DR. KELSE PATRICE MCKINLEY (NPI# 1649433178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649433178 |
| Entity Type | Individual |
| Full Name | DR. KELSE PATRICE MCKINLEY |
| Credential | M.D. |
| Practice Address |
2500 Milvia St Berkeley CA 94704 |
| Mailing Address |
2350 W El Camino Real Fl 2 Mountain View CA 94040-6203 |
| Practice Telephone | 5102045600 |
| Practice Fax Number | 5102045462 |
| Mailing Telephone | 5102045600 |
| Mailing Fax Number | 5102045462 |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2019-02-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A104778 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE MEDICAL LICENSE | A104778 | 01 |
| CA | FEDERAL DEA LICENSE | FM2462113 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2700 Grant St, Suite 200, Concord, CA 945202266 | 9259522888 | |
| 4053 Lone Tree Way, Antioch, CA 945316210 | 9257563499 | 9257570849 |
| 20101 Lake Chabot Rd Fl 1, Castro Valley, CA 945465305 | 5102476300 | 5102476303 |
| Street Address |
2500 MILVIA ST |
| City | BERKELEY |
| State | CA |
| Zip Code | 94704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770571903 | Jonathan Noble | Internal Medicine | 2500 Milvia St, Suite 218, Berkeley, CA 94704-2636 | 2005-10-11 |
| 1043753957 | Stephanie Guest | Nurse Practitioner | 2500 Milvia St, Berkeley, CA 94704-2636 | 2016-11-24 |
| 1477972917 | Melanie Manaku | Internal Medicine | 2500 Milvia St, Berkeley, CA 94704-2636 | 2014-04-14 |
| 1578992285 | Jennifer Madeline Owen | Family Medicine | 2500 Milvia St, Berkeley, CA 94704-2636 | 2013-11-03 |
| 1619311453 | Rebecca L Taub | Obstetrics & Gynecology | 2500 Milvia St, Berkeley, CA 94704 | 2013-04-23 |
| 1770822116 | Haruka Kelley | Nurse Practitioner | 2500 Milvia St, Berkeley, CA 94704 | 2013-02-05 |
| 1932469889 | Samara S. Nebenzahl | Family Medicine | 2500 Milvia St, Berkeley, CA 94704-2636 | 2012-05-25 |
| 1255656187 | Cindy Erxin Zhang | Obstetrics & Gynecology | 2500 Milvia St, Berkeley, CA 94704-2636 | 2010-04-03 |
| 1447587290 | Pavithra Venkat | Obstetrics & Gynecology | 2500 Milvia St, Berkeley, CA 94704-2636 | 2009-11-13 |
| 1063671386 | Roxanne Fiscella, M.d. | Legal Medicine | 2500 Milvia St, Suite 116, Berkeley, CA 94704-2636 | 2008-06-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698887 | Ka Yin Emma Liu | Counselor | 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 | 2020-10-29 |
| 1821617168 | Michelle Nagal Hunt | Behavior Technician | 2080 Addison Street, #302, Berkeley, CA 94704 | 2020-04-15 |
| 1366097081 | Sabrina Barnett | Behavior Technician | 2080 Addison St, #302, Berkeley, CA 94704 | 2019-08-08 |
| 1811559735 | Bonita House, Inc. | Community/Behavioral Health | 1909 University Ave, Berkeley, CA 94704 | 2019-07-01 |
| 1376014928 | Justin T Cooke | Specialist/Technologist | 2024 Durant Ave #508, Berkeley, CA 94704 | 2018-12-07 |
| 1972080158 | Cecilia Winfield | Student in an Organized Health Care Education/Training Program | 1918 University Ave., Suite 2b, Berkeley, CA 94704 | 2018-07-20 |
| 1952897332 | Jennifer Henry Henry | Naturopath | 2041 Bancroft Way #303, 2041 Bancroft Way, Berkeley, CA 94704 | 2018-07-09 |
| 1497267967 | Merlenet Michelle Riley | Counselor | 2640 Martin Luther King, Berkeley, CA 94704 | 2017-10-24 |
| 1265951719 | Caitlin Mary Mcdonough | Student in an Organized Health Care Education/Training Program | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-09-15 |
| 1922525120 | Patrice Werling | Counselor | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-08-28 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477161008 | Rebecca Allison Pell | Family Medicine | 1327 Parker St Apt C, Berkeley, CA 94702-2341 | 2020-07-20 |
| 1649895434 | Precision Psychological Medicine Corporation | Family Medicine | 2703 7th St Ste 301, Berkeley, CA 94710-2664 | 2020-06-08 |
| 1588213458 | Quantumv Medical Group, Inc. | Family Medicine | 46 Shattuck Sq Ste 16, Berkeley, CA 94704-1154 | 2019-09-04 |
| 1780166983 | Amal Salah Elsohemy | Family Medicine | 3100 San Pablo Ave Ste 300, Berkeley, CA 94702-2498 | 2018-09-04 |
| 1033536404 | Dana Gersten | Family Medicine | 1711 Ward St, Berkeley, CA 94703-2105 | 2014-03-24 |
| 1811269566 | Ernest Marvin Kotlier | Family Medicine | 1555 Scenic Ave, Berkeley, CA 94708-1813 | 2012-01-27 |
| 1811268246 | Miles Graber | Family Medicine | 1768 Sonoma Ave, Berkeley, CA 94707-2531 | 2012-01-17 |
| 1528123759 | Michele Ditomas | Family Medicine | 2031 6th Street, Berkeley, CA 94710 | 2006-12-27 |
| 1376613257 | Stephen Morris Brown | Family Medicine | 2435 Webster St Ste D, Berkeley, CA 94705-2050 | 2006-11-08 |
| 1437236163 | Shannon Lee Mccune | Family Medicine | 2850 Telegraph Ave Ste 130, Berkeley, CA 94705-1159 | 2006-11-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.