ANGELA WYBLE PAC
NPI 1871588715
Physician Assistant - Medical in Santa Rosa, CA

Q: What is Angela Wyble's NPI number?

The NPI number for Angela Wyble is 1871588715. It was assigned to this individual provider in the NPPES registry on September 16, 2005.

Q: What is Angela Wyble's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Angela Wyble was last updated on April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since September 16, 2005

100/100

CMS Quality Rating

2725 MENDOCINO AVE, SANTA ROSA, CA 95403(707) 545-4537(707) 545-6726 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Apr 13, 2022, Feb 26, 2021, Mar 28, 2017 (3 updates tracked since 2017).

On this page

About Angela Wyble Pac NPPES

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

ANGELA WYBLE PAC (NPI 1871588715) is an individual medical provider in Santa Rosa, California, licensed in California (PA17243) and active in the NPI registry since September 2005. She maintains a secondary practice location in Medford.

NPPES Registry Identity

NPI1871588715

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameANGELA WYBLECredential: PAC

Location Address2725 MENDOCINO AVESanta Rosa, CA 95403-2805

Mailing Address2725 Mendocino AveSanta Rosa, CA 95403-2805 · (707) 545-4537 · Fax (707) 545-6726

Phone(707) 545-4537

Fax(707) 545-6726

Sole ProprietorNo

Enumeration DateSeptember 16, 2005

Last NPPES UpdateApril 13, 20223 updates tracked since enumeration

NPPES CertifiedApril 13, 2022

✔ NPI 1871588715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA17243

2725 MENDOCINO AVE, Santa Rosa, CA 95403

Open in Google Maps ↗

Secondary Practice Location 1

Location 12959 Siskiyou Blvd Ste BMedford, OR 97504-8131 · Phone (541) 773-3636 ext. 1011 · Fax (541) 773-4643

Other Identifiers 2

OtherP01795158CA · Railroad Medicare

Medicaid1871588715CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

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

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