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NICOLE WILBERDING
NPI 1083139471
Student in an Organized Health Care Education/Training Program in Fremont, CA

Active since August 07, 2017PECOS Enrolled
39465 PASEO PADRE PKWY STE 2100, FREMONT, CA 94538(510) 745-9151(510) 745-9152 Get Directions Write a Review

NPPES record last updated: April 10, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 10, 2020, Aug 7, 2017 (2 updates tracked since 2017).

About Nicole Wilberding NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE WILBERDING (NPI 1083139471) is an individual student in an organized health care education/training program in Fremont, California and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083139471
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameNICOLE WILBERDING
Location Address39465 PASEO PADRE PKWY STE 2100Fremont, CA 94538-1624
Mailing Address3505 BroadwayOakland, CA 94611-5714 · (510) 752-9990
Phone(510) 745-9151
Fax(510) 745-9152
Sole ProprietorNo
Enumeration DateAugust 7, 2017
Last NPPES UpdateApril 10, 20202 updates tracked since enumeration
NPPES CertifiedApril 10, 2020
✔ NPI 1083139471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
39465 PASEO PADRE PKWY STE 2100, Fremont, CA 94538
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Wilberding is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nicole Wilberding reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
14 mi
Internal Medicine
1190 VETERANS BLVD
Redwood City, CA 94063
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1639252604 (650) 299-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEXANDRA MARIE DEMARCO
Student in an Organized Health Care Education/Training Program
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (510) 745-9151
LUKE HOLLAND
Psychologist (Clinical)
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (510) 745-9151
SAIRONG LU
Behavior Analyst
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (510) 745-9151
PORTIA BELL HUME CENTER
Clinic/Center (Mental Health (Including Community Mental Health Center))
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (510) 745-9151
ALYSSA J DENEAL
Peer Specialist
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (510) 745-9151
FLORIA MALEK MA
Psychologist (Counseling)
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (925) 998-8185
MONICA ANDREA SUNZERI HERNANDEZ BCBA
Behavior Analyst
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (510) 745-9151
JASMINE KAHLON
Student in an Organized Health Care Education/Training Program
39465 PASEO PADRE PKWY STE 2100
FREMONT, CA 94538
Alameda County (510) 745-9151

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Wilberding's NPI number?

The NPI number for Nicole Wilberding is 1083139471. It was assigned to this individual provider in the NPPES registry on August 7, 2017.

Where is Nicole Wilberding located?

Nicole Wilberding practices at 39465 Paseo Padre Pkwy Ste 2100, Fremont, CA 94538. The listed phone number is (510) 745-9151.

What is Nicole Wilberding's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nicole Wilberding enrolled in Medicare?

Yes. Nicole Wilberding is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Wilberding's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Wilberding reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Wilberding's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Wilberding was last updated on April 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.