WK MEDICAL GROUP (NPI# 1588083992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588083992 |
| Entity Type | Organization |
| Organization Name | WK MEDICAL GROUP |
| Practice Address |
2542 S Bascom Ave Ste 110 Campbell CA 95008-5526 |
| Practice Telephone | 4085593403 |
| Mailing Telephone | 4085593403 |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2020-06-16 |
| Authorized Official Name | DR. BRUCE MELVIN WERMUTH (PRESIDENT) |
| Authorized Official Telephone | 4085593403 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
G25581 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
G25581 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2542 S BASCOM AVE STE 110 |
| City | CAMPBELL |
| State | CA |
| Zip Code | 95008-5526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649253204 | Philip Richard Kavanaugh | Psychiatry & Neurology | 2542 S Bascom Ave, Suite 207, Campbell, CA 95008-5526 | 2005-11-28 |
| 1740639301 | Carolain Suzuki Peregrino | Nurse Practitioner | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2016-06-05 |
| 1659713329 | Jeweleeh Hanh Yu | Physician Assistant | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2013-07-23 |
| 1124141031 | David Frederick Dahl | Clinical Neuropsychologist | 2542 S Bascom Ave, Ste 265, Campbell, CA 95008-5565 | 2007-04-06 |
| 1073645701 | Archana Narayan Kulkarni | Social Worker | 2542 S Bascom Ave, Suite 255, Campbell, CA 95008-5526 | 2007-03-09 |
| 1871620542 | Sally Ann Sharrock | Marriage & Family Therapist | 2542 S Bascom Ave, 255, Campbell, CA 95008-5526 | 2007-02-28 |
| 1629104617 | Bruce Melvin Wermuth | Psychiatry & Neurology | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2007-02-26 |
| 1194766113 | Maria Virginia Castelli | Registered Nurse | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5541 | 2006-06-09 |
| 1063478964 | Diann Garcia | Nurse Practitioner | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2006-04-21 |
| 1902866049 | George D Guido IIi | Physician Assistant | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5541 | 2006-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298380 | Kerry Lynn Osteen | Massage Therapist | 3579 S Bascom Ave, Apt 5, Campbell, CA 95008 | 2020-09-02 |
| 1164057550 | Francesca Dalangin | Physical Therapist | 163 E. Hamilton Avenue, Campbell, CA 95008 | 2020-03-06 |
| 1144790767 | Haley Brucato | Behavior Technician | 131 Rose Court Apt. 21, Campbell, CA 95008 | 2018-11-27 |
| 1740765809 | Crystal-xuanthao Nguyen Curammeng | Licensed Vocational Nurse | 251 Llwelyn Ave, Campbell, CA 95008 | 2018-09-25 |
| 1841799236 | Gabrielle Suzanne Buma | Physician Assistant | Uplift Family Services 251 Llewellyn Ave, Campbell, CA 95008 | 2018-02-12 |
| 1093214660 | Toni Lynn Clementi | Marriage & Family Therapist | 116 E. Campbell Ave, Campbell, CA 95008 | 2018-02-08 |
| 1184132573 | My Hanh Thi Nguyen | Behavioral Analyst | 1440 Theresa Avenue, Campbell, CA 95008 | 2018-01-19 |
| 1346770948 | Stephanie Michele Klahold | Pharmacist | 100 North San Tomas Aquino Road, Campbell, CA 95008 | 2017-06-15 |
| 1578095378 | Elina Josephson | Marriage & Family Therapist | 155 E Campbell Ave Ste 117, Campbell, CA 95008 | 2017-03-30 |
| 1912448408 | Suzane Mitchualmacauley | Licensed Vocational Nurse | 251 Llewelyn Ave, Uplift Family Services, Campbell, CA 95008 | 2017-03-16 |
| Find all providers in zip 95008 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760550370 | Ahsan Shaikh | Psychiatry & Neurology | 251 Llewellyn Ave, Campbell, CA 95008 | 2006-12-01 |
| 1194891705 | Elena Braverman | Psychiatry & Neurology | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2006-11-27 |
| 1679648158 | Diane Harris | Psychiatry & Neurology | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2006-11-21 |
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| 1225527427 | Better Life Therapy, Inc. | Psychiatry & Neurology | 9520 Escondido Canyon Rd, Santa Clarita, CA 91390-4811 | 2018-05-03 |
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| 1912432055 | Centered Health LLC | Psychiatry & Neurology | 6422 W 6th St, Los Angeles, CA 90048-4714 | 2017-04-26 |
| 1255871182 | Carol R Harrus | Psychiatry & Neurology | 517 Patricia Ln, Palo Alto, CA 94303-2856 | 2017-02-25 |
| 1437539509 | Ehab Yacoub, Md Inc. | Psychiatry & Neurology | 1225 W 190th St Ste 470, Gardena, CA 90248-4316 | 2015-06-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.