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Expert care, in the comfort of home

Sonoma Valley Nurse Practitioners Group brings unhurried, personalized medical care to your door. No waiting rooms, no rushed appointments — just a trusted clinician who knows you, your home, and your goals.

Request a home visit How it works

Rebecca “Becky” Spear, DNP · Serving the Sonoma Valley

“The best care happens where life happens. When I sit with someone at their own kitchen table, I see the whole picture — and I have the time to actually listen.”

— Becky Spear, DNP

Simple by design

How house calls work

1

Reach out

Request a visit online in about two minutes, call (707) 939-5345, or email info@sonomavalleynp.com. We’ll follow up with a free phone conversation to make sure we’re the right fit for you or your loved one.

2

We come to you

Your first visit happens at home and is never rushed. We review health history, medications, mobility, and what matters most to you.

3

Ongoing partnership

Regular follow-up visits, clear communication with family, and coordination with your other providers — so nothing falls through the cracks.

A different kind of practice

Why families choose home-based care

Time to listen

Visits typically last 60–90 minutes — several times longer than a standard office appointment.

Care in context

Seeing the home reveals what an exam room can’t: fall risks, medication routines, nutrition, and daily life.

Geriatric expertise

Care designed specifically for older adults — from managing multiple conditions to supporting independence and dignity.

No middlemen

Simple, transparent membership pricing. Your care is guided by your needs and your goals — not by 15-minute time slots.

What we offer

Services brought to your door

Care for adults at every stage of life — from busy professionals and parents who need answers fast, to older adults who want to stay safely at home.

Acute & urgent care visits

Sinus infections, sore throats, UTIs, rashes, minor injuries, and other sudden illnesses — handled same-day or next-day by telehealth or an in-person visit, without an urgent-care waiting room.

Same-day telehealth & direct messaging

Text or message your nurse practitioner directly for rapid advice, triage, and prescriptions — including after-hours guidance on whether something can safely wait.

Preventive & wellness care for adults

Annual health audits, metabolic and cardiovascular screening, lab review, and a practical plan to stay ahead of problems — for adults in their 30s, 40s, 50s, and 60s.

Comprehensive geriatric assessment

A whole-person review of health, function, memory, mood, and goals of care.

Chronic condition management

Ongoing support for diabetes, heart disease, COPD, hypertension, arthritis, and more.

Medication review & simplification

Careful review of every prescription to reduce side effects, interactions, and unnecessary pills.

Memory & cognitive concerns

Thoughtful evaluation of memory changes, with practical guidance for patients and families.

Fall prevention & home safety

In-home assessment of mobility and hazards, with a concrete plan to stay steady and independent.

After-hospital visits

Extra support during the fragile weeks after a hospital or rehab stay, when problems most often arise.

Care coordination & family support

Clear communication with specialists, caregivers, and family — everyone on the same page.

Advance care planning

Unhurried conversations about wishes and priorities, documented properly before a crisis.

Rebecca Spear, DNP, geriatric nurse practitioner

Meet your clinician

Rebecca “Becky” Spear, DNP

DNP, ARNP, AGNP-C, GS-C · 20 years caring for older adults

I’ve spent 20 years caring for older adults, and I believe good medicine starts with a relationship — and relationships take time. Again and again I’ve seen the same thing: the people who most need thorough, thoughtful care are often the ones for whom getting to a clinic is hardest.

Sonoma Valley Nurse Practitioners Group is my answer. I bring the visit to you: a full appointment at your kitchen table or favorite armchair, with time to talk through every medication, every concern, and every goal. I work alongside your specialists and other providers, and I keep your family in the loop at every step.

I also care for younger adults — and that part is personal. I’m a working mom, and I know exactly what it’s like to put off calling about something because the wait for an appointment is longer than the time you have. You shouldn’t have to take a half-day off work, or sit in an urgent-care waiting room with a sick kid in your lap, to get a straight answer. My members text me and I answer — whether it’s a sinus infection that won’t quit, a lab result you don’t understand, or a question about what to do this weekend.

I earned my Master of Science in Nursing from Seattle University and my Doctor of Nursing Practice from the University of Arizona, where my award-winning research focused on preventing delirium in post-acute care. Over more than two decades of hospital-based and post-acute geriatric care, I’ve led senior-care initiatives — including work that helped earn Age-Friendly Health System recognition. I’m board-certified in adult-gerontology primary care (AGNP-C), hold the Gerontological Specialist certification (GS-C), and am an active member of the American Association of Nurse Practitioners (AANP), the Gerontological Advanced Practice Nurses Association (GAPNA), and the American Delirium Society.

Aging well doesn’t mean giving things up — it means having the right support to keep living the life you love, in the place you love. It would be a privilege to be part of that support for you.

In their words

What families are saying

We are so grateful for the exceptional care and compassion Becky has provided. She takes the time to truly listen, explains everything clearly, and makes us feel valued and supported. Her genuine concern has made a difficult journey so much easier. We highly recommend her.

— Emilie C.

Having a dedicated, board-certified advanced practice nurse come directly to my parent’s home has been an absolute game-changer. The visits are never rushed, the communication is seamless, and the level of expertise in senior care has given our entire family complete peace of mind. Exceptional, highly personalized medicine.

— A patient’s family

Simple & transparent

Direct Primary Care & Membership Options

At Sonoma Valley Nurse Practitioners Group, we offer transparent, relationship-centered healthcare without the constraints of insurance middlemen. Choose the membership or care tier that fits your stage of life.

Direct Primary Care — adults under 65

Simple monthly memberships providing direct, unhurried access to your Nurse Practitioner.

Young Adult Membership

Ages 30–45 · billed monthly

$85/mo

+ $65/month to add a spouse or partner

For busy professionals, working parents, and active adults who are generally healthy but want a trusted clinician “in their pocket” for quick answers, acute care, and proactive wellness.

  • Direct “in-pocket” digital access — unlimited secure portal messaging and text access for rapid advice and triage
  • Same-day / next-day telehealth — virtual appointments for acute issues like sinus infections, rashes, minor illnesses, or travel prescriptions
  • Urgent-care avoidance triage — after-hours and weekend guidance on whether an issue needs urgent care or the ER, or can be managed safely at home
  • Annual comprehensive health audit — a dedicated yearly wellness visit covering baseline metabolic, cardiovascular, and preventive health goals
  • Insurance integration — routine labs, imaging, and prescriptions are ordered through your existing health insurance (PPO, HSA/FSA, etc.) at your preferred local pharmacies and facilities

Ask about membership →

Mid-Life & Health Navigation

Ages 46–64 · billed monthly

$125/mo

For adults navigating changing metabolic health, preventive screenings, or early chronic-condition management who want dedicated one-on-one time and care coordination.

  • Everything in the Young Adult Membership, plus:
  • Two in-person visits included annually — comprehensive clinical exams in the comfort of your home or office
  • Proactive preventive care planning — tailored cardiovascular, hormone, and metabolic screening strategies
  • Specialist & system navigation — expert advocacy and coordination for local specialists, imaging, and complex referrals
  • Expanded telehealth access — routine virtual check-ins for lab reviews and treatment adjustments

Ask about membership →

Senior Concierge & Primary Care — adults 65+

Specialized geriatric care for older adults, retirees, and individuals managing complex health needs.

Because we participate in Medicare Part B, clinical medical care for seniors is billed directly to Medicare, while our retainer fee covers non-covered amenities and direct mobile access.

Senior Hybrid Concierge

Ages 65+ · retainer + Medicare Part B for clinical visits

$95/mo

For older adults and families who want comprehensive primary care, house calls, and direct access to a board-certified geriatric nurse practitioner.

  • Clinical care, billed to Medicare Part B — in-home primary care visits, chronic-condition management, acute sick visits, physical exams, and advance care planning, billed directly to Medicare
  • Direct mobile access — direct phone and portal access for rapid questions and after-hours triage
  • Extended appointments — unhurried 45–60 minute visits at your kitchen table or living room
  • Care & family coordination — continuous updates to family members, healthcare proxies, and local home-health teams
  • Medication review & de-prescribing — ongoing polypharmacy audits to reduce side effects and fall risks
  • Mobile house calls — primary care delivered at your private home, independent living, or assisted living community in Sonoma Valley

Ask about senior concierge →

Standalone Age-in-Place Assessment

One-time service · up to 90-minute in-home visit

$395

A comprehensive, non-membership evaluation for families seeking an expert clinical baseline for an aging loved one.

  • Up to 90-minute in-home visit — comprehensive health and mobility evaluation
  • Home safety walk-through — environmental fall-risk and hazard assessment
  • Polypharmacy audit — deep-dive medication review (Beers Criteria) to flag unnecessary pills and risky interactions
  • Cognitive & functional screening — baseline memory, mood, and daily-function review
  • Personalized care roadmap — detailed care plan and family debrief

Request an assessment →

Sonoma Valley Nurse Practitioners Group operates on a transparent, relationship-centered model. Memberships for adults under 65 are direct-pay and billed monthly; for seniors 65+, clinical visits are billed to Medicare Part B while the monthly retainer covers non-covered amenities. Most HSA and FSA plans can be used for memberships, assessments, and retainer fees. Questions about how this pairs with your coverage? We’re happy to talk you through it.

Where we visit

Serving the Sonoma Valley

Home visits are available throughout the valley. Not sure if you’re in our service area? Send us a note — we’ll do our best to reach you.

  • Sonoma
  • Glen Ellen
  • Kenwood
  • Boyes Hot Springs
  • El Verano
  • Agua Caliente
  • Schellville
  • Vineburg

Good questions

Frequently asked questions

What is a DNP, and what can a nurse practitioner do?
A DNP (Doctor of Nursing Practice) is the highest clinical degree in nursing. In California, nurse practitioners evaluate and diagnose conditions, order and interpret tests, prescribe medications, and manage ongoing care. Becky is board-certified in adult-gerontology primary care (AGNP-C) with 20 years dedicated to older adults.
What is Direct Primary Care?
Direct Primary Care (DPC) is a simple, transparent way to pay for care: you work directly with your nurse practitioner through a clear monthly membership fee instead of going through insurance — that’s how our under-65 memberships work. Removing insurance billing means more time at each visit, honest up-front pricing, and direct access to Becky when you need her. For seniors 65+, we pair the same unhurried approach with Medicare Part B.
Do you replace my regular doctor?
Only if you’d like. If you choose an ongoing membership, Becky can serve as your primary care provider — annual exams, prescriptions, and day-to-day medical care. Your specialists always stay exactly as they are, and we coordinate closely with them. If you prefer a one-time assessment instead, we work alongside your existing doctor rather than replacing them.
Who is a good fit for house calls?
Older adults for whom getting to a clinic is difficult or exhausting, people managing several chronic conditions, families who want more time and attention than a 15-minute appointment allows, and anyone recovering after a hospital stay.
How does insurance work for under-65 memberships?
Your monthly membership fee covers all direct clinical communication, telehealth, and primary-care access with Becky Spear, DNP. For outside services — such as blood work, diagnostic imaging (X-rays, MRIs), and prescription medications — we order them using your standard health insurance at your local pharmacy, Quest/Labcorp, or hospital.
How does Medicare work for seniors (65+)?
We bill Medicare Part B directly for your clinical medical visits and house calls. The monthly retainer fee ($95/mo) strictly covers non-covered amenities, such as direct mobile cell/text access, extended visit times, and family care coordination. You remain responsible for standard Medicare deductibles and copays.
How do I pay?
We keep our billing simple, predictable, and transparent.

For standalone services & assessments (such as the Age-in-Place Assessment, LIC 602 pre-admission paperwork, or a standalone medication review), payment is private-pay and due securely at the time of the visit.

For ongoing memberships, your monthly fee is conveniently and automatically billed on a recurring basis, ensuring continuous, unhurried care and direct mobile access to your provider without any surprise costs.

For the Senior Hybrid Concierge tier (65+), clinical visits are billed directly to Medicare Part B — only the monthly retainer is billed to you. More on paying for your visit →
Can I use my HSA or FSA?
Yes! Most Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) allow you to use tax-free funds for direct primary care memberships, one-time clinical assessments, and concierge retainer fees. We recommend checking with your specific plan administrator for verification.
What happens at the first visit?
Plan for up to 90 minutes. We review your full health history and every medication, talk through current concerns, look at mobility and safety around the home, and build a care plan around your goals. Family members are welcome to join.
Is Becky a doctor? How is she licensed?
Clinical services at Sonoma Valley Nurse Practitioners Group are provided independently by Rebecca Spear, DNP, AGNP-C, GS-C. Becky is a Doctor of Nursing Practice and a fully independent Nurse Practitioner holding an NP 104 endorsement from the California Board of Registered Nursing. This endorsement authorizes her to comprehensively evaluate, diagnose, manage primary care conditions, and prescribe medications independently, without standardized physician protocols or supervision. Please note that while Becky holds the highest academic clinical doctorate in nursing education, she practices as an advanced practice nurse practitioner, not a medical doctor (MD) or osteopath (DO).
What if I have an emergency?
House calls are not an emergency service. If you are experiencing a medical emergency, call 911 right away.

Get in touch

Request a visit or ask a question

We’d love to hear from you

Whether you’re asking for yourself, a parent, or a neighbor, we’ll get back to you within one business day. No obligation — just a conversation.

Ready to schedule? Request a visit online — the form here is for general questions.

(707) 939-5345
info@sonomavalleynp.com
Sonoma Valley, California

Fields marked * are required.

Please don’t include urgent medical concerns here. For emergencies, call 911.