Individual provider · Type 1 NPI

John David Wildgust, RN, MSN, PHN, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Santa Rosa, CA

NPI number 1013698232 Active

Practice location

480 Tesconi Cir Ste B
Santa Rosa, CA 95401-4691

Fax (707) 206-7254

Mailing address

935 Hunter Ln
Santa Rosa, CA 95404-8717

Other practice locations

  • 935 Hunter Ln, Santa Rosa, CA 95404-8717 · (707) 480-2030

Specialties and licenses

TaxonomyCodeLicense
Medical-Surgical Registered Nurse 163WM0705X78261 (CA)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNP95034156 (CA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1013698232

John David Wildgust, RN, MSN, PHN, PMHNP's National Provider Identifier is 1013698232, issued on Jul 31, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Santa Rosa, CA. The record was last updated on Apr 9, 2025.