Provider Demographics
NPI:1003110974
Name:ADAMS, WENDY LEIGH (ARNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:LEIGH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:LEIGH
Other - Last Name:BERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1804 EMBARCADERO RD
Mailing Address - Street 2:STE 100
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3341
Mailing Address - Country:US
Mailing Address - Phone:650-497-8000
Mailing Address - Fax:
Practice Address - Street 1:725 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1601
Practice Address - Country:US
Practice Address - Phone:650-497-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9306512363LN0000X
CA21185363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0031379-00Medicaid
GA003105211BMedicaid
GA003105211AMedicaid
GA003105211BMedicaid
FLEQ853ZMedicare PIN