A	N/A	N/A	N/A	N/A	5555 RESERVOIR DRIVE	104	SAN DIEGO	CA	92120	5198	00	06000	32.77628471	-117.0563688	San Diego County
343011	Ordering, Referring, Prescribing	N/A	1699193623	0	0	WOODS, AMY MD	12/16/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139551	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
343024	Ordering, Referring, Prescribing	N/A	1699202010	0	0	WHITNEY, KELLYANNE M LCSW	8/15/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	117396	N/A	N/A	N/A	N/A	N/A	485 N 1ST ST	None	SAN JOSE	CA	95112	4041	00	06000	37.34444033	-121.8968517	Santa Clara County
343037	Ordering, Referring, Prescribing	N/A	1699239459	0	0	WALWOOD, EMILY N PA-C	5/26/2019	Taxonomy not applicable	NA	n/a	000	Unknown	56474	N/A	N/A	N/A	N/A	N/A	147 N BRENT ST	None	VENTURA	CA	93003	2809	00	06000	34.2746295	-119.2573399	Ventura County
343043	Ordering, Referring, Prescribing	N/A	1699255174	0	0	WRIGHT, CHELA MD	6/23/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166513	N/A	N/A	N/A	N/A	N/A	3800 W CHAPMAN AVE	None	ORANGE	CA	92868	1638	00	06000	33.78885849	-117.8950802	Orange County
343070	Ordering, Referring, Prescribing	N/A	1699296897	0	0	WIDERHORN, JENNIFER LMFT	1/27/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT123389	N/A	N/A	N/A	N/A	N/A	1260 N DUTTON AVE	SUITE 105	SANTA ROSA	CA	95401	4659	00	06000	38.449197	-122.7320775	Sonoma County
343094	Ordering, Referring, Prescribing	N/A	1699345421	0	0	WARRIACH, ZAIN MD	6/11/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A196854	N/A	N/A	N/A	N/A	N/A	22675 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	8506	00	06000	33.91695337	-117.2672536	Riverside County
343128	Ordering, Referring, Prescribing	N/A	1699401927	0	0	WU, XIBIN LMFT	7/30/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	148461	N/A	N/A	N/A	N/A	N/A	165 ARCH ST	None	REDWOOD CITY	CA	94062	1303	00	06000	37.48727912	-122.2376673	San Mateo County
343140	Ordering, Referring, Prescribing	N/A	1699438820	0	0	WEIXLER, JOHN K NP	4/21/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95246561	N/A	N/A	N/A	N/A	N/A	300 HARTLE CT	None	NAPA	CA	94559	4078	00	06000	38.28326249	-122.2801759	Napa County
343159	Ordering, Referring, Prescribing	N/A	1699505081	0	0	WIN KEMP, RIKA NP	6/14/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95030577	N/A	N/A	N/A	N/A	N/A	751 LOMBARDI CT	None	SANTA ROSA	CA	95407	6793	00	06000	38.427804	-122.7493035	Sonoma County
343170	Ordering, Referring, Prescribing	N/A	1699701532	0	0	WHEELER, FRANK R MD	12/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	6909A	N/A	N/A	N/A	N/A	N/A	2521 E 15TH STREET	None	CASPER	WY	82609	4126	00	06000	42.834753	-106.2938295	Natrona County
343207	Ordering, Referring, Prescribing	N/A	1699818245	0	0	WILD, LISA LMFT	5/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT37077	N/A	N/A	N/A	N/A	N/A	747 52ND STREET	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
343217	Ordering, Referring, Prescribing	N/A	1699835348	0	0	WOMACK, ROSELYN D LMFT	6/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111105	N/A	N/A	N/A	N/A	N/A	1309 EVANS AVENUE	None	SAN FRANCISCO	CA	94124	1705	00	06000	37.74005234	-122.3834106	San Francisco County
343265	Ordering, Referring, Prescribing	N/A	1699946376	0	0	WILLIS, DANIEL L MD	1/13/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A102873	N/A	N/A	N/A	N/A	N/A	1330 LAS TABLAS RD	None	TEMPLETON	CA	93465	9758	00	06000	35.55442548	-120.723759	San Luis Obispo County
343319	Ordering, Referring, Prescribing	N/A	1700093523	0	0	WARE-KAWAMOTO, CARRIE A LMFT	6/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT31005	N/A	N/A	N/A	N/A	N/A	7200 BANCROFT AVE.	125C	OAKLAND	CA	94605	2454	00	06000	37.768221	-122.17608	Alameda County
343365	Ordering, Referring, Prescribing	N/A	1700165131	0	0	WILEY, LAUREN M LMFT	1/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53908	N/A	N/A	N/A	N/A	N/A	35912 AVENUE H.	None	YUCAIPA	CA	92346	6219	00	06000	34.01032324	-117.0223299	San Bernardino County
343370	Ordering, Referring, Prescribing	N/A	1700169356	0	0	WOO, TOMMY H PHARMD	8/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	48749	N/A	N/A	N/A	N/A	N/A	200 N WINCHESTER BLVD	None	SANTA CLARA	CA	95050	6501	00	06000	37.329138	-121.950268	Santa Clara County
343377	Ordering, Referring, Prescribing	N/A	1700173945	0	0	WEBB, BAHAREH PHARMD	8/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63724	N/A	N/A	N/A	N/A	N/A	12120 NEW AIRPORT RD	None	AUBURN	CA	95603	9592	00	06000	38.93274836	-121.0900902	Placer County
343418	Ordering, Referring, Prescribing	N/A	1700235918	0	0	WURBEL, JOSEPH DO	2/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17239	N/A	N/A	N/A	N/A	N/A	3250 WILSHIRE BLVD	SUITE 320	LOS ANGELES	CA	90010	1577	00	06000	34.06176363	-118.2932622	Los Angeles County
343446	Ordering, Referring, Prescribing	N/A	1700286465	0	0	WALKER, LANI LCSW	8/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82671	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
343458	Ordering, Referring, Prescribing	N/A	1700300167	0	0	WEBSTERVEIGA, DANIEL DC	10/28/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	34897	N/A	N/A	N/A	N/A	N/A	1133 N PALM CANYON DRIVE	SUITE A	PALM SPRINGS	CA	92262	4431	00	06000	33.838164	-116.546796	Riverside County
343485	Ordering, Referring, Prescribing	N/A	1700345584	0	0	WEAVER, LISA D MD	6/30/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A180077	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
343504	Ordering, Referring, Prescribing	N/A	1700368073	0	0	WRIGHT, HERBERT B LMFT	1/30/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	141767	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
343547	Ordering, Referring, Prescribing	N/A	1700435435	0	0	WEBB, IMANI LCSW	4/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114833	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
343548	Ordering, Referring, Prescribing	N/A	1700439684	0	0	WILKINS, CANDICE V LCSW	5/18/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW108132	N/A	N/A	N/A	N/A	N/A	2490 W SHAW AVE	101	FRESNO	CA	93711	3305	00	06000	36.80841598	-119.8371594	Fresno County
343559	Ordering, Referring, Prescribing	N/A	1700452299	0	0	WHITAKER, LILY	5/27/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017435	N/A	N/A	N/A	N/A	N/A	4555 PRECISSI LN	None	STOCKTON	CA	95207	6239	00	06000	37.98919284	-121.3152121	San Joaquin County
343561	Ordering, Referring, Prescribing	N/A	1700447877	0	0	WOFFINGTON, LISA J LMFT	4/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132200	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVENUE	None	SAN JOSE	CA	95128	2450	00	06000	37.31712017	-121.9185451	Santa Clara County
343599	Ordering, Referring, Prescribing	N/A	1700577434	0	0	WHEELER, KIM PSYD	5/26/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	34237	N/A	N/A	N/A	N/A	N/A	875 EL CAJON BLVD	None	EL CAJON	CA	92020	5714	00	06000	32.78535272	-116.9770049	San Diego County
343611	Ordering, Referring, Prescribing	N/A	1700598265	0	0	WELDESELASE, RAHWA G PA	12/15/2022	Taxonomy not applicable	NA	n/a	000	Unknown	62124	N/A	N/A	N/A	N/A	N/A	1316 3RD STREET PROMENAD	201	SANTA MONICA	CA	90401	1328	00	06000	34.01670895	-118.497462	Los Angeles County
343613	Ordering, Referring, Prescribing	N/A	1700652591	0	0	WILSON, COLLEEN RN BS	3/13/2024	Taxonomy not applicable	NA	n/a	000	Unknown	669955	N/A	N/A	N/A	N/A	N/A	550 S. CLAY ST	None	INDEPENDENCE	CA	93526	0000	00	06000	36.79860325	-118.1942413	Inyo County
343639	Ordering, Referring, Prescribing	N/A	1700900164	0	0	WILSON, ANGELA M LMFT	7/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT45200	N/A	N/A	N/A	N/A	N/A	1617 CRAVENS AVENUE	None	TORRANCE	CA	90501	3203	00	06000	33.83269486	-118.3158222	Los Angeles County
343659	Ordering, Referring, Prescribing	N/A	1700938917	0	0	WILSON, LESLIE A LMFT	3/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47378	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DR.	None	SACRAMENTO	CA	95841	3105	00	06000	38.662227	-121.3378965	Sacramento County
343748	Ordering, Referring, Prescribing	N/A	1710154265	0	0	WISDA, KATE A NP	3/11/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95011370	N/A	N/A	N/A	N/A	N/A	1578 COLORADO BLVD	13	LOS ANGELES	CA	90041	1451	00	06000	34.13947661	-118.2009328	Los Angeles County
343785	Ordering, Referring, Prescribing	N/A	1710232707	0	0	WHETSELL, KRISTEN L	10/27/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D62862	N/A	N/A	N/A	N/A	N/A	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	00	06000	32.55831005	-117.0475102	San Diego County
343794	Ordering, Referring, Prescribing	N/A	1710241815	0	0	WONG, GEARY	10/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	44079	N/A	N/A	N/A	N/A	N/A	1993 MCKEE ROAD	STE 1164	SAN JOSE	CA	95116	1406	00	06000	37.366029	-121.8533535	Santa Clara County
343891	Ordering, Referring, Prescribing	N/A	1710388723	0	0	WILLIAMS, BROOKE C LMFT	12/15/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT104805	N/A	N/A	N/A	N/A	N/A	11512 B AVE	None	AUBURN	CA	95603	2605	00	06000	38.93969517	-121.1046397	Placer County
343915	Ordering, Referring, Prescribing	N/A	1710422589	0	0	WILLIAMS, LANEE LMFT	11/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	81816	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
343931	Ordering, Referring, Prescribing	N/A	1710441167	0	0	WEGENER, RACHAEL J LCSW	5/24/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101625	N/A	N/A	N/A	N/A	N/A	160 EAST VIRGINIA	None	SAN JOSE	CA	95112	5857	00	06000	37.32582868	-121.8777868	Santa Clara County
344003	Ordering, Referring, Prescribing	N/A	1710628565	0	0	WU, LESLIE C PHARMD	8/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84703	N/A	N/A	N/A	N/A	N/A	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	00	06000	38.00450116	-122.5540001	Marin County
344054	Ordering, Referring, Prescribing	N/A	1720003056	0	0	WILLIAMS, MIRANDA B LP	2/10/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	19618	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
344061	Ordering, Referring, Prescribing	N/A	1720041494	0	0	WHITAKER, ANITA NP	3/23/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP2398	N/A	N/A	N/A	N/A	N/A	12619 BENTLEY STREET	None	WATERFORD	CA	95386	9011	00	06000	37.64073442	-120.7613165	Stanislaus County
344086	Ordering, Referring, Prescribing	N/A	1720118995	0	0	WICKS, BRENDA I LMFT	3/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51256	N/A	N/A	N/A	N/A	N/A	909 N MAIN ST	#1	SANTA ANA	CA	92701	3502	00	06000	33.75288	-117.867582	Orange County
344089	Ordering, Referring, Prescribing	N/A	1720126436	0	0	WAINWRIGHT, JAMES A LMFT	2/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT34961	N/A	N/A	N/A	N/A	N/A	1020 S ARROYO PKWY	None	PASADENA	CA	91105	3911	00	06000	34.128351	-118.1471735	Los Angeles County
344121	Ordering, Referring, Prescribing	N/A	1720191885	0	0	WHEELER, ANISE T NP	3/14/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	11081	N/A	N/A	N/A	N/A	N/A	650 HOWE AVE	400	SACRAMENTO	CA	95825	4731	00	06000	38.577294	-121.4146395	Sacramento County
344158	Ordering, Referring, Prescribing	N/A	1720280878	0	0	WOODY, JOSHUA S LMFT	1/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51266	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	None	SANTA BARBARA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
344161	Ordering, Referring, Prescribing	N/A	1720286818	0	0	WONG, LYNETTE CCC-SLP	4/13/2020	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	SP5700	N/A	N/A	N/A	N/A	N/A	312 CLAY STREET	STE. 150	OAKLAND	CA	94607	3510	00	06000	37.79802567	-122.2780981	Alameda County
344197	Ordering, Referring, Prescribing	N/A	1720340318	0	0	WUEST, VICTORIA M LMFT	2/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110999	N/A	N/A	N/A	N/A	N/A	1411 YUBA ST.	None	REDDING	CA	96001	1010	00	06000	40.58326998	-122.3906244	Shasta County
344247	Ordering, Referring, Prescribing	N/A	1720408537	0	0	WINESBERRY, EMILY L LMFT	5/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119012	N/A	N/A	N/A	N/A	N/A	1385 MISSION STREET	200	SAN FRANCISCO	CA	94103	2631	00	06000	37.77552014	-122.4155639	San Francisco County
344249	Ordering, Referring, Prescribing	N/A	1720409329	0	0	WILLIAMS, JASON R LMFT	9/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT121679	N/A	N/A	N/A	N/A	N/A	1393 BAILEY DR.	None	HANFORD	CA	93230	5922	00	06000	36.32726257	-119.6663418	Kings County
344250	Ordering, Referring, Prescribing	N/A	1720407901	0	0	WILSON, SHARLENA P MD	3/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A142653	N/A	N/A	N/A	N/A	N/A	1386 W 7TH ST	None	SAN PEDRO	CA	90732	3517	00	06000	33.73798378	-118.3075373	Los Angeles County
344254	Ordering, Referring, Prescribing	N/A	1720414600	0	0	WOLLIN, HEZ C LCSW	10/9/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	70723	N/A	N/A	N/A	N/A	N/A	2023 VALE RD	None	SAN PABLO	CA	94806	3834	00	06000	37.95369824	-122.3378493	Contra Costa County
344285	Ordering, Referring, Prescribing	N/A	1720451610	0	0	WHITING, CARRIE PA-C	6/13/2017	Taxonomy not applicable	NA	n/a	000	Unknown	54348	N/A	N/A	N/A	N/A	N/A	1850 SPRING RIDGE DRIVE	None	SUSANVILLE	CA	96130	6100	00	06000	40.43814074	-120.6259249	Lassen County
344298	Ordering, Referring, Prescribing	N/A	1720465925	0	0	WILSON, MARITZA K MD	6/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146931	N/A	N/A	N/A	N/A	N/A	728 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3052	00	06000	33.12769389	-117.0730873	San Diego County
344366	Ordering, Referring, Prescribing	N/A	1720551385	0	0	WONG, FRIEDA RN PHN	3/5/2019	Taxonomy not applicable	NA	n/a	000	Unknown	531393	N/A	N/A	N/A	N/A	N/A	16703 S. CLARK AVE	None	BELLFLOWER	CA	90706	5245	00	06000	33.88289607	-118.1340285	Los Angeles County
344382	Ordering, Referring, Prescribing	N/A	1720584253	0	0	WHIPPLE, CASEY MD	1/11/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174604	N/A	N/A	N/A	N/A	N/A	1300 W OCEAN AVE	None	LOMPOC	CA	93436	5678	00	06000	34.63907053	-120.473361	Santa Barbara County
344397	Ordering, Referring, Prescribing	N/A	1720605702	0	0	WATKINS, JALEESA PA-C	10/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59326	N/A	N/A	N/A	N/A	N/A	1971 E 4TH ST	200	SANTA ANA	CA	92705	3917	00	06000	33.7482685	-117.83934	Orange County
344434	Ordering, Referring, Prescribing	N/A	1720687288	0	0	WONG, LAUREN PHARMD	8/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH83561	N/A	N/A	N/A	N/A	N/A	23072 ALICIA PKWY	None	MISSION VIEJO	CA	92692	1636	00	06000	33.62803407	-117.636481	Orange County
344458	Ordering, Referring, Prescribing	N/A	1720745946	0	0	WILLINGHAM, TOTTYONA U LCSW	6/18/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	123279	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
344461	Ordering, Referring, Prescribing	N/A	1720756992	0	0	WIEST, RAELYNNE NP	4/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018071	N/A	N/A	N/A	N/A	N/A	3800 KILROY AIRPORT WAY	100	LONG BEACH	CA	90806	2494	00	06000	33.80725242	-118.14497	Los Angeles County
344486	Ordering, Referring, Prescribing	N/A	1730123746	0	0	WILKEY, NEIL L MD	5/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C149616	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVENUE	None	SAN JOSE	CA	95128	2407	00	06000	37.31712017	-121.9185451	Santa Clara County
344526	Ordering, Referring, Prescribing	N/A	1730230277	0	0	WILHITE, MARGUERITE LCSW	4/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS17529	N/A	N/A	N/A	N/A	N/A	7200 BANCROFT AVE.	125-D	OAKLAND	CA	94605	2403	00	06000	37.768221	-122.17608	Alameda County
344535	Ordering, Referring, Prescribing	N/A	1730243551	0	0	WONG, YUMIKO PA-C	4/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA18604	N/A	N/A	N/A	N/A	N/A	1310 SAN BERNARDINO RD	105	UPLAND	CA	91786	4979	00	06000	34.10260261	-117.6332582	San Bernardino County
344549	Ordering, Referring, Prescribing	N/A	1730256124	0	0	WYMAN-DIXSON, DEBORAH A LCSW	5/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25560	N/A	N/A	N/A	N/A	N/A	399 LAUREL ST	None	SAN FRANCISCO	CA	94118	1951	00	06000	37.78792725	-122.4503912	San Francisco County
344591	Ordering, Referring, Prescribing	N/A	1730382508	0	0	WU, JENNIFER	12/4/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23892	N/A	N/A	N/A	N/A	N/A	2325 CLEMENT AVE	None	ALAMEDA	CA	94501	7063	00	06000	37.77017367	-122.2389726	Alameda County
344609	Ordering, Referring, Prescribing	N/A	1730427915	0	0	WALCHSHAUSER, LEA R LMFT	2/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53663	N/A	N/A	N/A	N/A	N/A	3845 SPRING DR	18	SPRING VALLEY	CA	91977	1234	00	06000	32.74889129	-117.0031816	San Diego County
344610	Ordering, Referring, Prescribing	N/A	1730422049	0	0	WALKER, AMANDA E LMFT	7/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT99066	N/A	N/A	N/A	N/A	N/A	4309 3RD AVE	None	SAN DIEGO	CA	92103	1407	00	06000	32.75638577	-117.162084	San Diego County
344627	Ordering, Referring, Prescribing	N/A	1730457243	0	0	WANG, YIN SHIH ALICE	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56681	N/A	N/A	N/A	N/A	N/A	6325 ROSEMEAD BLVD	None	SAN GABRIEL	CA	91775	1933	00	06000	34.11410169	-118.0737024	Los Angeles County
344631	Ordering, Referring, Prescribing	N/A	1730458787	0	0	WALTERSPIEL, JUAN N MD	4/26/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C52365	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
344640	Ordering, Referring, Prescribing	N/A	1730471590	0	0	WALI, PRIYANKA K MD	6/11/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124182	N/A	N/A	N/A	N/A	N/A	303 TWIN DOLPHIN DR	None	REDWOOD CITY	CA	94065	1497	00	06000	37.52230449	-122.2597146	San Mateo County
344651	Ordering, Referring, Prescribing	N/A	1730495730	0	0	WINGE, KARRE R LMFT	7/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120153	N/A	N/A	N/A	N/A	N/A	11980 MOUNT VERNON AVENU	None	GRAND TERRACE	CA	92313	5172	00	06000	34.036353	-117.3136565	San Bernardino County
344664	Ordering, Referring, Prescribing	N/A	1730505165	0	0	WONG, JASON Y	6/20/2016	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	70858	N/A	N/A	N/A	N/A	N/A	1380 HOWARD ST	ROOM 130	SAN FRANCISCO	CA	94103	2614	00	06000	37.77424669	-122.4141502	San Francisco County
344710	Ordering, Referring, Prescribing	N/A	1730593674	0	0	WERTHEIMER, SAHAR E MD	5/1/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A154011	N/A	N/A	N/A	N/A	N/A	1316 3RD STREET PROMENAD	None	SANTA MONICA	CA	90401	1328	00	06000	34.01670895	-118.497462	Los Angeles County
344788	Ordering, Referring, Prescribing	N/A	1730718818	0	0	WING, SHANE MD MPH	4/20/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A185684	N/A	N/A	N/A	N/A	N/A	9655 GRANITE RIDGE DR	STE 300	SAN DIEGO	CA	92123	2674	00	06000	32.80652495	-117.1200582	San Diego County
344818	Ordering, Referring, Prescribing	N/A	1730789884	0	0	WILLIAMS, JACQUELINE A MD	9/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A191181	N/A	N/A	N/A	N/A	N/A	2150 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1337	00	06000	38.557287	-121.461444	Sacramento County
344859	Ordering, Referring, Prescribing	N/A	1730949801	0	0	WOMBACHER, CARRIE M MSW LCSW	3/19/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76183	N/A	N/A	N/A	N/A	N/A	702 WORKMAN STREET	None	BAKERSFIELD	CA	93307	6800	00	06000	35.3485563	-118.9532007	Kern County
344872	Ordering, Referring, Prescribing	N/A	1740062041	0	0	WRIGHT, EYANA D	8/22/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026802	N/A	N/A	N/A	N/A	N/A	1526 MISSION LN	None	LOS ANGELES	CA	90047	5300	00	06000	33.92437983	-118.3029594	Los Angeles County
344874	Ordering, Referring, Prescribing	N/A	1740055052	0	0	WALKERLY, AUTUMN PHARMD	1/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	85495	N/A	N/A	N/A	N/A	N/A	510 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.065	-118.291631	Los Angeles County
344883	Ordering, Referring, Prescribing	N/A	1740263037	0	0	WHITE, WILLIAM B MD	11/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G87633	N/A	N/A	N/A	N/A	N/A	2180 HARVARD STREET	210	SACRAMENTO	CA	95815	3318	00	06000	38.60568	-121.4345385	Sacramento County
344935	Ordering, Referring, Prescribing	N/A	1740373414	0	0	WHISENHUNT, ARIEH R MD	12/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A49791	N/A	N/A	N/A	N/A	N/A	460 KINGS COUNTY DR.,	101	HANFORD	CA	93230	5953	00	06000	36.32980315	-119.668609	Kings County
345011	Ordering, Referring, Prescribing	N/A	1740565894	0	0	WILCOCK, KRISTIN PHARMD	10/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59455	N/A	N/A	N/A	N/A	N/A	3416 DEER VALLEY RD	None	ANTIOCH	CA	94531	6650	00	06000	37.98943237	-121.7853073	Contra Costa County
345028	Ordering, Referring, Prescribing	N/A	1740606664	0	0	WEIR, AMY E PSYD	2/23/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30235	N/A	N/A	N/A	N/A	N/A	680 LANGSDORF DR	SUITE 200	FULLERTON	CA	92831	3702	00	06000	33.87673088	-117.8824577	Orange County
345035	Ordering, Referring, Prescribing	N/A	1740608777	0	0	WHITEHEAD, TASHYA J MD	1/12/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152829	N/A	N/A	N/A	N/A	N/A	250 W 5TH ST	None	HANFORD	CA	93230	8823	00	06000	36.32439821	-119.6472235	Kings County
345045	Ordering, Referring, Prescribing	N/A	1740620210	0	0	WONG, SHIRLEY L	5/5/2017	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	64122	N/A	N/A	N/A	N/A	N/A	995 POTRERO AVE	None	SAN FRANCISCO	CA	94110	2859	00	06000	37.75729541	-122.4066641	San Francisco County
345058	Ordering, Referring, Prescribing	N/A	1740635994	0	0	WHITE KNAYZEH, LISA M MD	7/24/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150550	N/A	N/A	N/A	N/A	N/A	2425 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
345063	Ordering, Referring, Prescribing	N/A	1740650506	0	0	WRIGHT, LEANN LMFT	8/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117279	N/A	N/A	N/A	N/A	N/A	590 ANTELOPE BLVD	40A	RED BLUFF	CA	96080	2474	00	06000	40.18602075	-122.2057399	Tehama County
345145	Ordering, Referring, Prescribing	N/A	1740766310	0	0	WESTFALL, CODY C LMFT	11/21/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	151510	N/A	N/A	N/A	N/A	N/A	1260 N DUTTON AVE	230	SANTA ROSA	CA	95401	4659	00	06000	38.449197	-122.7320775	Sonoma County
345168	Ordering, Referring, Prescribing	N/A	1740802479	0	0	WANG, JESSIE	7/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81328	N/A	N/A	N/A	N/A	N/A	3521 DEL PASO RD	None	SACRAMENTO	CA	95835	2800	00	06000	38.65608	-121.541625	Sacramento County
345169	Ordering, Referring, Prescribing	N/A	1740803600	0	0	WOGAHN, DANA	1/24/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114086	N/A	N/A	N/A	N/A	N/A	11800 CENTRAL AVE	225	CHINO	CA	91710	7200	00	06000	34.0388092	-117.689654	San Bernardino County
345170	Ordering, Referring, Prescribing	N/A	1740807171	0	0	WILLIAMS, MARY L LMFT	4/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111274	N/A	N/A	N/A	N/A	N/A	1247 7TH STREET	SUITE 202	SANTA MONICA	CA	90401	1643	00	06000	34.02039477	-118.4942357	Los Angeles County
345172	Ordering, Referring, Prescribing	N/A	1740810613	0	0	WON, JENIFFER	9/20/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95026724	N/A	N/A	N/A	N/A	N/A	7677 CENTER AVE	None	HUNTINGTON BEACH	CA	92647	3074	00	06000	33.736257	-117.995535	Orange County
345277	Ordering, Referring, Prescribing	N/A	1750167649	0	0	WILLIAMSON, JUDITH K	1/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	8591	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
345323	Ordering, Referring, Prescribing	N/A	1750438081	0	0	WILLIAMS, CARY LCSW	7/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27815	N/A	N/A	N/A	N/A	N/A	4411 E KINGS CANYON RD	None	FRESNO	CA	93702	3604	00	06000	36.73594649	-119.7521955	Fresno County
345337	Ordering, Referring, Prescribing	N/A	1750455291	0	0	WATSON, JOYCE PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55284	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
345343	Ordering, Referring, Prescribing	N/A	1750472676	0	0	WEBBER, MARCIA E LMFT	12/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	33463	N/A	N/A	N/A	N/A	N/A	3161 DWIGHT RD.	None	ELK GROVE	CA	95758	6456	00	06000	38.427372	-121.4606025	Sacramento County
345381	Ordering, Referring, Prescribing	N/A	1750581591	0	0	WRIGHT, LISA NP	7/22/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	17111	N/A	N/A	N/A	N/A	N/A	2213 BUCHANAN RD	SUITE 101-103	ANTIOCH	CA	94509	4265	00	06000	37.99879828	-121.8360576	Contra Costa County
345383	Ordering, Referring, Prescribing	N/A	1750583928	0	0	WONG, SAI H	6/7/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	12720	N/A	N/A	N/A	N/A	N/A	22675 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	8506	00	06000	33.91695337	-117.2672536	Riverside County
345400	Ordering, Referring, Prescribing	N/A	1750630604	0	0	WARREN, AMY PSYD	11/11/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	29645	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PARK	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
345525	Ordering, Referring, Prescribing	N/A	1750822904	0	0	WADA, PAUL Y MD	8/8/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157786	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
345564	Ordering, Referring, Prescribing	N/A	1750892238	0	0	WOLDU, HENOCK PHARMD	4/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75029	N/A	N/A	N/A	N/A	N/A	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	00	06000	37.24047903	-121.7998157	Santa Clara County
345566	Ordering, Referring, Prescribing	N/A	1750898078	0	0	WITTEN, ELIZABETH A CNM	11/29/2017	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	235934	N/A	N/A	N/A	N/A	N/A	1104 BUCHANAN ROAD	#C10	ANTIOCH	CA	94509	4226	00	06000	37.99867244	-121.823243	Contra Costa County
345585	Ordering, Referring, Prescribing	N/A	1750928354	0	0	WALKER, LISA M PHARMD	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78690	N/A	N/A	N/A	N/A	N/A	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	00	06000	37.89702115	-122.0569066	Contra Costa County
345588	Ordering, Referring, Prescribing	N/A	1750941050	0	0	WU, LESLIE T MD	1/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192691	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
345640	Ordering, Referring, Prescribing	N/A	1760044655	0	0	WOLENS, ALANA MSW LCSW	9/5/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	117908	N/A	N/A	N/A	N/A	N/A	250 EXECUTIVE PARK BLVD	4900	SAN FRANCISCO	CA	94134	3394	00	06000	37.71122789	-122.3917813	San Francisco County
345649	Ordering, Referring, Prescribing	N/A	1760074819	0	0	WILSON, CHRISSY L PA	12/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59341	N/A	N/A	N/A	N/A	N/A	7655 GREENLEAF AVE	None	WHITTIER	CA	90602	1626	00	06000	33.9719973	-118.0374206	Los Angeles County
345672	Ordering, Referring, Prescribing	N/A	1760130504	0	0	WILLIAMS, DE ANNE NP	10/21/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95019467	N/A	N/A	N/A	N/A	N/A	808 W. 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
345679	Ordering, Referring, Prescribing	N/A	1760172688	0	0	WAGONER, KENYADA LCSW	4/10/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114731	N/A	N/A	N/A	N/A	N/A	9380 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3749	00	06000	33.9215355	-117.4442978	Riverside County
345687	Ordering, Referring, Prescribing	N/A	1760192520	0	0	WHITE, FAWN L PHARMD	10/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87074	N/A	N/A	N/A	N/A	N/A	750 N IMPERIAL AVE	None	EL CENTRO	CA	92243	1914	00	06000	32.79886547	-115.5699885	Imperial County
345729	Ordering, Referring, Prescribing	N/A	1760516728	0	0	WELCH-TORRES, KATHLEEN E PHD	8/9/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY12191	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
345745	Ordering, Referring, Prescribing	N/A	1760551717	0	0	WANG, DANNY C	1/24/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77219	N/A	N/A	N/A	N/A	N/A	1605 EASTLAKE AVENUE	None	LOS ANGELES	CA	90033	1009	00	06000	34.06300636	-118.2054784	Los Angeles County
345754	Ordering, Referring, Prescribing	N/A	1760565147	0	0	WILLIAMS, KIRA A MD	11/20/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77772	N/A	N/A	N/A	N/A	N/A	1720 E. 120TH STREET	None	LOS ANGELES	CA	90059	3052	00	06000	33.92455929	-118.2423557	Los Angeles County
345764	Ordering, Referring, Prescribing	N/A	1760565725	0	0	WANG, ASHLEY C PHARMD	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57256	N/A	N/A	N/A	N/A	N/A	1955 COWELL BLVD	None	DAVIS	CA	95618	6728	00	06000	38.5399459	-121.7284328	Yolo County
345777	Ordering, Referring, Prescribing	N/A	1760648604	0	0	WAUGH, DEANNA A	3/2/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	31184	N/A	N/A	N/A	N/A	N/A	2141 HIGH STREET	SUITE E	SELMA	CA	93662	0000	00	06000	36.57049208	-119.6139528	Fresno County
345798	Ordering, Referring, Prescribing	N/A	1760685218	0	0	WANG, SHARON I LMFT	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111785	N/A	N/A	N/A	N/A	N/A	1356 RIDDER PARK DR	None	SAN JOSE	CA	95131	2313	00	06000	37.38742031	-121.9009533	Santa Clara County
345802	Ordering, Referring, Prescribing	N/A	1760688295	0	0	WALKER, SHAYNA MD	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A107393	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
345839	Ordering, Referring, Prescribing	N/A	1760758676	0	0	WILSON, MEGAN E	5/8/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0639251	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
345842	Ordering, Referring, Prescribing	N/A	1760765952	0	0	WONG, DAVID S LCSW	12/11/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76172	N/A	N/A	N/A	N/A	N/A	529 MAPLE AVE.	None	LOS ANGELES	CA	90013	1511	00	06000	34.04465262	-118.2472846	Los Angeles County
345857	Ordering, Referring, Prescribing	N/A	1760785141	0	0	WOOD, ERIN L LAC	8/23/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC13941	N/A	N/A	N/A	N/A	N/A	250 LOCUST ST	None	SANTA CRUZ	CA	95060	3813	00	06000	36.97493323	-122.028799	Santa Cruz County
345933	Ordering, Referring, Prescribing	N/A	1760890396	0	0	WOO, ADAM PHARMD	8/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70684	N/A	N/A	N/A	N/A	N/A	830 3RD ST	None	SAN RAFAEL	CA	94901	3302	00	06000	37.97188236	-122.5255096	Marin County
345943	Ordering, Referring, Prescribing	N/A	1760914170	0	0	WANG, CAROLINE MD	5/8/2019	Taxonomy not applicable	NA	n/a	000	Unknown	A157222	N/A	N/A	N/A	N/A	N/A	2020 J STREET	None	SACRAMENTO	CA	95811	3120	00	06000	38.576331	-121.4791155	Sacramento County
345950	Ordering, Referring, Prescribing	N/A	1760917504	0	0	WHITE, AMY LCSW	11/17/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW112165	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	None	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
345975	Ordering, Referring, Prescribing	N/A	1760941249	0	0	WERTH, ELISA LMFT	2/27/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT153520	N/A	N/A	N/A	N/A	N/A	6051 N FRESNO ST	STE 201	FRESNO	CA	93710	5280	00	06000	36.823905	-119.781436	Fresno County
345976	Ordering, Referring, Prescribing	N/A	1760948798	0	0	WHITLOW, DYLAN K LCSW	7/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	109366	N/A	N/A	N/A	N/A	N/A	3810 ROSIN CT	STE 100	SACRAMENTO	CA	95834	1657	00	06000	38.637702	-121.474773	Sacramento County
346020	Ordering, Referring, Prescribing	N/A	1770034142	0	0	WANG, HUEYYOUNG E	3/31/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH75177	N/A	N/A	N/A	N/A	N/A	1260 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3411	00	06000	33.89200144	-118.2982685	Los Angeles County
346051	Ordering, Referring, Prescribing	N/A	1770081655	0	0	WEIR, DANIEL NP	11/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008384	N/A	N/A	N/A	N/A	N/A	7277 CENTER AVE	None	HUNTINGTON BEACH	CA	92647	3074	00	06000	33.73380643	-118.0003031	Orange County
346069	Ordering, Referring, Prescribing	N/A	1770098378	0	0	WILKINSON, ELIZABETH G NP	11/30/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006946	N/A	N/A	N/A	N/A	N/A	3939 TRACY ST	None	LOS ANGELES	CA	90029	3207	00	06000	34.10836346	-118.278765	Los Angeles County
346111	Ordering, Referring, Prescribing	N/A	1770249039	0	0	WEI, XUAN PHARMD	9/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85299	N/A	N/A	N/A	N/A	N/A	1990 MONUMENT BLVD	None	CONCORD	CA	94520	3800	00	06000	37.95593881	-122.0395891	Contra Costa County
346159	Ordering, Referring, Prescribing	N/A	1770615551	0	0	WING, JOSEPH D LMFT	11/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47514	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
346162	Ordering, Referring, Prescribing	N/A	1770618407	0	0	WEAVER, TAMARA L	3/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25342	N/A	N/A	N/A	N/A	N/A	1330 E COOLEY DR.	None	COLTON	CA	92324	3905	00	06000	34.0544745	-117.305721	San Bernardino County
346177	Ordering, Referring, Prescribing	N/A	1770652786	0	0	WAITZMAN YI, JANINE A PHD	10/23/2017	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY16255	N/A	N/A	N/A	N/A	N/A	1889 LAWRENCE ROAD	None	SANTA CLARA	CA	95051	2162	00	06000	37.35761102	-121.9947195	Santa Clara County
346194	Ordering, Referring, Prescribing	N/A	1770708935	0	0	WESTOVER, STACY LMFT	12/13/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113312	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	None	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
346213	Ordering, Referring, Prescribing	N/A	1770751257	0	0	WHEAT, KIMBERLY M LMFT	4/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38939	N/A	N/A	N/A	N/A	N/A	26081 MOCINE AVE	None	HAYWARD	CA	94544	2923	00	06000	37.64800936	-122.0758633	Alameda County
346222	Ordering, Referring, Prescribing	N/A	1770757544	0	0	WOOD, JESSICA R LMFT	3/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52662	N/A	N/A	N/A	N/A	N/A	560 COHASSET RD	140	CHICO	CA	95926	2281	00	06000	39.7519137	-121.8477606	Butte County
346279	Ordering, Referring, Prescribing	N/A	1770881344	0	0	WONG, MELISSA W PHARMD	3/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	47994	N/A	N/A	N/A	N/A	N/A	2400 MONUMENT BLVD	None	CONCORD	CA	94520	3105	00	06000	37.957662	-122.0323545	Contra Costa County
346281	Ordering, Referring, Prescribing	N/A	1770880189	0	0	WILLIAMS, KELLY A PSYD	12/1/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	93418	N/A	N/A	N/A	N/A	N/A	1200 WILSHIRE BLVD	210	LOS ANGELES	CA	90017	1908	00	06000	34.05307427	-118.2651099	Los Angeles County
346293	Ordering, Referring, Prescribing	N/A	1770907511	0	0	WONG, SONNY T PHARMD	8/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH65706	N/A	N/A	N/A	N/A	N/A	1800 W SLAUSON AVE	None	LOS ANGELES	CA	90047	1126	00	06000	33.98910151	-118.3119255	Los Angeles County
346340	Ordering, Referring, Prescribing	N/A	1770967952	0	0	WESTCOTT, MARGARET LCSW	10/18/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94837	N/A	N/A	N/A	N/A	N/A	1202 MORENA BLVD	None	SAN DIEGO	CA	92108	4711	00	06000	32.77025942	-117.2017196	San Diego County
346341	Ordering, Referring, Prescribing	N/A	1770975674	0	0	WATANABE, LAUREN OT	5/27/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	14995	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
346348	Ordering, Referring, Prescribing	N/A	1770983983	0	0	WU, WEI-YEN	9/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DDS63756	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
346419	Ordering, Referring, Prescribing	N/A	1780102350	0	0	WONG, RICHARD C	11/27/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	103229	N/A	N/A	N/A	N/A	N/A	1209 WHITLEY AVE	None	CORCORAN	CA	93212	2327	00	06000	36.09801547	-119.5628355	Kings County
346435	Ordering, Referring, Prescribing	N/A	1780113209	0	0	WOODS, JENNIFER	9/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	54506	N/A	N/A	N/A	N/A	N/A	18533 SOLEDAD CANYON RD	None	SANTA CLARITA	CA	91351	3722	00	06000	34.41652146	-118.45647	Los Angeles County
346475	Ordering, Referring, Prescribing	N/A	1780187427	0	0	WONG, STEPHANY PHARMD	7/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78215	N/A	N/A	N/A	N/A	N/A	27983 SLOAN CANYON RD	None	CASTAIC	CA	91384	2594	00	06000	34.49476297	-118.6260515	Los Angeles County
346477	Ordering, Referring, Prescribing	N/A	1780189456	0	0	WEISS, KAELA LMFT	12/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT123799	N/A	N/A	N/A	N/A	N/A	14535 SHERMAN CIR	None	VAN NUYS	CA	91405	3087	00	06000	34.20064259	-118.450312	Los Angeles County
346617	Ordering, Referring, Prescribing	N/A	1780765255	0	0	WEBER, JAN B MD	3/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A83860	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	SUITE 300	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
346718	Ordering, Referring, Prescribing	N/A	1780971465	0	0	WANG, CHENGWEI MD	1/25/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A131994	N/A	N/A	N/A	N/A	N/A	210 N GARFIELD AVE	203	MONTEREY PARK	CA	91754	1746	00	06000	34.064181	-118.122834	Los Angeles County
346728	Ordering, Referring, Prescribing	N/A	1780995068	0	0	WADA, JONATHAN MD	11/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A121522	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
346741	Ordering, Referring, Prescribing	N/A	1790003325	0	0	WHITTLE, STEPHANIE M MD	5/11/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A116253	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	100	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
346750	Ordering, Referring, Prescribing	N/A	1790035400	0	0	WINOWIECKI, ALISA J PT	5/4/2021	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	43490	N/A	N/A	N/A	N/A	N/A	3800 JANES ROAD	None	ARCATA	CA	95521	4742	00	06000	40.89645172	-124.0930637	Humboldt County
346823	Ordering, Referring, Prescribing	N/A	1790133767	0	0	WILLIE, KADEN DO	4/6/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17306	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
346852	Ordering, Referring, Prescribing	N/A	1790167328	0	0	WOODS, JESSICA A NP	7/25/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007023	N/A	N/A	N/A	N/A	N/A	455 EAST COLUMBIA STREET	None	LONG BEACH	CA	90806	1620	00	06000	33.80900524	-118.1874314	Los Angeles County
346875	Ordering, Referring, Prescribing	N/A	1790208494	0	0	WU, FANG-YI LMFT	6/24/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT126649	N/A	N/A	N/A	N/A	N/A	9353 E VALLEY BLVD	None	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
346953	Ordering, Referring, Prescribing	N/A	1790297257	0	0	WARE, SOMMER J LMFT	10/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122630	N/A	N/A	N/A	N/A	N/A	8019 S. COMPTON AVENUE	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
346978	Ordering, Referring, Prescribing	N/A	1790378990	0	0	WHITE, CLARE M NP	9/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015523	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
347023	Ordering, Referring, Prescribing	N/A	1790548907	0	0	WHITE, HALEY	3/31/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	154307	N/A	N/A	N/A	N/A	N/A	1500 MEREDITH AVE	None	GUSTINE	CA	95322	1701	00	06000	37.24930699	-121.0111954	Merced County
347032	Ordering, Referring, Prescribing	N/A	1790725539	0	0	WONG, JACK K K MD	5/11/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C50860	N/A	N/A	N/A	N/A	N/A	337 E KINGS ST	None	AVENAL	CA	93204	1630	00	06000	36.00253508	-120.1335979	Kings County
347035	Ordering, Referring, Prescribing	N/A	1790738896	0	0	WILTSE, ANNA M MD	12/22/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A84070	N/A	N/A	N/A	N/A	N/A	6833 STOCKTON BLVD	485	SACRAMENTO	CA	95823	2376	00	06000	38.502684	-121.430124	Sacramento County
347039	Ordering, Referring, Prescribing	N/A	1790768869	0	0	WARD, LISA M MD	1/19/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80946	N/A	N/A	N/A	N/A	N/A	8465 OLD REDWOOD HWY	320	WINDSOR	CA	95492	8090	00	06000	38.5435006	-122.8006981	Sonoma County
347166	Ordering, Referring, Prescribing	N/A	1801044243	0	0	WASHINGTON, STUART J	3/31/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A95941	N/A	N/A	N/A	N/A	N/A	760 HARRISON ST	None	SAN FRANCISCO	CA	94107	1235	00	06000	37.78155484	-122.3987081	San Francisco County
347224	Ordering, Referring, Prescribing	N/A	1801151964	0	0	WONG, ELEA C NP	9/12/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	446105	N/A	N/A	N/A	N/A	N/A	330 S GARFIELD AVE	STE 300	ALHAMBRA	CA	91801	3893	00	06000	34.09137167	-118.1241735	Los Angeles County
347234	Ordering, Referring, Prescribing	N/A	1801163589	0	0	WATERS, ROSE CNM	4/19/2022	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	1962	N/A	N/A	N/A	N/A	N/A	2051 JOHN JONES RD	None	DAVIS	CA	95616	9701	00	06000	38.56371578	-121.7691963	Yolo County
347332	Ordering, Referring, Prescribing	N/A	1801296439	0	0	WILLIS, LINDSAY K LMFT	3/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98183	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DRIVE	None	SACRAMENTO	CA	95841	3105	00	06000	38.662227	-121.3378965	Sacramento County
347380	Ordering, Referring, Prescribing	N/A	1801371521	0	0	WOO, SARAH	6/27/2023	Taxonomy not applicable	NA	n/a	000	Unknown	61385	N/A	N/A	N/A	N/A	N/A	1300 S SUNSET AVE	ROOM 100	WEST COVINA	CA	91790	3342	00	06000	34.0601054	-117.9474205	Los Angeles County
347408	Ordering, Referring, Prescribing	N/A	1801438783	0	0	WOODY, SONYA LCSW	12/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW112096	N/A	N/A	N/A	N/A	N/A	2313 I ST	None	EUREKA	CA	95501	4244	00	06000	40.78679534	-124.1601037	Humboldt County
347417	Ordering, Referring, Prescribing	N/A	1801451000	0	0	WIXSON, MOLLY LMFT	11/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122990	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVE	None	OAKLAND	CA	94602	3311	00	06000	37.8007257	-122.2064578	Alameda County
347428	Ordering, Referring, Prescribing	N/A	1801473178	0	0	WALKER, DAN DDS	9/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	107991	N/A	N/A	N/A	N/A	N/A	5925 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	8537	00	06000	37.68360997	-121.8990082	Alameda County
347458	Ordering, Referring, Prescribing	N/A	1801564620	0	0	WARNSHUIS, DEVIN NP	12/12/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028353	N/A	N/A	N/A	N/A	N/A	11850 PIERCE ST	None	RIVERSIDE	CA	92505	4406	00	06000	33.89915406	-117.4942851	Riverside County
347481	Ordering, Referring, Prescribing	N/A	1801819362	0	0	WONG, LAURA A	1/26/2017	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	45044	N/A	N/A	N/A	N/A	N/A	144 STONY POINT RD	None	SANTA ROSA	CA	95401	4122	00	06000	38.440494	-122.74353	Sonoma County
347530	Ordering, Referring, Prescribing	N/A	1811010895	0	0	WORDEN, DANIEL K LMFT	11/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT33805	N/A	N/A	N/A	N/A	N/A	995 HELLING WAY	None	NEVADA CITY	CA	95959	8619	00	06000	39.27021381	-121.0243425	Nevada County
347555	Ordering, Referring, Prescribing	N/A	1811036502	0	0	WONG, CHRISTINA W LCSW	3/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW24062	N/A	N/A	N/A	N/A	N/A	242 N VILLA AVE	None	WILLOWS	CA	95988	2607	00	06000	39.52243848	-122.208844	Glenn County
347572	Ordering, Referring, Prescribing	N/A	1811061310	0	0	WU, ROGER M MD	3/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G76561	N/A	N/A	N/A	N/A	N/A	720 SACRAMENTO ST	None	SAN FRANCISCO	CA	94108	2535	00	06000	37.79355846	-122.4050846	San Francisco County
347603	Ordering, Referring, Prescribing	N/A	1811157373	0	0	WISE, ANDREW R	8/10/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	D45790	N/A	N/A	N/A	N/A	N/A	2540 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	00	06000	40.14893664	-122.2178101	Tehama County
347626	Ordering, Referring, Prescribing	N/A	1811197072	0	0	WANG, TINA L PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59732	N/A	N/A	N/A	N/A	N/A	400 CRAVEN RD	None	SAN MARCOS	CA	92078	4201	00	06000	33.12746646	-117.17028	San Diego County
347652	Ordering, Referring, Prescribing	N/A	1811249790	0	0	WARDAK, ZABIHULLAH MD	11/20/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A122644	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE# C	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
347658	Ordering, Referring, Prescribing	N/A	1811262884	0	0	WANG, EDWARD MD	2/24/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149443	N/A	N/A	N/A	N/A	N/A	513 E LIME AVE	103	MONROVIA	CA	91016	2982	00	06000	34.14819851	-117.993105	Los Angeles County
347664	Ordering, Referring, Prescribing	N/A	1811267776	0	0	WONG, DOROTHY S PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH59729	N/A	N/A	N/A	N/A	N/A	16020 PERRIS BLVD	None	MORENO VALLEY	CA	92551	4618	00	06000	33.887844	-117.2261435	Riverside County
347685	Ordering, Referring, Prescribing	N/A	1811290471	0	0	WOSKANIAN, MONICA LCSW	3/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW114214	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
347706	Ordering, Referring, Prescribing	N/A	1811339641	0	0	WILLIAMS, NOLAN MD	2/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159440	N/A	N/A	N/A	N/A	N/A	2180 JOHNSON AVE	None	SAN LUIS OBISPO	CO	93401	4558	00	06000	35.27488974	-120.6468257	San Luis Obispo County
347796	Ordering, Referring, Prescribing	N/A	1811471352	0	0	WENDT, PATRICIA A LCSW	6/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	102050	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
347871	Ordering, Referring, Prescribing	N/A	1811620800	0	0	WIRFEL, RANDI K PA	7/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63026	N/A	N/A	N/A	N/A	N/A	1066 S WHITE RD	170	SAN JOSE	CA	95127	3812	00	06000	37.35676387	-121.8196933	Santa Clara County
347950	Ordering, Referring, Prescribing	N/A	1821123134	0	0	WILSON, BRENDA A LMFT	5/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT79107	N/A	N/A	N/A	N/A	N/A	1950 MARKET ST	None	RIVERSIDE	CA	92501	1720	00	06000	34.00316496	-117.3767967	Riverside County
347984	Ordering, Referring, Prescribing	N/A	1821171000	0	0	WINNICK, JAMES E OD FAAO	5/22/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	12016	N/A	N/A	N/A	N/A	N/A	141 CALIFORNIA AVE	None	OAKDALE	CA	95361	2946	00	06000	37.76502164	-120.8528439	Stanislaus County
348022	Ordering, Referring, Prescribing	N/A	1821259086	0	0	WANG, JIANPENG MD	5/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A115730	N/A	N/A	N/A	N/A	N/A	5256 MISSION BLVD,	None	RIVERSIDE	CA	92509	0000	00	06000	33.99261717	-117.3987262	Riverside County
348029	Ordering, Referring, Prescribing	N/A	1821283946	0	0	WINN, AYISHA L LCSW	9/5/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	85603	N/A	N/A	N/A	N/A	N/A	201 S HARBOR BLVD	None	LA HABRA	CA	90631	5654	00	06000	33.93029897	-117.9331306	Orange County
348075	Ordering, Referring, Prescribing	N/A	1821364712	0	0	WEEDEN, MIRIAM LMFT	3/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	94339	N/A	N/A	N/A	N/A	N/A	436 S MAGNOLIA AVE	201	EL CAJON	CA	92020	5237	00	06000	32.791122	-116.962417	San Diego County
348078	Ordering, Referring, Prescribing	N/A	1821371063	0	0	WAN, HELEN	7/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49542	N/A	N/A	N/A	N/A	N/A	2050 IRVING ST	None	SAN FRANCISCO	CA	94122	1716	00	06000	37.76346003	-122.4800787	San Francisco County
348111	Ordering, Referring, Prescribing	N/A	1821434036	0	0	WRIGHT, BETH LMFT	12/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118975	N/A	N/A	N/A	N/A	N/A	1025 CALIMESA BLVD	5A	CALIMESA	CA	92320	1146	00	06000	33.99998425	-117.0603297	Riverside County
348183	Ordering, Referring, Prescribing	N/A	1821530163	0	0	WEST, MICHELLE K NP	3/12/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011734	N/A	N/A	N/A	N/A	N/A	5353 G STREET	None	CHINO	CA	91710	5249	00	06000	34.00987149	-117.6880905	San Bernardino County
348187	Ordering, Referring, Prescribing	N/A	1821534025	0	0	WURSTER, JESSICA	9/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	181935	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
348203	Ordering, Referring, Prescribing	N/A	1821559956	0	0	WINN, PHOEBE A MD	3/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL1864	N/A	N/A	N/A	N/A	N/A	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
348305	Ordering, Referring, Prescribing	N/A	1831110071	0	0	WANG, DORA-LINDA L MD	8/3/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72211	N/A	N/A	N/A	N/A	N/A	201 N COURT ST	None	VISALIA	CA	93291	4918	00	06000	36.331218	-119.292561	Tulare County
348348	Ordering, Referring, Prescribing	N/A	1831231893	0	0	WANG, RAZIYA S	1/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A86388	N/A	N/A	N/A	N/A	N/A	222 WEST 39TH AVENUE	PSYCHIATRY RESIDENCY PRO	SAN MATEO	CA	94403	4364	00	06000	37.53039072	-122.2987772	San Mateo County
348415	Ordering, Referring, Prescribing	N/A	1831403195	0	0	WHEELER, CARLINA R PHD	12/29/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26556	N/A	N/A	N/A	N/A	N/A	3331 POWER INN RD	140	SACRAMENTO	CA	95826	3889	00	06000	38.543391	-121.4077095	Sacramento County
348431	Ordering, Referring, Prescribing	N/A	1831446301	0	0	WOODLAND, CHAD E PHARMD	6/16/2022	Taxonomy not applicable	NA	n/a	000	Unknown	74365	N/A	N/A	N/A	N/A	N/A	14200 PALM DRIVE	None	DESERT HOT SPRING	CA	92240	1234	00	06000	33.94538937	-116.5012248	Riverside County
348441	Ordering, Referring, Prescribing	N/A	1831465574	0	0	WEHR, STEPHANIE L	3/15/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0634551	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
348452	Ordering, Referring, Prescribing	N/A	1831483502	0	0	WILLIAMS, KARA M PA	9/19/2017	Taxonomy not applicable	NA	n/a	000	Unknown	1979	N/A	N/A	N/A	N/A	N/A	10820 PARKSIDE DR	None	KNOXVILLE	TN	37934	1956	00	06000	35.90003918	-84.14416556	Knox County
348457	Ordering, Referring, Prescribing	N/A	1831492230	0	0	WANG, YING PHARMD	10/19/2018	Taxonomy not applicable	NA	n/a	000	Unknown	47413	N/A	N/A	N/A	N/A	N/A	639 S BERNARDO AVE	None	SUNNYVALE	CA	94087	1020	00	06000	37.37252789	-122.0568068	Santa Clara County
348470	Ordering, Referring, Prescribing	N/A	1831505247	0	0	WILLIAMS, SAGE LMFT	9/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122154	N/A	N/A	N/A	N/A	N/A	982 MISSION ST	None	SAN FRANCISCO	CA	94103	2911	00	06000	37.7813638	-122.4082438	San Francisco County
348474	Ordering, Referring, Prescribing	N/A	1831520477	0	0	WATKINS, PHILIPPA K LMFT	6/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	97086	N/A	N/A	N/A	N/A	N/A	2777 VENTURA AVE	None	SANTA ROSA	CA	95403	2226	00	06000	38.467683	-122.7260025	Sonoma County
348484	Ordering, Referring, Prescribing	N/A	1831522861	0	0	WARREN, RACHEL M LMFT	5/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT117866	N/A	N/A	N/A	N/A	N/A	500B JEFFERSON BLVD	180	WEST SARCRAMENTO	CA	95605	2394	00	06000	38.58811316	-121.5270471	Yolo County
348488	Ordering, Referring, Prescribing	N/A	1831542620	0	0	WYATT, KATHERINE NP	7/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004936	N/A	N/A	N/A	N/A	N/A	3772 TIBBETTS ST	None	RIVERSIDE	CA	92506	2605	00	06000	33.94720849	-117.399204	Riverside County
348507	Ordering, Referring, Prescribing	N/A	1831565639	0	0	WELCH, DANIEL LCSW	4/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW94667	N/A	N/A	N/A	N/A	N/A	18350 MOUNT LANGLEY ST	220	FOUNTAIN VALLEY	CA	92708	6900	00	06000	33.69633523	-117.9420534	Orange County
348529	Ordering, Referring, Prescribing	N/A	1831598424	0	0	WALTERMIRE, LAUREN E LCSW	7/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93136	N/A	N/A	N/A	N/A	N/A	1801 PARK COURT PLACE	BUILDING H	SANTA ANA	CA	92701	5028	00	06000	33.74986153	-117.8429355	Orange County
348545	Ordering, Referring, Prescribing	N/A	1831627181	0	0	WALDRUP, LA RHONDA M NP	8/14/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95080869	N/A	N/A	N/A	N/A	N/A	625 HILBY AVE	None	SEASIDE	CA	93955	5720	00	06000	36.60257396	-121.8495595	Monterey County
348554	Ordering, Referring, Prescribing	N/A	1831635150	0	0	WALKER, JASMINE LCSW	2/28/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106340	N/A	N/A	N/A	N/A	N/A	30 PROFESSIONAL CENTER P	None	SAN RAFAEL	CA	94903	2703	00	06000	38.00989519	-122.5391142	Marin County
348555	Ordering, Referring, Prescribing	N/A	1831644004	0	0	WANG, JESSICA A MD MPH	5/21/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184694	N/A	N/A	N/A	N/A	N/A	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	00	06000	34.02564555	-118.477319	Los Angeles County
348599	Ordering, Referring, Prescribing	N/A	1831686492	0	0	WINN, JOSHUA MD	3/9/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166070	N/A	N/A	N/A	N/A	N/A	47923 OASIS ST	None	INDIO	CA	92201	9203	00	06000	33.70080223	-116.2209518	Riverside County
348600	Ordering, Referring, Prescribing	N/A	1831690783	0	0	WONG, JEANNIE LAC	6/11/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC17768	N/A	N/A	N/A	N/A	N/A	2595 E. WASHINGTON BLVD.	STE 108	PASADENA	CA	91107	1409	00	06000	34.16917051	-118.096893	Los Angeles County
348661	Ordering, Referring, Prescribing	N/A	1831817873	0	0	WANG, MARGARET C LMFT	6/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132544	N/A	N/A	N/A	N/A	N/A	3160 CROW CANYON PL	None	SAN RAMON	CA	94583	1100	00	06000	37.77581169	-121.9722889	Contra Costa County
348672	Ordering, Referring, Prescribing	N/A	1831834498	0	0	WAGENBACH, AMANDA LCSW	4/24/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89021	N/A	N/A	N/A	N/A	N/A	1881 BUSINESS CENTER DR	None	SAN BERNARDINO	CA	92408	3465	00	06000	34.06846141	-117.2811029	San Bernardino County
348708	Ordering, Referring, Prescribing	N/A	1841060506	0	0	WALKER, BREA	1/18/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023518	N/A	N/A	N/A	N/A	N/A	8480 ENTERPRISE WAY	None	OAKLAND	CA	94621	1318	00	06000	37.74207882	-122.1925503	Alameda County
348711	Ordering, Referring, Prescribing	N/A	1841063435	0	0	WOJCIK, KYRA J PA-C	12/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63834	N/A	N/A	N/A	N/A	N/A	4129 E GAGE AVE	None	BELL	CA	90201	1128	00	06000	33.97868838	-118.1928157	Los Angeles County
348713	Ordering, Referring, Prescribing	N/A	1841066214	0	0	WU, CHIA HSIN PHARMD	10/9/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88441	N/A	N/A	N/A	N/A	N/A	2143 FOOTHILL BLVD	None	LA VERNE	CA	91750	2942	00	06000	34.11289169	-117.7633964	Los Angeles County
348721	Ordering, Referring, Prescribing	N/A	1841215001	0	0	WANG, HARRY C MD	2/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G31589	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DR	None	SACRAMENTO	CA	95841	3105	00	06000	38.662227	-121.3378965	Sacramento County
348736	Ordering, Referring, Prescribing	N/A	1841273208	0	0	WILLIAMSON, BRIAN R PT	6/22/2021	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT12361	N/A	N/A	N/A	N/A	N/A	1505 MERIDAIN AVE.	A	SAN JOSE	CA	95125	5353	00	06000	37.29792153	-121.9136218	Santa Clara County
348739	Ordering, Referring, Prescribing	N/A	1841304714	0	0	WARNER, DAVID PA	5/30/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64577	N/A	N/A	N/A	N/A	N/A	1850 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43814074	-120.6259249	Lassen County
348755	Ordering, Referring, Prescribing	N/A	1841335890	0	0	WASHINGTON, ANTOINETTE M LCSW	6/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65714	N/A	N/A	N/A	N/A	N/A	2311 W EL SEGUNDO BLVD	None	HAWTHORNE	CA	90250	3315	00	06000	33.91647947	-118.3189815	Los Angeles County
348759	Ordering, Referring, Prescribing	N/A	1841338159	0	0	WHITE, CHRISTOPHER R MD	4/2/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A78199	N/A	N/A	N/A	N/A	N/A	1680 PAUL BUNYAN RD	None	SUSANVILLE	CA	96130	3133	00	06000	40.42141164	-120.6468171	Lassen County
348791	Ordering, Referring, Prescribing	N/A	1841392032	0	0	WONG, LI C MD	2/13/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A60736	N/A	N/A	N/A	N/A	N/A	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	00	06000	34.06750236	-117.925203	Los Angeles County
348812	Ordering, Referring, Prescribing	N/A	1841439429	0	0	WADDELL, REIDUN L LCSW	3/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87080	N/A	N/A	N/A	N/A	N/A	560 COHASSET RD	180	CHICO	CA	95926	2281	00	06000	39.7519137	-121.8477606	Butte County
348817	Ordering, Referring, Prescribing	N/A	1841453487	0	0	WALLACE, LA TANYA NP	6/9/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22485	N/A	N/A	N/A	N/A	N/A	3356 SECOND AVE	SUITE G	SAN DIEGO	CA	92103	5636	00	06000	32.74048649	-117.1631499	San Diego County
348826	Ordering, Referring, Prescribing	N/A	1841465556	0	0	WIGFALL, DONNELL DO	12/7/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A11625	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD.	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
348879	Ordering, Referring, Prescribing	N/A	1841552395	0	0	WEISS, JESSICA DO	2/26/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15098	N/A	N/A	N/A	N/A	N/A	14411 HAMLIN ST	None	VAN NUYS	CA	91401	1467	00	06000	34.18869553	-118.447074	Los Angeles County
348969	Ordering, Referring, Prescribing	N/A	1841687472	0	0	WONG, ASHLEY G DO	7/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A18424	N/A	N/A	N/A	N/A	N/A	18035 BROOKHURST ST	SUITE 1200	FOUNTAIN VALLEY	CA	92708	6728	00	06000	33.701184	-117.9544385	Orange County
349026	Ordering, Referring, Prescribing	N/A	1841771144	0	0	WILSON, JERI E LCSW	11/13/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74608	N/A	N/A	N/A	N/A	N/A	9995 CARMEL MOUNTAIN RD	STE B10 & B11	SAN DIEGO	CA	92129	2359	00	06000	32.96073738	-117.1119913	San Diego County
349070	Ordering, Referring, Prescribing	N/A	1841855525	0	0	WATHUGALA, MELANIE MD	6/19/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A187166	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
349074	Ordering, Referring, Prescribing	N/A	1841870300	0	0	WELLS, ADRIENNE DMD	2/7/2023	Taxonomy not applicable	NA	n/a	099	DENTIST	108573	N/A	N/A	N/A	N/A	N/A	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	00	06000	40.89808837	-124.0923819	Humboldt County
349136	Ordering, Referring, Prescribing	N/A	1851068159	0	0	WILKINS, BRANDON G RN	4/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95049302	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	STE 210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
349155	Ordering, Referring, Prescribing	N/A	1851313159	0	0	WAGNER, AMY C MD	7/16/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70385	N/A	N/A	N/A	N/A	N/A	18520 VIA PRINCESSA	C-2	CANYON COUNTRY	CA	91387	8326	00	06000	34.40317439	-118.4585559	Los Angeles County
349209	Ordering, Referring, Prescribing	N/A	1851465686	0	0	WONG, MATTHEW L MD	12/16/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A84553	N/A	N/A	N/A	N/A	N/A	23700 CAMINO DEL SOL	None	TORRANCE	CA	90505	5017	00	06000	33.8102385	-118.3441185	Los Angeles County
349237	Ordering, Referring, Prescribing	N/A	1851520654	0	0	WILLIAMS, JENNIE LCSW	11/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25738	N/A	N/A	N/A	N/A	N/A	12440 E. FIRESTONE BLVD.	316	NORWALK	CA	90650	4368	00	06000	33.90523023	-118.0681168	Los Angeles County
349250	Ordering, Referring, Prescribing	N/A	1851564355	0	0	WHEELOCK, MELISSA LMFT	12/8/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	36641	N/A	N/A	N/A	N/A	N/A	210 E ENOS DR	None	SANTA MARIA	CA	93454	7215	00	06000	34.9340215	-120.4343968	Santa Barbara County
349294	Ordering, Referring, Prescribing	N/A	1851636021	0	0	WHITE, DERRICK P LMFT	10/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111579	N/A	N/A	N/A	N/A	N/A	2667 CAMINO DEL RIO S	STE 301-7	SAN DIEGO	CA	92108	3707	00	06000	32.76977026	-117.135564	San Diego County
349307	Ordering, Referring, Prescribing	N/A	1851668792	0	0	WANG, KATHY PHARMD	4/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	51772	N/A	N/A	N/A	N/A	N/A	1220 W FOOTHILL BLVD	None	AZUSA	CA	91702	2819	00	06000	34.13048487	-117.9261514	Los Angeles County
349357	Ordering, Referring, Prescribing	N/A	1851724157	0	0	WERDERMAN, CARLYN PSYD	3/29/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33178	N/A	N/A	N/A	N/A	N/A	1126 W FOOTHILL BLVD SUI	110	UPLAND	CA	91786	3786	00	06000	34.10674652	-117.6680183	San Bernardino County
349483	Ordering, Referring, Prescribing	N/A	1851929442	0	0	WONG, STEPHANIE MD	6/29/2023	Taxonomy not applicable	NA	n/a	000	Unknown	A187481	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
349492	Ordering, Referring, Prescribing	N/A	1851941405	0	0	WILLIAMS, LAKISHA N LMFT	4/10/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	146301	N/A	N/A	N/A	N/A	N/A	2275 ARLINGTON DR	None	SAN LEANDRO	CA	94578	1132	00	06000	37.70851907	-122.1117036	Alameda County
349495	Ordering, Referring, Prescribing	N/A	1851946172	0	0	WILSON, OLIVIA LMFT	3/25/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	145982	N/A	N/A	N/A	N/A	N/A	8233 E. STOCKTON BLVD	STE D	SACRAMENTO	CA	95828	8203	00	06000	38.459628	-121.4095815	Sacramento County
349512	Ordering, Referring, Prescribing	N/A	1851978522	0	0	WALSH, ERIN R MD	12/18/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A200437	N/A	N/A	N/A	N/A	N/A	8788 JAMACHA RD	None	SPRING VALLEY	CA	91977	4035	00	06000	32.71482507	-117.0098243	San Diego County
349562	Ordering, Referring, Prescribing	N/A	1861122889	0	0	WORK, ROSEANNE OD	8/29/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35213	N/A	N/A	N/A	N/A	N/A	625 34TH STREET	SUITE 100 & 200	BAKERSFIELD	CA	93301	2305	00	06000	35.39046051	-119.0092725	Kern County
349567	Ordering, Referring, Prescribing	N/A	1861147340	0	0	WOOLSEY, EMILY NP	6/27/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95025730	N/A	N/A	N/A	N/A	N/A	1260 MORENA BLVD	SUITE 100	SAN DIEGO	CA	92110	3889	00	06000	32.77077343	-117.2018542	San Diego County
349585	Ordering, Referring, Prescribing	N/A	1861416661	0	0	WALL, NORMAN DO	3/7/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A7180	N/A	N/A	N/A	N/A	N/A	999 ADAMS STREET	201	ST HELENA	CA	94574	1148	00	06000	38.5071543	-122.4685546	Napa County
349594	Ordering, Referring, Prescribing	N/A	1861166803	0	0	WILSON, SEDONNI DDS	10/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	106158	N/A	N/A	N/A	N/A	N/A	7821 S. AVALON BLVD	None	LOS ANGELES	CA	90003	2358	00	06000	33.969393	-118.265197	Los Angeles County
349620	Ordering, Referring, Prescribing	N/A	1861528309	0	0	WEISS, RALPH A LMFT	11/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT36525	N/A	N/A	N/A	N/A	N/A	1411 N GRAND AVENUE	None	COVINA	CA	91724	1005	00	06000	34.105149	-117.87435	Los Angeles County
349721	Ordering, Referring, Prescribing	N/A	1861752172	0	0	WU, YOU M MD	7/3/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A130748	N/A	N/A	N/A	N/A	N/A	280 W MACARTHUR BLVD	11TH FL	OAKLAND	CA	94611	5642	00	06000	37.8242017	-122.2578306	Alameda County
349722	Ordering, Referring, Prescribing	N/A	1861754632	0	0	WASHINGTON, DEMARIS R PHD	5/12/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	24625	N/A	N/A	N/A	N/A	N/A	370 W CRENSHAW	E100	TORRANCE	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles County
349745	Ordering, Referring, Prescribing	N/A	1861779803	0	0	WU, EMILY J PHARMD	7/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59859	N/A	N/A	N/A	N/A	N/A	3320 CHINO HILLS PKWY	None	CHINO HILLS	CA	91709	4228	00	06000	33.9825291	-117.7318314	San Bernardino County
349753	Ordering, Referring, Prescribing	N/A	1861803330	0	0	WINN, AUBREY MD	8/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178569	N/A	N/A	N/A	N/A	N/A	9460 NO NAME UNO	STE 210	GILROY	CA	95020	3532	00	06000	37.037781	-121.570965	Santa Clara County
349784	Ordering, Referring, Prescribing	N/A	1861842809	0	0	WEINBAUM, KAREN Z	1/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150760	N/A	N/A	N/A	N/A	N/A	165 CAPP ST	None	SAN FRANCISCO	CA	94110	1209	00	06000	37.76403824	-122.4185654	San Francisco County
349796	Ordering, Referring, Prescribing	N/A	1861861031	0	0	WALKER, JOLEE LMFT	2/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53278	N/A	N/A	N/A	N/A	N/A	1921 S CATALINA AVE	1	REDONDO BEACH	CA	90277	5516	00	06000	33.81545027	-118.3866495	Los Angeles County
349852	Ordering, Referring, Prescribing	N/A	1861938441	0	0	WOODS, CARRIE E CNP	5/18/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95004592	N/A	N/A	N/A	N/A	N/A	815 DR. MARTIN LUTHER KI	None	BAKERSFIELD	CA	93307	1365	00	06000	35.3655	-118.985202	Kern County
349896	Ordering, Referring, Prescribing	N/A	1871012286	0	0	WATANABE, NICOLE S	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77241	N/A	N/A	N/A	N/A	N/A	3000 S ROBERTSON BLVD	416	LOS ANGELES	CA	90034	3158	00	06000	34.03262164	-118.3900457	Los Angeles County
349914	Ordering, Referring, Prescribing	N/A	1871041467	0	0	WILBUR, JOYCE OD	12/2/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT11080	N/A	N/A	N/A	N/A	N/A	351 FELICE DRIVE	None	HOLLISTER	CA	95023	3361	00	06000	36.85325269	-121.4170104	San Benito County
349959	Ordering, Referring, Prescribing	N/A	1871098731	0	0	WELSH, NICHOLAS J MD	11/13/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A175378	N/A	N/A	N/A	N/A	N/A	1525 SILVER AVE	2ND FLOOR	SAN FRANCISCO	CA	94134	1229	00	06000	37.73224392	-122.4063707	San Francisco County
349977	Ordering, Referring, Prescribing	N/A	1871131698	0	0	WANG, EILEEN PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81327	N/A	N/A	N/A	N/A	N/A	3701 BROADWAY	None	OAKLAND	CA	94611	5613	00	06000	37.82533768	-122.258094	Alameda County
350008	Ordering, Referring, Prescribing	N/A	1871210021	0	0	WAGNER, RYAN PA	12/9/2022	Taxonomy not applicable	NA	n/a	000	Unknown	62101	N/A	N/A	N/A	N/A	N/A	20601 WEST PAOLI LANE	None	WEIMAR	CA	95736	0518	00	06000	39.03521526	-120.9755343	Placer County
350032	Ordering, Referring, Prescribing	N/A	1871281279	0	0	WILCOX, ANDREA H	5/3/2022	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	32013	N/A	N/A	N/A	N/A	N/A	312 S LINCOLN ST	None	FORT BRAGG	CA	95437	4416	00	06000	39.43892314	-123.7955129	Mendocino County
350056	Ordering, Referring, Prescribing	N/A	1871507962	0	0	WANG, NATALIE Y MD	11/25/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G80797	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
350057	Ordering, Referring, Prescribing	N/A	1871539221	0	0	WHITE, MICHAEL J	2/4/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D34257	N/A	N/A	N/A	N/A	N/A	250 N SEE VEE LN	None	BISHOP	CA	93514	8130	00	06000	37.365066	-118.410912	Inyo County
350132	Ordering, Referring, Prescribing	N/A	1871710772	0	0	WITKOSKY, GARY S	9/26/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D30242	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	200	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
350161	Ordering, Referring, Prescribing	N/A	1871772186	0	0	WINN, JEREMY LCSW	2/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27134	N/A	N/A	N/A	N/A	N/A	1720 E 120TH ST	None	LOS ANGELES	CA	90059	3052	00	06000	33.92455929	-118.2423557	Los Angeles County
350186	Ordering, Referring, Prescribing	N/A	1871823096	0	0	WHITING, ROXANNE J NP	1/14/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	18974	N/A	N/A	N/A	N/A	N/A	600 G STREET	None	UNION CITY	CA	94587	2400	00	06000	37.59996226	-122.0201927	Alameda County
350189	Ordering, Referring, Prescribing	N/A	1871826289	0	0	WALIA, SUMANPREET DDS	4/15/2024	Taxonomy not applicable	NA	n/a	000	Unknown	58823	N/A	N/A	N/A	N/A	N/A	753 CENTRAL AVE	None	LIVERMORE	CA	94551	7469	00	06000	37.70926841	-121.7270926	Alameda County
350208	Ordering, Referring, Prescribing	N/A	1871849968	0	0	WALLACE, MELISSA E PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66906	N/A	N/A	N/A	N/A	N/A	215 N 2ND ST	None	EL CAJON	CA	92021	0000	00	06000	32.796792	-116.935631	San Diego County
350294	Ordering, Referring, Prescribing	N/A	1871976571	0	0	WATSON, TERESA R LPCC	5/11/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC7747	N/A	N/A	N/A	N/A	N/A	1000 BROADWAY	100	EL CAJON	CA	92021	7417	00	06000	32.80772549	-116.94771	San Diego County
350308	Ordering, Referring, Prescribing	N/A	1871985564	0	0	WALKER, CHRISTOPHER L	12/12/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015234	N/A	N/A	N/A	N/A	N/A	1315 S ADAMS ST	None	FORT WORTH	TX	76104	4404	00	06000	32.72994159	-97.33672572	Tarrant County
350320	Ordering, Referring, Prescribing	N/A	1881003697	0	0	WHITE, KEISHA C	3/9/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31617	N/A	N/A	N/A	N/A	N/A	8300 S VERMONT AVE	4TH FLOOR	LOS ANGELES	CA	90044	3493	00	06000	33.963021	-118.291474	Los Angeles County
350327	Ordering, Referring, Prescribing	N/A	1881018422	0	0	WALKER, KATARZYNA PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67623	N/A	N/A	N/A	N/A	N/A	918 E FOOTHILL BLVD	None	RIALTO	CA	92376	2377	00	06000	34.10679947	-117.352134	San Bernardino County
350349	Ordering, Referring, Prescribing	N/A	1881056307	0	0	WILSON, ERIC MD	10/10/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150741	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
350353	Ordering, Referring, Prescribing	N/A	1881046985	0	0	WU, SAIFEI MD	9/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A143211	N/A	N/A	N/A	N/A	N/A	1060 EXPOSITION BLVD	None	LOS ANGELES	CA	90037	3632	00	06000	34.0181337	-118.2933113	Los Angeles County
350371	Ordering, Referring, Prescribing	N/A	1881073898	0	0	WHANG, STEVESEON I PHARMD	3/16/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH42230	N/A	N/A	N/A	N/A	N/A	1301 E VISTA WAY	None	VISTA	CA	92084	4041	00	06000	33.219396	-117.2260925	San Diego County
350424	Ordering, Referring, Prescribing	N/A	1881157717	0	0	WONG, EVA MD	11/13/2022	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5886	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
350470	Ordering, Referring, Prescribing	N/A	1881236735	0	0	WILLARD, BARBARA L NP	10/16/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007277	N/A	N/A	N/A	N/A	N/A	1141 PEAR TREE LANE	100	NAPA	CA	94558	6484	00	06000	38.32125908	-122.2921523	Napa County
350476	Ordering, Referring, Prescribing	N/A	1881256733	0	0	WU, LESLIE S PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81085	N/A	N/A	N/A	N/A	N/A	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	00	06000	33.9040752	-118.1328995	Los Angeles County
350488	Ordering, Referring, Prescribing	N/A	1881271849	0	0	WALSH, JESSICA MD	4/2/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A195182	N/A	N/A	N/A	N/A	N/A	335 EAST AVENUE I	None	LANCASTER	CA	93535	0000	00	06000	34.7041113	-118.1247548	Los Angeles County
350520	Ordering, Referring, Prescribing	N/A	1881415107	0	0	WILLIAMS, MAYA Y	6/21/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030715	N/A	N/A	N/A	N/A	N/A	3030 ALUM ROCK AVE	None	SAN JOSE	CA	95127	0005	00	06000	37.36514449	-121.8292446	Santa Clara County
350560	Ordering, Referring, Prescribing	N/A	1881707610	0	0	WILSON, SHANNON K PSYD	10/23/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY27323	N/A	N/A	N/A	N/A	N/A	23461 S POINTE DR	None	LAGUNA HILLS	CA	92653	1547	00	06000	33.62535142	-117.7206568	Orange County
350566	Ordering, Referring, Prescribing	N/A	1881723625	0	0	WU, STEPHEN C MD	1/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A86921	N/A	N/A	N/A	N/A	N/A	3801 3RD STREET	400	SAN FRANCISCO	CA	94124	1409	00	06000	37.74208019	-122.3880422	San Francisco County
350569	Ordering, Referring, Prescribing	N/A	1881727386	0	0	WILLIAMS, TAKISHA K NP	10/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95013978	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
350622	Ordering, Referring, Prescribing	N/A	1881823045	0	0	WILSON, SAMANTHA LCSW	3/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76389	N/A	N/A	N/A	N/A	N/A	3322 SWEETWATER SPRINGS	None	SPRING VALLEY	CA	91977	3162	00	06000	32.73879556	-116.9724522	San Diego County
350644	Ordering, Referring, Prescribing	N/A	1881896082	0	0	WALTON, PAULETTE L	10/28/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010139	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
350664	Ordering, Referring, Prescribing	N/A	1881949642	0	0	WASEMILLER, TARA E	8/26/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D61518	N/A	N/A	N/A	N/A	N/A	26352 KELLER DR	None	LOMA LINDA	CA	92354	6567	00	06000	34.04940638	-117.229908	San Bernardino County
350720	Ordering, Referring, Prescribing	N/A	1891036299	0	0	WALDEN, KATHERINE J PHD	1/11/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	18936	N/A	N/A	N/A	N/A	N/A	500 CROWN POINT CIR	STE. 120	GRASS VALLEY	CA	95945	9561	00	06000	39.22028885	-121.0316663	Nevada County
350729	Ordering, Referring, Prescribing	N/A	1891062378	0	0	WILCOX, MARITA PHARMD	8/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH60736	N/A	N/A	N/A	N/A	N/A	1660 WINCHESTER BLVD	None	CAMPBELL	CA	95008	1114	00	06000	37.293849	-121.949873	Santa Clara County
350733	Ordering, Referring, Prescribing	N/A	1891068334	0	0	WESTMORELAND, CRYSTAL S LMFT	9/9/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT114860	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	None	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
350754	Ordering, Referring, Prescribing	N/A	1891087706	0	0	WONG, LISA Y	2/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	47192	N/A	N/A	N/A	N/A	N/A	7981 E STOCKTON BLVD	None	SACRAMENTO	CA	95823	9606	00	06000	38.468034	-121.4140185	Sacramento County
350782	Ordering, Referring, Prescribing	N/A	1891137824	0	0	WILLIAMS, GLORIA A LMFT	8/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113183	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	SUITE 220	MISSION VIEJO	CA	92691	6441	00	06000	33.56536541	-117.670334	Orange County
350824	Ordering, Referring, Prescribing	N/A	1891190831	0	0	WALLACE, KATHERINE L LMFT	6/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109572	N/A	N/A	N/A	N/A	N/A	11175 SAN PABLO AVE	None	EL CERRITO	CA	94530	2157	00	06000	37.91926262	-122.31424	Contra Costa County
350834	Ordering, Referring, Prescribing	N/A	1891204251	0	0	WU, STEFANIE H NP	10/20/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	788721	N/A	N/A	N/A	N/A	N/A	2907 EL CAMINO REAL	None	REDWOOD CITY	CA	94061	4003	00	06000	37.46906354	-122.2114417	San Mateo County
350856	Ordering, Referring, Prescribing	N/A	1891250445	0	0	WOO, KINDRA DC	9/13/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	34425	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
350953	Ordering, Referring, Prescribing	N/A	1891472502	0	0	WONG, ERICA PHARMD	8/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86614	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
350967	Ordering, Referring, Prescribing	N/A	1891567483	0	0	WEST, BRINLEY S NP	10/25/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027843	N/A	N/A	N/A	N/A	N/A	480 1ST AVE	None	PORTOLA	CA	96122	9405	00	06000	39.80603471	-120.463888	Plumas County
350990	Ordering, Referring, Prescribing	N/A	1891815155	0	0	WALTERS, CAROLYN D LMFT	5/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43069	N/A	N/A	N/A	N/A	N/A	301 13TH STREET	None	MERCED	CA	95341	6214	00	06000	37.29248035	-120.4730619	Merced County
350998	Ordering, Referring, Prescribing	N/A	1891823944	0	0	WAKEFIELD, CYNTHIA J LCSW	3/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84805	N/A	N/A	N/A	N/A	N/A	5575 HOSPITAL AVE	None	ATASCADERO	CA	93422	0001	00	06000	35.49162766	-120.6627516	San Luis Obispo County
351025	Ordering, Referring, Prescribing	N/A	1891858684	0	0	WANG, FRANCES L PHARMD	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49147	N/A	N/A	N/A	N/A	N/A	411 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	00	06000	33.8531521	-117.8160824	Orange County
351029	Ordering, Referring, Prescribing	N/A	1891877064	0	0	WILLS, KRISTINA M PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49502	N/A	N/A	N/A	N/A	N/A	1640 BLACKBIRD ST	None	ROSEVILLE	CA	95747	4822	00	06000	38.76101394	-121.3458414	Placer County
351044	Ordering, Referring, Prescribing	N/A	1891929386	0	0	WINTON, JASON LMFT	4/7/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT85416	N/A	N/A	N/A	N/A	N/A	2919 MISSION ST	None	SAN FRANCISCO	CA	94110	3917	00	06000	37.75028364	-122.418239	San Francisco County
351065	Ordering, Referring, Prescribing	N/A	1891968459	0	0	WHITE, TAMMY J NP	2/4/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	18034	N/A	N/A	N/A	N/A	N/A	2640 BRESLAUER WAY	None	REDDING	CA	96001	4246	00	06000	40.5496754	-122.3791396	Shasta County
351144	Ordering, Referring, Prescribing	N/A	1902144918	0	0	WASEER, AYESHA R	7/9/2013	Taxonomy not applicable	NA	n/a	099	DENTIST	D61776	N/A	N/A	N/A	N/A	N/A	355 CENTRAL AVE	None	FILLMORE	CA	93015	1920	00	06000	34.40028802	-118.9137057	Ventura County
351187	Ordering, Referring, Prescribing	N/A	1902182090	0	0	WILLIAMS, ALI	11/1/2020	Taxonomy not applicable	NA	n/a	000	Unknown	PA21657	N/A	N/A	N/A	N/A	N/A	650 N STATE ST	None	HEMET	CA	92543	2960	00	06000	33.757695	-116.9717535	Riverside County
351190	Ordering, Referring, Prescribing	N/A	1902200173	0	0	WONG, ANTHONY S PHARMD	8/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH71773	N/A	N/A	N/A	N/A	N/A	498 CASTRO STREET	None	SAN FRANCISCO	CA	94114	2020	00	06000	37.76111969	-122.4350504	San Francisco County
351224	Ordering, Referring, Prescribing	N/A	1902261258	0	0	WASH, ELENA C LCSW	12/16/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88505	N/A	N/A	N/A	N/A	N/A	905 E. 8TH ST.	None	LOS ANGELES	CA	90021	1848	00	06000	34.03639545	-118.2465917	Los Angeles County
351244	Ordering, Referring, Prescribing	N/A	1902290604	0	0	WONG, DEANNA G LMFT	8/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT120844	N/A	N/A	N/A	N/A	N/A	11429 VALLEY BLVD	None	EL MONTE	CA	91731	3229	00	06000	34.06953065	-118.0288485	Los Angeles County
351274	Ordering, Referring, Prescribing	N/A	1902336837	0	0	WEBSTER, KRISTIN K LCSW	1/27/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW16118	N/A	N/A	N/A	N/A	N/A	1111 W CHASE AVE	None	EL CAJON	CA	92020	5710	00	06000	32.78161035	-116.9764603	San Diego County
351279	Ordering, Referring, Prescribing	N/A	1902350051	0	0	WONG, KENNETH LCSW	3/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88603	N/A	N/A	N/A	N/A	N/A	33 ENCINA AVE	None	PALO ALTO	CA	94301	2343	00	06000	37.43913037	-122.1608344	Santa Clara County
351337	Ordering, Referring, Prescribing	N/A	1902496789	0	0	WU, APRIL S NP	3/22/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015342	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
351348	Ordering, Referring, Prescribing	N/A	1902562291	0	0	WALIA, GURSIMRAN S PHARMD	11/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85536	N/A	N/A	N/A	N/A	N/A	1801 W. 11TH STREET	None	TRACY	CA	95376	3727	00	06000	37.73945553	-121.449447	San Joaquin County
351381	Ordering, Referring, Prescribing	N/A	1902880610	0	0	WORTHINGTON, RANDY DC	12/19/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	24036	N/A	N/A	N/A	N/A	N/A	37491 ENTERPRISE DRIVE	None	BURNEY	CA	96013	4379	00	06000	40.88784451	-121.6526265	Shasta County
351417	Ordering, Referring, Prescribing	N/A	1902936875	0	0	WALKER-BAUER, MICHELE A PHD	7/17/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY22189	N/A	N/A	N/A	N/A	N/A	1721 GRIFFIN AVENUE	None	LOS ANGELES	CA	90031	3312	00	06000	34.06331668	-118.2114477	Los Angeles County
351504	Ordering, Referring, Prescribing	N/A	1912112335	0	0	WILSON, MICHAL C PSYD	4/24/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	34175	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
351518	Ordering, Referring, Prescribing	N/A	1912154667	0	0	WILLIAMS, KIMBERLY E LCSW	11/20/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65321	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	6TH FLOOR	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
351545	Ordering, Referring, Prescribing	N/A	1912216581	0	0	WIJESINGHE, SAMPATH	9/11/2017	Taxonomy not applicable	NA	n/a	000	Unknown	21068	N/A	N/A	N/A	N/A	N/A	1939 ACADEMY AVE	None	SANGER	CA	93657	3737	00	06000	36.68936951	-119.5550306	Fresno County
351557	Ordering, Referring, Prescribing	N/A	1912242975	0	0	WALLACE, JOSEPHINE P LMFT	5/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	78374	N/A	N/A	N/A	N/A	N/A	1625 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	3809	00	06000	34.04957404	-118.2750068	Los Angeles County
351576	Ordering, Referring, Prescribing	N/A	1912275116	0	0	WANG, ALISHA S PHARMD	7/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66461	N/A	N/A	N/A	N/A	N/A	217 ALMA ST.	200	PALO ALTO	CA	94301	0000	00	06000	37.44563438	-122.1673764	Santa Clara County
351583	Ordering, Referring, Prescribing	N/A	1912281635	0	0	WILLIAMS, JONNIE R PSYD	1/24/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	30219	N/A	N/A	N/A	N/A	N/A	4141 STATE STREET	SUITE B6	SANTA BARBARA	CA	93110	1814	00	06000	34.4404695	-119.7612045	Santa Barbara County
351592	Ordering, Referring, Prescribing	N/A	1912288853	0	0	WONG, PO T PHARMD	7/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54366	N/A	N/A	N/A	N/A	N/A	8490 SANTA MONICA BLVD	1	LOS ANGELES	CA	90069	4261	00	06000	34.08950508	-118.3760465	Los Angeles County
351596	Ordering, Referring, Prescribing	N/A	1912289778	0	0	WEYER, CHRISTINA L LMFT	11/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT89076	N/A	N/A	N/A	N/A	N/A	43520 DIVISION ST	None	LANCASTER	CA	93535	4089	00	06000	34.673445	-118.130143	Los Angeles County
351602	Ordering, Referring, Prescribing	N/A	1912301433	0	0	WALSER, BEVERLY G PHARMD	3/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH44805	N/A	N/A	N/A	N/A	N/A	475 M ST	None	CRESCENT CITY	CA	95531	9401	00	06000	41.75553707	-124.1942635	Del Norte County
351620	Ordering, Referring, Prescribing	N/A	1912322140	0	0	WALLIS, KRISTEN LMFT	5/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	101201	N/A	N/A	N/A	N/A	N/A	7986 DAGGET ST	None	SAN DIEGO	CA	92111	2321	00	06000	32.82363345	-117.1512855	San Diego County
351640	Ordering, Referring, Prescribing	N/A	1912356817	0	0	WUU, RROBERT-JIM LAC	4/22/2020	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC16523	N/A	N/A	N/A	N/A	N/A	1999 MOWRY AVENUE	None	FREMONT	CA	94538	1723	00	06000	37.55783419	-121.9808484	Alameda County
351667	Ordering, Referring, Prescribing	N/A	1912380940	0	0	WILLIAMS, JACOB A LMFT	7/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT127064	N/A	N/A	N/A	N/A	N/A	777 N 1ST ST	444	SAN JOSE	CA	95112	6337	00	06000	37.35064564	-121.9015633	Santa Clara County
351683	Ordering, Referring, Prescribing	N/A	1912408410	0	0	WYEK, ALANNA PSYD	1/25/2025	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY35647	N/A	N/A	N/A	N/A	N/A	3031 S VERMONT AVE	None	LOS ANGELES	CA	90007	3033	00	06000	34.02666679	-118.2915608	Los Angeles County
351752	Ordering, Referring, Prescribing	N/A	1912521246	0	0	WHITNEY, DEBORAH J LMFT	4/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139267	N/A	N/A	N/A	N/A	N/A	676 PISMO ST	None	SAN LUIS OBISPO	CA	93401	3945	00	06000	35.27640631	-120.6628883	San Luis Obispo County
351783	Ordering, Referring, Prescribing	N/A	1912569609	0	0	WILSON, SANDRA L LMFT	3/4/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT131566	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3394	00	06000	33.7831762	-118.1333125	Los Angeles County
351793	Ordering, Referring, Prescribing	N/A	1912622622	0	0	WISE, HAYLEY E NP	6/10/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021225	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
351811	Ordering, Referring, Prescribing	N/A	1912667213	0	0	WARD, LA VIOLA A LPCC	4/24/2024	Taxonomy not applicable	NA	n/a	000	Unknown	16405	N/A	N/A	N/A	N/A	N/A	9837 FOLSOM BLVD	SUITE F	SACRAMENTO	CA	95827	1356	00	06000	38.575764	-121.330647	Sacramento County
351824	Ordering, Referring, Prescribing	N/A	1912688946	0	0	WOODWARD, ADRIANA CNP	7/27/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026315	N/A	N/A	N/A	N/A	N/A	16233 KING ST	None	DELHI	CA	95315	9460	00	06000	37.43319758	-120.7809931	Merced County
351832	Ordering, Referring, Prescribing	N/A	1912900739	0	0	WILDENBERG, HOPE A MD	8/27/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G83457	N/A	N/A	N/A	N/A	N/A	105 E SYDNOR AVE	None	RIDGECREST	CA	93555	5546	00	06000	35.64096373	-117.6688699	Kern County
351833	Ordering, Referring, Prescribing	N/A	1912914961	0	0	WEINTZ, DONALD K LPCC	6/23/2020	Taxonomy not applicable	NA	n/a	000	Unknown	241	N/A	N/A	N/A	N/A	N/A	3424 W PACKWOOD AVE	None	VISALIA	CA	93277	5000	00	06000	36.294921	-119.3287005	Tulare County
351912	Ordering, Referring, Prescribing	N/A	1922242668	0	0	WHITE, AMANDA	11/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	23447	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD ROAD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
351917	Ordering, Referring, Prescribing	N/A	1922261288	0	0	WASHINGTON, GUADALUPE LCSW	2/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29860	N/A	N/A	N/A	N/A	N/A	1333 CHESTNUT AVE	None	LONG BEACH	CA	90813	2944	00	06000	33.78354312	-118.1963702	Los Angeles County
351967	Ordering, Referring, Prescribing	N/A	1922356187	0	0	WONG, CAMILLE PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67691	N/A	N/A	N/A	N/A	N/A	23621 MAIN ST	None	CARSON	CA	90745	5743	00	06000	33.810615	-118.2757055	Los Angeles County
352006	Ordering, Referring, Prescribing	N/A	1922410273	0	0	WILLIAMS, YASMIN L LMFT	3/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT99179	N/A	N/A	N/A	N/A	N/A	3002 ARMSTRONG ST	None	SAN DIEGO	CA	92111	5702	00	06000	32.80043242	-117.165431	San Diego County
352033	Ordering, Referring, Prescribing	N/A	1922459114	0	0	WHEELER, SUZANNA LCSW	9/24/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	126139	N/A	N/A	N/A	N/A	N/A	123 W GUTIERREZ ST	None	SANTA BARBARA	CA	93101	1249	00	06000	34.41387023	-119.6962788	Santa Barbara County
352063	Ordering, Referring, Prescribing	N/A	1922491596	0	0	WOJTANOWICZ, TODD R MD	1/29/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158817	N/A	N/A	N/A	N/A	N/A	14140 BEACH BLVD	200	WESTMINSTER	CA	92683	4453	00	06000	33.756966	-117.9894915	Orange County
352118	Ordering, Referring, Prescribing	N/A	1922560762	0	0	WANG, HUBERT	8/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A181127	N/A	N/A	N/A	N/A	N/A	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
352164	Ordering, Referring, Prescribing	N/A	1922667443	0	0	WILDER, SHANE L	2/8/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL396	N/A	N/A	N/A	N/A	N/A	6043 HOLLYWOOD BLVD	LOS ANGELES CA 90028	LOS ANGELES	CA	90028	5411	00	06000	34.1016835	-118.321569	Los Angeles County
352219	Ordering, Referring, Prescribing	N/A	1932130648	0	0	WESLING, PAUL J OD	10/4/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	10869	N/A	N/A	N/A	N/A	N/A	7850 BROADWAY	None	LEMON GROVE	CA	91945	1801	00	06000	32.7428152	-117.0294346	San Diego County
352243	Ordering, Referring, Prescribing	N/A	1932229655	0	0	WALKER, CHERYL L LMFT	3/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT22532	N/A	N/A	N/A	N/A	N/A	802 BREWSTER AVE	None	REDWOOD CITY	CA	94063	1510	00	06000	37.48873991	-122.2339433	San Mateo County
352251	Ordering, Referring, Prescribing	N/A	1932235413	0	0	WILSON, JEANNETTE LMFT	1/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52144	N/A	N/A	N/A	N/A	N/A	3321 POWER INN ROAD	SUITE 110	SACRAMENTO	CA	95826	3893	00	06000	38.544273	-121.407714	Sacramento County
352276	Ordering, Referring, Prescribing	N/A	1932280922	0	0	WOO, FRANKLIN DDS	1/3/2024	Taxonomy not applicable	NA	n/a	000	Unknown	25310	N/A	N/A	N/A	N/A	N/A	2727 MACDONALD AVE	None	RICHMOND	CA	94804	3006	00	06000	37.93503193	-122.3422799	Contra Costa County
352288	Ordering, Referring, Prescribing	N/A	1932310489	0	0	WATT, DAVID PHD	6/18/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY17366	N/A	N/A	N/A	N/A	N/A	39155 LIBERTY ST.	SUITE E500	FREMONT	CA	94537	5006	00	06000	37.55123907	-121.9828956	Alameda County
352328	Ordering, Referring, Prescribing	N/A	1932423571	0	0	WHELCHEL, MELANIE M LCSW	4/25/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW114947	N/A	N/A	N/A	N/A	N/A	130 YELLOWSTONE DR	110	CHICO	CA	95973	5884	00	06000	39.7697419	-121.8758344	Butte County
352345	Ordering, Referring, Prescribing	N/A	1932467362	0	0	WHITTAKER, LATASHA R LMFT	8/26/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT134438	N/A	N/A	N/A	N/A	N/A	1212 N CALIFORNIA ST	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
352346	Ordering, Referring, Prescribing	N/A	1932459336	0	0	WILLIAMS, LAUREL A LCSW	1/17/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23146	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
352399	Ordering, Referring, Prescribing	N/A	1932538394	0	0	WOODSOME, MICHAEL NP	12/22/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23735	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL STREET	None	SAN FRANCISCO	CA	94110	1323	00	06000	37.76460716	-122.416335	San Francisco County
352426	Ordering, Referring, Prescribing	N/A	1932580974	0	0	WONG, KWOK MING PHARMD	3/26/2018	Taxonomy not applicable	NA	n/a	000	Unknown	51139	N/A	N/A	N/A	N/A	N/A	260 W FOOTHILL PKWY	None	CORONA	CA	92882	8540	00	06000	33.8448074	-117.5736088	Riverside County
352459	Ordering, Referring, Prescribing	N/A	1932626736	0	0	WOODSORREL, SANJE C NP	12/26/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006108	N/A	N/A	N/A	N/A	N/A	1311 N SAN FERNANDO BLVD	None	BURBANK	CA	91504	4236	00	06000	34.18947282	-118.3206362	Los Angeles County
352468	Ordering, Referring, Prescribing	N/A	1932635281	0	0	WANG, KEVIN	11/3/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158708	N/A	N/A	N/A	N/A	N/A	223 N GARFIELD	#208	MONTEREY PARK	CA	91754	1700	00	06000	34.0646166	-118.1228948	Los Angeles County
352489	Ordering, Referring, Prescribing	N/A	1932680006	0	0	WILLIAMS, JESSICA D CCC-SLP	1/29/2023	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	27677	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
352574	Ordering, Referring, Prescribing	N/A	1932874039	0	0	WHITLATCH, JASMINE P CNP	4/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024835	N/A	N/A	N/A	N/A	N/A	1119 E MONTE VISTA AVE	None	VACAVILLE	CA	95688	3009	00	06000	38.36024633	-121.9763983	Solano County
352653	Ordering, Referring, Prescribing	N/A	1942364393	0	0	WEIGEL, JULIE K	9/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38814	N/A	N/A	N/A	N/A	N/A	2425 BISSO LANE	200	CONCORD	CA	94520	4817	00	06000	37.98393807	-122.0466953	Contra Costa County
352676	Ordering, Referring, Prescribing	N/A	1942423215	0	0	WOODS, REINA M LCSW	10/2/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	73339	N/A	N/A	N/A	N/A	N/A	5256 MISSION BLVD	None	RIVERSIDE	CA	92509	4624	00	06000	33.99261717	-117.3987262	Riverside County
352732	Ordering, Referring, Prescribing	N/A	1942550207	0	0	WEITZ, DINA T PHARMD	4/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67550	N/A	N/A	N/A	N/A	N/A	5601 DE SOTO AVE	None	CANOGA PARK	CA	91303	0000	00	06000	34.1722845	-118.5881913	Los Angeles County
352734	Ordering, Referring, Prescribing	N/A	1942558721	0	0	WATSON, LORENA NP	8/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22120	N/A	N/A	N/A	N/A	N/A	925 BEVINS CT	None	LAKEPORT	CA	95453	9754	00	06000	39.03772106	-122.9223338	Lake County
352751	Ordering, Referring, Prescribing	N/A	1942578075	0	0	WEINSTEIN, NINA D PHARMD	7/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	48803	N/A	N/A	N/A	N/A	N/A	25533 MARGUERITE PARKWAY	None	MISSION VIEJO	CA	92692	2904	00	06000	33.59203067	-117.6600186	Orange County
352774	Ordering, Referring, Prescribing	N/A	1942610902	0	0	WILLIAMS, RASHMI T MD	2/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A167927	N/A	N/A	N/A	N/A	N/A	537 W 8TH ST	None	SAN PEDRO	CA	90731	3119	00	06000	33.7369376	-118.2887848	Los Angeles County
352802	Ordering, Referring, Prescribing	N/A	1942654959	0	0	WONG, AMY DPM	4/12/2019	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5540	N/A	N/A	N/A	N/A	N/A	2119 EL CAMINO REAL	None	OCEANSIDE	CA	92054	6202	00	06000	33.18935666	-117.3283002	San Diego County
352806	Ordering, Referring, Prescribing	N/A	1942656947	0	0	WALTER, SARAH A LCSW	11/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	105305	N/A	N/A	N/A	N/A	N/A	15305 RAYEN ST	None	NORTH HILLS	CA	91343	5117	00	06000	34.23191048	-118.4657625	Los Angeles County
352914	Ordering, Referring, Prescribing	N/A	1942833280	0	0	WRIGHT, BRENDA A LMFT	3/21/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	145936	N/A	N/A	N/A	N/A	N/A	3385 BASS LAKE RD	SUITE 140	EL DORADO HILLS	CA	95762	6635	00	06000	38.67565742	-121.0300379	El Dorado County
352915	Ordering, Referring, Prescribing	N/A	1942847272	0	0	WARREN, YASHICA NP	12/5/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013432	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
352962	Ordering, Referring, Prescribing	N/A	1942981212	0	0	WILLIAMS, ALEJANDRA NP	7/27/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026322	N/A	N/A	N/A	N/A	N/A	1530 HILLHURST AVE	None	LOS ANGELES	CA	90027	5516	00	06000	34.098921	-118.287374	Los Angeles County
353017	Ordering, Referring, Prescribing	N/A	1952363178	0	0	WONG, DEBORAH F MD	12/19/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G64641	N/A	N/A	N/A	N/A	N/A	13975 MONO WAY	None	SONORA	CA	95370	2824	00	06000	37.97831488	-120.3396851	Tuolumne County
353022	Ordering, Referring, Prescribing	N/A	1952407694	0	0	WALI, SUSHMA MD	1/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A32236	N/A	N/A	N/A	N/A	N/A	2940 INLAND EMPIRE BLVD	None	ONTARIO	CA	91764	4898	00	06000	34.069788	-117.5884605	San Bernardino County
353026	Ordering, Referring, Prescribing	N/A	1952420234	0	0	WELCH, DONNA M LCSW	2/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24085	N/A	N/A	N/A	N/A	N/A	6651 BALBOA BLVD.	None	VAN NUYS	CA	91406	5529	00	06000	34.191468	-118.5011883	Los Angeles County
353060	Ordering, Referring, Prescribing	N/A	1952469850	0	0	WIELENGA, ROBERT J MD	1/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	G81044	N/A	N/A	N/A	N/A	N/A	10835 NEW ST	None	DOWNEY	CA	90241	3714	00	06000	33.94342419	-118.1318514	Los Angeles County
353097	Ordering, Referring, Prescribing	N/A	1952559551	0	0	WIENS, SARAH L LMFT	10/21/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84708	N/A	N/A	N/A	N/A	N/A	3133 N MILLBROOK AVE	None	FRESNO	CA	93703	1425	00	06000	36.77841	-119.7635455	Fresno County
353103	Ordering, Referring, Prescribing	N/A	1952575730	0	0	WAHLE, TIMOTHY J DDS	8/9/2022	Taxonomy not applicable	NA	n/a	000	Unknown	CA44799	N/A	N/A	N/A	N/A	N/A	51 BRANSCOMB RD	None	LAYTONVILLE	CA	95454	0870	00	06000	39.68776653	-123.4841265	Mendocino County
353125	Ordering, Referring, Prescribing	N/A	1952628042	0	0	WALSEMAN, KATHRYN MD	5/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152724	N/A	N/A	N/A	N/A	N/A	1425 MONTGOMERY RD	None	RED BLUFF	CA	96080	4605	00	06000	40.157883	-122.2250685	Tehama County
353169	Ordering, Referring, Prescribing	N/A	1952701856	0	0	WISE-PETRENKO, JENNIFER A LMFT	2/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110441	N/A	N/A	N/A	N/A	N/A	101 CIRBY HILLS DR	None	ROSEVILLE	CA	95678	4360	00	06000	38.7303989	-121.2872592	Placer County
353178	Ordering, Referring, Prescribing	N/A	1952729543	0	0	WASEF, PHILIP S MD	1/18/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C191957	N/A	N/A	N/A	N/A	N/A	350 E COMMERCIAL RD	SUITE 112	SAN BERNARDINO	CA	92408	3764	00	06000	34.05584763	-117.2773573	San Bernardino County
353191	Ordering, Referring, Prescribing	N/A	1952749996	0	0	WHITLOW, SHANNA M LMFT	12/4/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116363	N/A	N/A	N/A	N/A	N/A	1007 MYRTLE AVE.	None	INGLEWOOD	CA	90301	4009	00	06000	33.95067513	-118.3491758	Los Angeles County
353216	Ordering, Referring, Prescribing	N/A	1952782666	0	0	WATKINS, LORRAINE S LMFT	6/18/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	87207	N/A	N/A	N/A	N/A	N/A	785 18TH ST	None	ARCATA	CA	95221	5683	00	06000	40.8760592	-124.0837498	Humboldt County
353306	Ordering, Referring, Prescribing	N/A	1952924631	0	0	WATTS, SHANICE R PA-C	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59811	N/A	N/A	N/A	N/A	N/A	9460 NO NAME UNO	210	GILROY	CA	95020	3532	00	06000	37.037781	-121.570965	Santa Clara County
353339	Ordering, Referring, Prescribing	N/A	1952977811	0	0	WESLEY, STARR S LCSW	9/16/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	126093	N/A	N/A	N/A	N/A	N/A	6736 LAUREL CANYON BLVD	#200	NORTH HOLLYWOOD	CA	91606	1576	00	06000	34.193493	-118.3964925	Los Angeles County
353378	Ordering, Referring, Prescribing	N/A	1962068106	0	0	WONG-JENSEN, LULU L MD	6/17/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A179359	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
353405	Ordering, Referring, Prescribing	N/A	1962167254	0	0	WILLIAMS, LAUREN LMFT	4/11/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131141	N/A	N/A	N/A	N/A	N/A	315 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	00	06000	34.444881	-119.7793725	Santa Barbara County
353419	Ordering, Referring, Prescribing	N/A	1962260646	0	0	WONG, MELISSA NP	2/27/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95029233	N/A	N/A	N/A	N/A	N/A	220 HOSPITAL DR	None	VALLEJO	CA	94589	2517	00	06000	38.13109785	-122.238998	Solano County
353420	Ordering, Referring, Prescribing	N/A	1962234781	0	0	WHITTEN, HANNAH M RDH	8/21/2023	Taxonomy not applicable	NA	n/a	000	Unknown	33657	N/A	N/A	N/A	N/A	N/A	740 SOLANO ST	None	CORNING	CA	96021	3352	00	06000	39.92792649	-122.175513	Tehama County
353421	Ordering, Referring, Prescribing	N/A	1962197541	0	0	WEBBER, JAY C LMFT	9/19/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	149974	N/A	N/A	N/A	N/A	N/A	2226 N FIRST ST	None	SAN JOSE	CA	95131	2007	00	06000	37.3776967	-121.9213514	Santa Clara County
353513	Ordering, Referring, Prescribing	N/A	1962635953	0	0	WILLIAMS, LARABA R LCSW	2/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29327	N/A	N/A	N/A	N/A	N/A	439 W 97TH ST	None	LOS ANGELES	CA	90003	3968	00	06000	33.94831439	-118.282325	Los Angeles County
353533	Ordering, Referring, Prescribing	N/A	1962680330	0	0	WELLS, MICHELLE E LMFT	6/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	93583	N/A	N/A	N/A	N/A	N/A	2719 N AIR FRESNO DR	None	FRESNO	CA	93727	1547	00	06000	36.77448139	-119.7281325	Fresno County
353567	Ordering, Referring, Prescribing	N/A	1962751685	0	0	WILKERSON, KATHERINE LCSW	11/18/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW77085	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
353649	Ordering, Referring, Prescribing	N/A	1962840926	0	0	WINTERROWD, JESSICA E LMFT	10/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99734	N/A	N/A	N/A	N/A	N/A	170 9TH STREET	None	SAN FRANCISCO	CA	94103	2603	00	06000	37.77542325	-122.4137412	San Francisco County
353652	Ordering, Referring, Prescribing	N/A	1962846881	0	0	WATSON-ALVARADO, SAMANTHA E	6/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT119505	N/A	N/A	N/A	N/A	N/A	200 24TH STREET	None	RICHMOND	CA	94804	1804	00	06000	37.93439778	-122.3465322	Contra Costa County
353653	Ordering, Referring, Prescribing	N/A	1962847145	0	0	WILKINS, EMILIA G MD	7/18/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133431	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
353654	Ordering, Referring, Prescribing	N/A	1962848986	0	0	WELCH, BROOKE A PSYD	5/8/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY27866	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
353657	Ordering, Referring, Prescribing	N/A	1962850156	0	0	WONG, CARRIE	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73248	N/A	N/A	N/A	N/A	N/A	1263 E ARQUES AVE	None	SUNNYVALE	CA	94085	4701	00	06000	37.38060846	-121.9896672	Santa Clara County
353717	Ordering, Referring, Prescribing	N/A	1962942078	0	0	WADSWORTH, THELMA R PA	10/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61886	N/A	N/A	N/A	N/A	N/A	554-850 MEDICAL CENTER D	None	BIEBER	CA	96009	8000	00	06000	0	0	None
353838	Ordering, Referring, Prescribing	N/A	1972179828	0	0	WIDMAN, NICOLE D LCSW	1/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120505	N/A	N/A	N/A	N/A	N/A	3011 HARBOR BLVD	B	COSTA MESA	CA	92626	2592	00	06000	33.68101226	-117.9194731	Orange County
353841	Ordering, Referring, Prescribing	N/A	1972179810	0	0	WELLS, SONYA L PHARMD	8/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH41039	N/A	N/A	N/A	N/A	N/A	3999 FOOTHILLS BLVD	None	ROSEVILLE	CA	95747	7256	00	06000	38.75127171	-121.3093622	Placer County
353853	Ordering, Referring, Prescribing	N/A	1972230738	0	0	WALLACE, ANGELA NP	5/20/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95021029	N/A	N/A	N/A	N/A	N/A	1035 PLACER STREET	None	REDDING	CA	96001	4245	00	06000	40.58349378	-122.3853903	Shasta County
353913	Ordering, Referring, Prescribing	N/A	1972612844	0	0	WHITE, DIANA J LMFT	11/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT40644	N/A	N/A	N/A	N/A	N/A	10850 GOLD CENTER DR STE	325	RANCHO CORDOVA	CA	95670	6034	00	06000	38.590353	-121.282488	Sacramento County
353916	Ordering, Referring, Prescribing	N/A	1972628261	0	0	WHEELWRIGHT, WENDY LMFT	10/25/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40762	N/A	N/A	N/A	N/A	N/A	2245 CHALLENGER WAY	100	SANTA ROSA	CA	95407	5418	00	06000	38.42559	-122.751243	Sonoma County
353918	Ordering, Referring, Prescribing	N/A	1972631711	0	0	WILLIAMSON, SUSAN L LCSW	10/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61513	N/A	N/A	N/A	N/A	N/A	1965 LIVE OAK BLVD	None	YUBA CITY	CA	95991	8850	00	06000	39.15563037	-121.620091	Sutter County
353936	Ordering, Referring, Prescribing	N/A	1972649275	0	0	WILLIAMS, CHARLENE R NP	5/25/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP6472	N/A	N/A	N/A	N/A	N/A	4327 GOLDEN CENTER DR	None	PLACERVILLE	CA	95667	6287	00	06000	38.70662835	-120.8276613	El Dorado County
353989	Ordering, Referring, Prescribing	N/A	1972763407	0	0	WEITZMAN, BRUCE LMFT	7/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT44864	N/A	N/A	N/A	N/A	N/A	295 FELL ST	B	SAN FRANCISCO	CA	94102	5147	00	06000	37.77591387	-122.4225651	San Francisco County
354009	Ordering, Referring, Prescribing	N/A	1972805208	0	0	WALLACE, KINDLE LMFT	9/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84604	N/A	N/A	N/A	N/A	N/A	2041 ALMOND ST.	None	DOS PALOS	CA	93620	2303	00	06000	36.98482353	-120.6287505	Merced County
354041	Ordering, Referring, Prescribing	N/A	1972859023	0	0	WEINSTEIN, AARON A LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98181	N/A	N/A	N/A	N/A	N/A	1885 LUNDY AVE	223	SAN JOSE	CA	95131	1887	00	06000	37.39329538	-121.8907367	Santa Clara County
354046	Ordering, Referring, Prescribing	N/A	1972870889	0	0	WEI, DANIEL C	10/18/2018	Taxonomy not applicable	NA	n/a	000	Unknown	66408	N/A	N/A	N/A	N/A	N/A	751 BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
354050	Ordering, Referring, Prescribing	N/A	1972872539	0	0	WONG, MELISSA K PHARMD	8/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66492	N/A	N/A	N/A	N/A	N/A	1111 3RD AVE	None	CHULA VISTA	CA	91911	3105	00	06000	32.61310923	-117.0688372	San Diego County
354112	Ordering, Referring, Prescribing	N/A	1972952455	0	0	WATSON, VERONICA M LMFT	1/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117307	N/A	N/A	N/A	N/A	N/A	731 E YOSEMITE AVE	STE B 203	MERCED	CA	95340	8039	00	06000	37.33216946	-120.461247	Merced County
354127	Ordering, Referring, Prescribing	N/A	1972968188	0	0	WANGSADIPURA, PATRICIA NP	4/8/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000769	N/A	N/A	N/A	N/A	N/A	308 N LA CADENA DR	None	COLTON	CA	92324	2946	00	06000	34.06815282	-117.3240225	San Bernardino County
354182	Ordering, Referring, Prescribing	N/A	1982058566	0	0	WANG, DEBRA B MD	7/25/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150587	N/A	N/A	N/A	N/A	N/A	2425 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
354200	Ordering, Referring, Prescribing	N/A	1982075180	0	0	WEINTRAUB, ROBIN L	6/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23578	N/A	N/A	N/A	N/A	N/A	711 W. FLORENCE AVENUE	None	LOS ANGELES	CA	90044	6105	00	06000	33.9746755	-118.286415	Los Angeles County
354313	Ordering, Referring, Prescribing	N/A	1982280079	0	0	WEI, JENNY MD	5/21/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A193536	N/A	N/A	N/A	N/A	N/A	2425 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
354326	Ordering, Referring, Prescribing	N/A	1982320172	0	0	WU, ALFRED H NP	8/3/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022128	N/A	N/A	N/A	N/A	N/A	3835 N FREEWAY BLVD STE	None	SACRAMENTO	CA	95834	1954	00	06000	38.641014	-121.4861085	Sacramento County
354334	Ordering, Referring, Prescribing	N/A	1982361325	0	0	WALKER, LAURA D	11/17/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	LEP3702	N/A	N/A	N/A	N/A	N/A	2240 OLD RIVER RD	None	UKIAH	CA	95482	6103	00	06000	39.1293897	-123.1645436	Mendocino County
354338	Ordering, Referring, Prescribing	N/A	1982380697	0	0	WANG, YANAN OD	5/31/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35476	N/A	N/A	N/A	N/A	N/A	14371 CLARK AVE	None	BELLFLOWER	CA	90706	2901	00	06000	33.90323754	-118.134141	Los Angeles County
354397	Ordering, Referring, Prescribing	N/A	1982739736	0	0	WILLIAM, SALLY S	7/30/2012	Taxonomy not applicable	NA	n/a	099	DENTIST	D55404	N/A	N/A	N/A	N/A	N/A	525 ROBERTS LANE	None	BAKERSFIELD	CA	93308	4799	00	06000	35.40860151	-119.0317455	Kern County
354406	Ordering, Referring, Prescribing	N/A	1982759338	0	0	WILLIAMS, CYNTHIA A	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0546705	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
354444	Ordering, Referring, Prescribing	N/A	1982843264	0	0	WANG, KAI-MIN DC	4/5/2024	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	27564	N/A	N/A	N/A	N/A	N/A	2633 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1597	00	06000	37.72840413	-122.4039067	San Francisco County
354463	Ordering, Referring, Prescribing	N/A	1982865572	0	0	WASHINGTON, JAZELLE L LPCC	10/26/2020	Taxonomy not applicable	NA	n/a	000	Unknown	8715	N/A	N/A	N/A	N/A	N/A	755 S VAN NESS AVENUE	None	SAN FRANCISCO	CA	94110	1908	00	06000	37.76103073	-122.4170932	San Francisco County
354470	Ordering, Referring, Prescribing	N/A	1982898136	0	0	WALIA, JASWINDER K MD	4/29/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A101014	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
354476	Ordering, Referring, Prescribing	N/A	1982907861	0	0	WRIGHT, ADELA P LMFT	2/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84310	N/A	N/A	N/A	N/A	N/A	1231 E DYER RD	135	SANTA ANA	CA	92705	5606	00	06000	33.710643	-117.856773	Orange County
354547	Ordering, Referring, Prescribing	N/A	1992013312	0	0	WHALL, HOLLY LCSW	10/12/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW86945	N/A	N/A	N/A	N/A	N/A	1515 5TH ST	None	LOS OSOS	CA	93402	1611	00	06000	35.3240874	-120.8376835	San Luis Obispo County
354551	Ordering, Referring, Prescribing	N/A	1992036727	0	0	WINKELMAN QUINN, AMY M NP	9/27/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	19454	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
354576	Ordering, Referring, Prescribing	N/A	1992072581	0	0	WASEF, SHADY	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62433	N/A	N/A	N/A	N/A	N/A	25455 BARTON RD	111A	LOMA LINDA	CA	92354	3128	00	06000	34.04805253	-117.249534	San Bernardino County
354582	Ordering, Referring, Prescribing	N/A	1992080691	0	0	WHIPPLE, MICHELLE D PA-C	6/30/2020	Taxonomy not applicable	NA	n/a	000	Unknown	53767	N/A	N/A	N/A	N/A	N/A	3132 JEFFERSON ST	None	SAN DIEGO	CA	92110	4421	00	06000	32.75567499	-117.203517	San Diego County
354623	Ordering, Referring, Prescribing	N/A	1992132757	0	0	WILSON, TERESA L LPCC	3/18/2020	Taxonomy not applicable	NA	n/a	000	Unknown	5080	N/A	N/A	N/A	N/A	N/A	631 S. ORCHARD AVE	None	UKIAH	CA	95482	5011	00	06000	39.14619517	-123.1986323	Mendocino County
354627	Ordering, Referring, Prescribing	N/A	1992140040	0	0	WARREN, CHASE R MD	6/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132051	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	00	06000	34.42887662	-119.7237878	Santa Barbara County
354640	Ordering, Referring, Prescribing	N/A	1992162242	0	0	WALLS, KEN C DO	4/14/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19453	N/A	N/A	N/A	N/A	N/A	26600 CACTUS AVE	300	MORENO VALLEY	CA	92555	3901	00	06000	33.91013953	-117.193383	Riverside County
354709	Ordering, Referring, Prescribing	N/A	1992298269	0	0	WASSATHER, STEPHEN	5/24/2024	Taxonomy not applicable	NA	n/a	000	Unknown	16640	N/A	N/A	N/A	N/A	N/A	11434 B AVE	None	AUBURN	CA	95603	2603	00	06000	38.9389028	-121.1059183	Placer County
354720	Ordering, Referring, Prescribing	N/A	1992326425	0	0	WINGFIELD, CAROL NP	5/30/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030308	N/A	N/A	N/A	N/A	N/A	81812 DOCTOR CARREON BOU	SUITE D	INDIO	CA	92201	5594	00	06000	33.70742848	-116.236728	Riverside County
354751	Ordering, Referring, Prescribing	N/A	1992376149	0	0	WELSCH, DESIREE	6/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017674	N/A	N/A	N/A	N/A	N/A	925 HILBY AVE	None	SEASIDE	CA	93955	0000	00	06000	36.60262817	-121.8473397	Monterey County
354757	Ordering, Referring, Prescribing	N/A	1992385538	0	0	WAND, TAYLOR H MD	11/7/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A187265	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County