Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bianca Neema Wibisono, PA-C

Individual provider Physician Assistant · NPI 1134812548

Bianca Neema Wibisono, PA-C is a Physician Assistant in San Jose, California. Qualified in 2022, 4 years ago. Practices with Sutter Bay Medical Foundation, a 3,762-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1071 Blossom Hill Rd
San Jose, CA 95123-1105
Phone: (408) 445-4020
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 62531 (CA)

Record details

NPI number1134812548
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 31, 2023
Last updated in NPPESSeptember 13, 2023
Certification dateSeptember 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Sutter Bay Medical Foundation — 3762 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in San Jose