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

Zeyerusalem Woldesilasse

Individual provider Primary Care Nurse Practitioner · NPI 1174292767

Zeyerusalem Woldesilasse is a Nurse Practitioner in Sacramento, California. Qualified in 2020, 6 years ago. Practices with Northbay Health Medical Foundation, a 202-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

10385 Old Placerville Rd
Sacramento, CA 95827-2506
Phone: (916) 448-1770
Fax: (916) 448-3015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence NP95016910 (CA)

Record details

NPI number1174292767
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 8, 2021
Last updated in NPPESSeptember 8, 2021
Certification dateSeptember 8, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northbay Health Medical Foundation — 202 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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